Graduation Year

2007

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Aging Studies

Major Professor

Larry Polivka, Ph.D.

Co-Major Professor

Lawrence Schonfeld, Ph.D.

Keywords

Somatic and staff-related allegations, Nursing home residency, Lawsuits, Attorneys, Settlements

Abstract

Since a substantial increase in lawsuits, settlements, jury trial awards, and insurance premiums involving nursing facilities began in the mid 1990s, addressing litigation has been a growing concern for the industry, consumers and their families, insurance carriers, and state and national elected officials. Curbing lawsuit growth has mirrored medical malpractice containment efforts, focusing on the addition of laws to inhibit litigation. The state of Florida initiated such tort reforms along with mandatory increased nursing facility staffing in 2001. Through secondary data analyses, this study examined the initial effects of Florida's tort reform measures. Lawsuits filed (N = 546) against any Hillsborough County nursing facility (N = 33) from 1999 through 2003 were reviewed. One-way analyses of variance and two-way contingency tables were used to identify variations in the elements, extent, and outcome of lawsuits between pre and post tort reform periods.

Based on nursing facility admission dates, post tort reform lawsuits exhibited multiple significant changes. Lawsuits filed per month dropped to 14% of pre reform monthly filings. On average, lawsuits were associated with shorter residencies, were filed earlier, and settled six months sooner. They were less apt to include combined wrongful death and negligence survival damage claims, charges intentionally addressed by reform measures in order to eliminate double damage claims. Other lawsuit charges increased, e.g., lethal negligence and breach of fiduciary duty. Mediation was less likely and arbitration attempts more likely to be documented in lawsuits. Mean somatic allegations did not change significantly. Staff-related allegations decreased 21.5% to 8.51 per lawsuit, with 12 out of 22 staff-related allegations decreasing significantly. On average, settlement proposals, total settlements, and attorney fees decreased to 40% and net plaintiff awards to 25% of pre reform amounts.

Overall, it appears that 2001 tort reform impacted post reform litigation substantially. However, further research examining a larger post reform lawsuit sample and longer post reform period is required to verify that research findings are stable and reflect sustained changes. Other factors, e.g., decreased nursing facility professional liability insurance coverage, may have affected the numbers and characteristics of lawsuits filed and require further investigation as well.

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