A lobbying group for the long-term acute-care hospital industry said last week that it strongly opposes a proposed regulation that would stem development of long-term acute-care hospitals within existing general hospitals. The regulation would require long-term acute-care hospitals to have separate ownership and draw no more than 25% of admissions from host hospitals. In comments on the proposed regulation, which was issued in May, the Acute Long Term Hospital Association, or ALTHA, said the CMS would do better to develop patient-based criteria. "The basis for Medicare payment should be medical necessity, not the location of the hospital making the transfer," the group said. Roughly half of all long-term acute-care hospitals would not be able to meet the proposed CMS requirements, ALTHA said.
Nursing homes embattled
The nation's nursing homes are facing a dramatic rise in costly consumer lawsuits, alleging everything from wrongful death to inadequate care resulting in painful bedsores, according to a recent study released by the American Health Care Association. The number of claims filed against nursing homes reached 15.3 for every 1,000 occupied beds in 2003, up from 13.8 in 2002 and 4.8 in 1992, the survey of 108 long-term-care operators found. The average size of a liability claim was $149,000 in 2003, more than double the $65,000 average in 1992 but down significantly from a peak of $187,000 in 1998. As a result, the cost of malpractice insurance for nursing homes jumped an average of 51% last year, following increases of 143% in 2002 and 131% in 2001. All told, the average liability cost per nursing home bed-a figure that includes both malpractice insurance and litigation costs-climbed to $2,290 last year, from $2,050 in 2002 and $310 in 1992. In Florida, a state with a particularly large population of nursing home residents and strong patients rights legal protections, the cost reached $8,170 in 2003, more than three times the national average.