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Focused Review: A Look into Long Term Care

With the ever-growing aging population, the demand for physicians to move outside their traditional work setting and into skilled nursing facilities is growing. Physicians practicing in Long Term Care (LTC) settings often treat patients with a multitude of issues, including chronic health conditions, skin care issues, medication management, loss of independence, and cognitive deficits. These patients present significant challenges to any practitioner of LTC medicine.

It is important for physicians to be aware of regulatory requirements and be familiar with other rules pertaining to LTC staff qualifications, certifications, licensing, knowledge, and expertise. The LTC practitioner must further understand the level of services available at each facility they practice in.

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The latest Focused Review explores issues specific to LTC practice as well as specific elder abuse statutes. The risk management and patient safety experts at CAP identified four common areas of liability risk associated with claims against physicians who provide care to LTC patients:

•        Lack of informed consent

•        Medication management

•        Documentation (wound care)

•        Regulatory Compliance

Each of these issues are reviewed with supporting case studies. Effective and actionable risk reduction strategies are provided for each area. While this focused review does not include all the potential areas of liability that an LTC physician may face, it does bring to light the common allegations and contributing factors that are seen most often in claims.

The Risk Management and Patient Safety Focused Review: A Look into Long Term Care can be downloaded at

Questions or comments about the focused review may be sent to

The well-being of CAP members and their patients remains a priority for our team of risk managers and patient safety specialists, who are committed to providing easily accessible resources and publications designed to improve healthcare, patient safety, and reduce your medical liability risk.

CAP members may seek assistance if a situation arises that calls for guidance on how best to handle an adverse event or outcome, reduce exposure, or manage the risks involved via the Risk Management Hotline at  800-252-0555. Experienced risk managers are available to members 24/7 to provide guidance and answer questions. 

Deborah Kichler is a Senior Risk Management and  Patient Safety Specialist for CAP. Questions or comments related to this article should be directed to