Arizona Republic investigations on senior living facilities, medical clinic win national awards

Two Arizona Republic investigations won first-place prizes in the 2023 Eppy Awards competition, which honors the best examples of digital news publishing across the country.

“The Bitter End” — an in-depth analysis of violence and harm impacting seniors in memory care facilities throughout Arizona — was recognized as the best investigative enterprise series, while “Blood and Money” — the story of a chain of medical clinics and its star doctor that put profits ahead of patient care — was recognized in a business and finance category.

Editor & Publisher magazine hosts the award contest.

"The stories uncovered by these reporters show how essential investigative reporting is," said Greg Burton, Arizona Republic executive editor. "Reading 'The Bitter End,’ all of us should be horrified, outraged and saddened by the conditions some of the most vulnerable people in our community find themselves in and how little oversight these facilities receive.

The reporters behind “The Bitter End” — Caitlin McGlade, Sahana Jayaraman and Melina Walling — have now published five stories about the plight of seniors living in memory care facilities, how they are subject to harm from fellow residents, how facilities are too understaffed to protect them and how regulators have not done enough to track the injuries and come up with a solution.

The reporters also have shined a light on caregivers, some of whom are injured on the job.

All the while, owners of assisted living facilities have kept some incidents quiet because there is nothing in Arizona law that forces them to report most of the violence to their state licensing agency. Nursing homes, which are a higher level of care and more closely regulated because they take Medicare and Medicaid dollars, are required to report assaults. But the state rarely cites facilities for resident-on-resident harm.

Thanks to The Republic’s reporting, however, that may soon change.

As soon as “The Bitter End” published, representatives from AARP met with Republic reporters to go over their findings and to discuss possible legislative change. AARP has since met with both Gov. Katie Hobbs and Attorney General Kris Mayes, and has come up with a wish list that includes requiring assisted living facilities to report violent incidents and to increase fines on senior living homes where seniors are clearly not safe.

More recently, Mayes has said she will look to prosecute facilities that don’t protect their residents and Hobbs ordered a review of the state’s response to problems at a Mesa assisted living facility that was the focus of one article. The governor also released a list of changes she’d like to see in the senior care system.

Those include raising the level of fines, giving the health department more power to shut down facilities and creating a transparent quality rating system of facilities for the public, among other objectives.

Hobbs and AARP also want caregivers to receive more training when they work with people with dementia and that they have better oversight requirements when doling out medicine.

Roommate assignments are another area of concern.

In a story published in August, McGlade wrote about how one woman was not given the medication that calmed her and she killed her roommate by dragging her out of bed.

Just three weeks later, that woman was sent to live in another facility and was assigned a roommate. That woman was later found on the floor and she said her new roommate pushed her, causing her to fall and break her arm -- an injury that contributed to her death a month later.

State health department investigators found nothing wrong when they looked into the situation.

Dept. of Justice cites The Republic's work in civil complaint

“Blood and Money,” authored by investigative reporter Andrew Ford, also has had impact.

The series, which first appeared in October 2022, chronicled the rapid growth of Modern Vascular, a Phoenix area chain of medical clinics focused on clearing arterial blockages in the lower leg.

Together with its star doctor – Scott Brannan – the chain took advantage of a loophole in federal anti-kickback legislation to lure podiatrists and other doctors into investing in the company and sending patients its way.  It collected six-figure rebates from a device manufacturer, strategized on choosing a Medicare billing code to pump up revenues, and — at least at one clinic — pressed for half of the patients who came for a consultation to get an expensive procedure.

The investigation was later quoted in a civil complaint filed by the U.S. Department of Justice against Modern Vascular, which largely corroborated Ford’s findings:

“As Modern Vascular Corporate’s Chief Medical Officer Steve Berkowitz told a reporter for The Arizona Republic, ‘If you run a pizza joint and you’re not selling enough pizzas, you’re not going to stay in business.’”

Ford’s reporting also revealed claims that Modern Vascular patients were getting unnecessary surgeries, and at least two patients who Ford interviewed lost their legs as a result.

"'Blood and Money' demonstrates how fee-for-service health care can go astray with the promise of easy money and little oversight. These are heartbreaking stories of people whose health and lives were compromised by surgeries they did not need,” Burton said.

After Ford’s investigation published, Modern Vascular shuttered two-thirds of its clinics. Where there were 17 advertised on its website, now five remain. And in May, Modern Vascular’s parent company was forced to seek bankruptcy protection.

That happened after Medicare shut off payments to the clinics, citing “credible allegations of fraud.” Medicare payments made up a large portion of the company’s revenue. An email circulated by the company’s new chief executive, Patrick F. Santore Jr., said Medicare was “presently suspending all payments pending the outcome of the DOJ investigation.”

In a follow up story, Ford showed how Arizona shields the documented problems of doctors like Scott Brannan from the public.

Under state law, the Arizona Medical Board is not permitted to post online advisory letters admonishing doctors for mistakes that include: removing a patient’s ovaries without consent, inadequate removal of a brain tumor, operating on the wrong knee, trying to prescribe drugs for euthanasia, and showing up to work under the influence of alcohol, among others.

For “Blood and Money,” the Eppy Awards are not its first recognition. It also has received laurels from the Association of Health Care Journalists, The Society for Advancing Business Editing and Writing, The National Headliner Awards and The Best of the West.

Both series required months of reporting, writing and editing to come to fruition.

"Arizona can do better in holding these operators to account. The Republic invests reporting time and expertise in work such as this to make the state a better, safer place to live," Burton said.

This article originally appeared on Arizona Republic: 2 Arizona Republic investigations win Eppy Awards for journalism