Policymakers continue to grapple with the escalating growth of the elderly population in the United States. The current and predicted strains on an already resource-strapped sector of the health care system are major concerns for both researchers and the general public. Of particular interest is the quality of care provided to this vulnerable population. Nursing homes trying to meet the requirements of the Omnibus Budget Reconciliation Act of 1987 (P.L. 100-203; 101 Stat. 1330) deal with a resident population that is very vulnerable due to chronic disease and disability. When adverse events occur within the elderly population, a common response is to seek legal remedy through the court system. The nursing home industry believes that many of these lawsuits are driven by monetary greed, while families, trial lawyers, and other advocates see the court system as a legitimate check on a long-term care industry known for high-profile examples of poor quality of care.

There are very few studies that use data aimed at disentangling the relationship between quality of care and litigation activity against nursing homes. Studies are beginning to emerge that examine Florida’s experience within its litigious environment. Lobbying groups funded most of the recent national studies for various interests concerned about the ramifications of policy changes to various regulatory statutes around the country (Bourdon and Dubin 2002). The few national studies not funded by these groups show an increase in both the numbers of lawsuits filed against nursing homes and the costs of these suits to the industry (Stevenson and Studdert 2003). Much of this independent empirical work is exploratory in nature and is limited by sample size or geography, but it is providing the first objective evidence about the nursing home litigation climate in the United States.