2024年养老及长期护理服务机构一般和专业责任基准报告_75页_8mb

2024 General and Professional Liability Benchmark Report Summary

Core Content

This report provides an actuarial benchmark analysis of general liability and professional liability (GL/PL) exposures for senior living and long-term care providers in the United States. The analysis covers countrywide and state-specific trends in claim costs, severity, and frequency, with a focus on the impact of the COVID-19 pandemic and large loss activity.

Main Findings

Countrywide Trends

• Senior Living:

  • Claim Frequency: Projected to be 0.31 claims per 100 occupied units in 2024, an increase of 0.6%.
  • Claim Severity: Forecasted at $246,800, an increase of 3.8%.
  • Loss Rate: Projected at $760 per occupied unit, an increase of 4.4%.

• Long-Term Care:

  • Claim Frequency: Projected to be 1.10 claims per 100 occupied units in 2024, an increase of 0.3%.
  • Claim Severity: Forecasted at $270,000, an increase of 3.7%.
  • Loss Rate: Projected at $2,970 per occupied unit, an increase of 4.0%.

Cost Comparison by Facility Type (Senior Living)

• Independent Living: Estimated cost relativity at $0.175, projected loss rate at $133.
• Assisted Living: Estimated cost relativity at $0.825, projected loss rate at $627.
• Memory Care: Estimated cost relativity at $1.850, projected loss rate at $1,406.
• Total Countrywide: Projected loss rate at $760.

Inflation Impact

• The U.S. annual inflation rate is around 3.0%, but claim costs have shown higher volatility, particularly in healthcare-related areas.
• "Nursing home and adult day services" inflation has increased to around 6.0% in 2023, surpassing the general CPI trend.
• Other sources suggest healthcare inflation trends of 7.0% to 10.0%.

COVID-19 Claims

• Total Closed Claims: Nearly 95% of claims identified as related to the pandemic are now closed.
• Claim Distribution by Year:
  • 2020: 4,540 closed claims, 64.1% of all closed claims.
  • 2021: 538 closed claims, 23.5% of all closed claims.
  • 2022: 203 closed claims, 10.3% of all closed claims.
  • 2023: 46 closed claims, 3.7% of all closed claims.
• Average Indemnity and Expense Severity:
  • 2020: $24,471 (indemnity) and $12,796 (expense).
  • 2023: $50,000 (indemnity) and $279 (expense).
• The percentage of claims closed without payment remains above 95% across all years.

Large Loss Activity

• Total Large Claims (> $1M): 319 closed claims, with 16% related to senior living and 84% to long-term care.
• Average Cost:
  • Senior Living: $1,182,730.
  • Long-Term Care: $758,000.
• Primary Causes of Loss:
  • Senior Living: Falls (70.91%), Abuse (7.36%), Choking (1.84%).
  • Long-Term Care: Falls (20.1%), Infection (13.1%), Skin/Wound Injury (10.1%).

Claim Cost by Close Lag

• Senior Living:
  • Claims with a close lag of 1 year: 5% of total claims, average severity $38,938.
  • Claims with a close lag of 5+ years: 30% of total claims, average severity $244,727.
• Long-Term Care:
  • Claims with a close lag of 1 year: 5% of total claims, average severity $3,630.
  • Claims with a close lag of 5+ years: 25% of total claims, average severity $35,535.

State-Specific Statistics

• Senior Living:

  • The report includes state-specific findings, with data from independent living, assisted living, and memory care providers.
  • State comparisons are provided, with detailed data for California, Florida, Illinois, New York, Pennsylvania, and Texas.

• Long-Term Care:

  • The report includes state-specific findings, with data from skilled nursing facilities.
  • State comparisons are provided, with detailed data for California, Colorado, Connecticut, Florida, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, North Carolina, Ohio, Pennsylvania, and Texas.

Key Information

• The analysis is based on data from approximately 50 senior living and long-term care providers, covering nearly 10,300 closed claims and $1.8 billion in paid indemnity and expense over the past ten years.
• The study excludes claims under $100 and those related to the pandemic to reduce bias.
• The shift from occurrence year to report year data aims to improve accuracy by mitigating the impact of IBNR (Incurred But Not Reported).
• The use of actuarial models and closed claim data helps in developing more reliable estimates.
• The report highlights the importance of communication and risk management strategies to address the high incidence of falls and other common causes of loss.