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The 1995 regulations also changed the format and scope of the survey process.(44) The surveyors mark down all violations on a grid.(45) Once plotted, the location of the violation on the grid determines the severity of the punishment.(46) The 1995 regulations broadened the scope of surveys, as surveyors may now consider residents'' quality of life.(47) "A resident''s happiness with staff treatment, or level of privacy, is now mixed with the old standards."(48) Facilities may no longer hide behind numerical standards. For example, a surveyor can still cite an adequately staffed facility "if [the] residents complain of inattention."(49)

ResultsAfter assessing the standard of care for each therapy, a cost analysis was performed taking into consideration the number of office visits required for eradication of the wart, physician costs for delivery of the therapy, and medication costs (Figure 1).[FIGURE 1 OMITTED]The costs for the treatment of non-genital warts using cryotherapy with liquid nitrogen, topical squaric acid, carbon dioxide and pulsed-dye lasers, intralesional bleomycin, intralesional interferon alpha, or intralesional Candida immunotherapy ranged from approximately $157 to $1227. Based on our data, carbon dioxide laser therapy was found to be the least expensive ($157). Immunotherapy utilizing Candida antigen was found to be the next-least expensive treatment option for the treatment of non-genital warts ($190), requiring an average of three treatments and a minimal medication expense (Table 4) (12-13). In contrast, interferon alpha was the most expensive modality ($1227), requiring an average of fifteen treatments (Table 5) to attain a complete response.

This Note discusses the causes of recent growth in nursing home litigation and its effects on nursing home residents, providers and government. Specific attention is devoted to Florida for demographic and legislative reasons. Complementing its large elderly population, Florida has one of the broadest private rights of action for nursing home residents. Consequently, other states use Florida''s statute as a model.(11) Part II of this Note examines the national nursing home environment, reflecting on the status of the industry and relevant legislation. Part III explores current federal nursing home legislation and discusses recent reform efforts. Part IV examines Florida''s nursing home industry and raises concern about particular state legislation widening nursing home liability. Through its residents'' rights statute, Florida has witnessed a tremendous growth in nursing home litigation and corresponding jury verdicts. Part V describes the actual and potential effects of Florida''s rapid growth in nursing home litigation on providers and residents. Part VI discusses the state''s reform efforts and powerful political lobbies'' countermeasures. Finally, Part VII suggests possible state regulation reforms to preserve the industry before excessive private litigation reaches devastating levels.

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