Breach Analysis Worksheet (LTC)

A structured tool to help attorneys identify deviations from standards of care, link failures to harm, and organize breach arguments with clarity and precision.

Breach Analysis Worksheet — Long-Term Care

A structured litigation tool to compare expected standards of care against actual clinical performance. Designed to isolate deviations, map causation, and organize breach arguments with disciplined clarity.

Print View converts the page into a clean worksheet format (no zebra/shadows) for easier printing and PDF export.

Expected Standard vs Actual Care • Deviation Mapping • Causation Control

Built for adversarial scrutiny. Structured for evidentiary precision.

Case Overview

Resident Information

Name
Age
Primary Diagnoses
Baseline Functional Status
Admission Source

Key Dates

Admission Date
Date of Incident
Date of Decline
Date of Hospitalization or Death

Standard Comparison Analysis

Expected Standard of Care

Applicable Federal Regulations (CMS F-Tags)
State LTC Regulations
Facility Policies
Required Assessments
Required Monitoring
Required Interventions
Communication Expectations
Documentation Standards

Actual Care Provided

Assessment Findings
Monitoring Frequency
Interventions Performed
Physician Notifications
Family Notifications
Documentation Entries
Observed Gaps or Inconsistencies

Identified Deviations (Breach Points)

Deviation Analysis

Missed or Delayed Assessments
Missed or Delayed Interventions
Failure to Monitor
Failure to Notify Physician
Failure to Notify Family
Failure to Update Care Plan
Inaccurate or Incomplete Documentation

For Each Deviation

What should have occurred?
What actually occurred?
Why is this a breach?
Supporting Evidence

Causation Link

Causation Evaluation

Did the deviation contribute to harm? (Yes / No / Unclear)
How the breach increased risk
How the breach led to decline
How earlier intervention could have changed the outcome

Supporting Evidence

Medical Records
Expert Opinions
Timeline Reconstruction
Facility Policies
Regulatory Standards

Timeline Reconstruction

Sequence of Events

Date/Time of Incident
Staff Observations
Interventions Performed
Notifications Made
Resident Response
Follow-Up Actions

Pairs directly with the Lexcura LTC Timeline Reconstruction Tool.

Strategic Review Panel

Attorney reviewing breach analysis on glass wall in structured office environment

Clinical Intelligence Model™ Alignment

Aligns breach identification with clinical reality, causation clarity, exposure insight, narrative stability, and strategic usability — transforming record review into structured litigation intelligence.

Long-Term Care Breach Analysis Identifies Deviations, System Failures, and Liability Exposure

Long-term care cases often involve allegations of failures in assessment, care planning, supervision, monitoring, staffing, and escalation over extended periods of time. The LTC Breach Analysis Worksheet evaluates resident care and facility practices against CMS nursing facility requirements, state regulations, facility policies, and accepted standards of long-term care practice. Our clinical-legal team identifies deviations from standards of care, systemic breakdowns, and documentation weaknesses that inform breach determination, causation analysis, regulatory exposure, and litigation or defense strategy.

Submit Records for LTC Breach Analysis
HIPAA-secure intake • LTC breach & compliance analysis • Standard 7-day delivery