LIABILITY REFORM AND LONG-TERM CARE

As we all know, for long-term care facilities and providers across the country, affordable liability insurance is becoming ever more scarce. As President Bush’s second term begins, liability reform is expected to be a high legislative priority for his administration. He floated the idea of restricting medical liability lawsuits repeatedly during the campaign, and officials in the White House and in Congress have indicated that the issue is being actively pursued.

While there are no plans for specific reforms aimed at long-term care facilities, the American Geriatrics Society is diligently partnering with other medical organizations to lobby for changes specifically geared toward this already overburdened segment of elder care, including the American Medical Association (AMA) and the American Medical Directors Association (AMDA).

The AMA has assembled a large coalition on the issue, identifying key states where medical liability crises are looming and sending out Physician Action Kits to individual doctors who wish to get involved. In response to discussion at our Annual Scientific Meeting in May, our Public Policy Advisory Committee compiled a summary of nursing home–related anecdotes and shared these with the AMA.

In addition to working with the AMA-led coalition, we have joined a smaller group composed of AMDA and the nursing home industry to focus on long-term care–specific liability reforms. AGS representatives joined AMDA at a Senate Special Committee on Aging hearing over the summer entitled “Medical Liability in Long-Term Care: Is Escalating Litigation a Threat to Quality and Access?” Committee Chairman Sen. Larry Craig of Idaho and others discussed the liability crisis for nursing homes, and nursing home directors specifically. Craig remarked that legal claims against long-term care providers nationwide is the fastest growing area of health care litigation, with insurance premiums rising 200% since 2001.

AMDA officials highlighted concerns over medical liability that are causing some physicians to stop seeing patients in nursing homes altogether, prompting others to resign from medical directorships and forcing nursing homes to lose their liability insurance. “We now see experienced long-term care physicians who are unable to renew liability coverage despite their claims history,” former AMDA President, James E. Lett, II, MD, CMD, stated at the hearing. “Equally alarming, we are now finding that physicians who wish to embark upon a nursing home practice, full-time or part-time, cannot obtain insurance coverage, even if they have completed advanced training programs in geriatrics.”

Along with AGS, AMDA is seeking common sense reforms that consider the role of the natural progression of degenerative diseases in unwanted outcomes, as well as the importance of evidence-based standards that will separate these cases from truly negligent long-term care. Unfortunately, Congress was unable to act on the liability issue in 2004.

As President Bush assembles his new administration and begins acting on his agenda, his campaign mantra that frivolous lawsuits are driving up the cost of liability insurance is certain to be on the front burner once again. It is hoped that the administration’s push for so-called tort reform will bring relief. AGS will continue to work toward meaningful changes that will increase the viability of the long-term care community. Please continue to visit https://www.americangeriatrics.org for updates. Regards,