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Long-term care liability

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In the New York area, some of the biggest advertisers on the news radio stations are long-term care providers.

Some of the other big advertisers on news radio are law firms offering to help families sue neglectful or actively abusive long-term care providers.

Analysts in the Columbia, Maryland-based office of Aon P.L.C. recently reported that liability claims average about 3 percent of the average amount Medicaid programs pay per patient, per day.

The ratio of liability losses to the Medicaid daily payment rate ranges from less than 1 percent in some states to more than 10 percent in Kentucky.

Related: Liability costs drive up long-term care bills

One challenge here is that long-term care is already expensive, and is already in short supply. The pressure on providers to do more with less is likely to build over the next 40 years, not shrink. The main competition for a low-quality nursing home bed in 2035 may be the sidewalk, not a home care aide, or a better nursing home.

Simply capping lawsuit awards does not seem like a great answer. Telling a family affected by a tragic incident, “Oops, we let an employee kill your mother. Here’s the $100,000 the state statutory cap lets you collect,” does not sound just.

I think one obvious solution is to keep finding new ways to use technology, and to make sure older people and people with disabilities have enough experience or guidance using the Internet, social media, mobile devices and other high-tech systems in general, to increase the odds that someone will get through to a problem solver before bad situations get out of hand.

Maybe another solution is to promote sales of private long-term care insurance. The care providers I interview sound amazed and grateful when clients have private coverage, and impressed by the care coordination private insurers often provide.

Maybe private insurance gives facilities extra cash they can use to improve the quality of care for all patients, and forces them to respond to market forces that can increase the quality of care for all patients.

Still another answer might be to figure out how to turn some long-term care planners into long-term care monitors. You know a lot about long-term care delivery and long-term care finance. You have people skills. You can size up complicated problems and come up with quick, practical solutions. Society needs to come up with the cash to pay some of you to shift from what amounts to the resource accumulation stage of long-term care planning to the care use stage, and supplement what the care coordinators are doing. 

Allison Bell is a senior editor at


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