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The Troubled Climate of Nursing Home Care: Nursing Home Litigation

The Troubled Climate of Nursing Home Care: Nursing Home Litigation

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nursing home insurance, nursing home trends, long term care litigation, long term care insurance, Nursing homes are affected by many challenges, many of which directly affect the quality of care and allegations of nursing home negligence. The challenges were highlighted by speakers at Preventing and Defending Long Term Care Litigation at The Conrad in Miami, April 4-5, 2011. I moderated a panel of defense and plaintiff attorneys and another legal nurse consultant. Here are some of the main points of the conference:

1. We live in an aging country with inadequate funds to care for our elderly.
2. There is a level of guilt that we feel towards having to place family elders in institutional care.
3. We live in the age of the sound bite, or remote control mentality. We have short attention spans and want information reduced to its smallest elements.
4. There is legislative inadequacy to deal with the problem of institutional long-term care.
5. We struggle with inadequate resources at care, oversight, and judicial levels.
6. Initially insurance companies that got into the long term care insurance field underestimated the exposure and underpriced coverage. They didn’t understand the difference between personal care and skilled care or the clinical components of long-term care.
7. Excess litigation occurred in Florida, Texas and California with plaintiff attorneys alleging breach of contract, false advertisements, state code violations, and violation of patient’s rights.
8. The excess judgments resulted in fewer carriers and much higher premiums with much lower coverage. Premiums rose from $50-$80 a bed in the early 1990s to $600 – $1000 per bed and higher in states like Florida.
9. The current environment consists of a soft insurance market with rates suppressed. Some facilities are reluctant to purchase large limits. Risk management, claims management and arbitration agreements are prominent.
10. Many claims are settled at mediation and pre-suit.
11. States seeing more claims include Arkansas, Kentucky, New Jersey, Pennsylvania, Tennessee, Alabama, Missouri, and California. States with fewer claims include Texas, Mississippi, Georgia and Florida. States having severity issues include New Mexico and Illinois.
12. Future issues and trends include more claims related to infectious disease: methicillin resistant staphylococcus aureus, tuberculosis, mold, swine flu, and salmonella.
13. Obama Care requires posting ownership of the facility.
14. There may be more fraud claims.
15. Reducing claims involves revising the corporate culture, addressing and preventing employee burnout, improving documentation, preventing falls, preventing pressure ulcers, changing consumer expectations, and proactive involvement by risk management.

 The information in this blog post is drawn from the slides and presentations of Kippy Wroten, Esq. of Wroten and Associates and Keith Parnell, Vice President, National Accounts, Hamilton Insurance Agency.

Med League provides medical expert witnesses to trial lawyers. Please call us at (908)788-8227 or contact us today to discuss your next case.

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