The most common harms alleged were fall-related injuries (27 percent) and pressure ulcers or bedsores (16 percent). Other claims were for dehydration, malnutrition and excessive weight loss, physical or verbal abuse and medication errors.
Sixty-one percent of the claims resulted in a payment, which averaged nearly $200,000.
Researchers then analyzed the likelihood of a nursing home being sued based on 10 measures of quality gleaned from two national databases, including one that tracks the health of nursing home residents on a monthly basis.
Nursing homes that did the best on quality measures were only a little less likely to be sued. In any given year, nursing homes with the best records (the top 10 percent) had a 40 percent risk of being sued, while the worst 10 percent of nursing homes had a 47 percent chance of being sued.
Nursing homes that had the most nurse's aide hours per resident-day -- a measure of how well staffed a nursing home is -- were also slightly less likely to get sued, but again, not by much -- 45 percent compared to 41 percent annually for those with the lowest staffing levels.
One measure for which there was a significant difference in the likelihood of lawsuits was pressure ulcers or bedsores. Nursing homes with the lowest pressure ulcer rates had a 6 percent chance of being sued in a given year because of bedsore-related complaints compared to 11 percent for the worst-performing nursing homes.
Overall, for half of the 10 measures of quality, top nursing homes were slightly less likely to be sued than the worst nursing homes, but for five of the measures there was no significant connection.
Concluding that lawsuits have little effect on quality of care, the authors say that other long-term efforts, such as public reporting of nursing home conditions and performance-based reimbursement schedules, may be needed to encourage improvements.
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