By Jordan Parnell
Litigation is a fact of life for nursing homes, and we all know the circumstances that have shaped this environment.
The population of the elderly has mushroomed and awareness of issues like elder abuse and neglect has grown. The industry is challenged to find and keep qualified staff to adequately care for residents. Meanwhile, many plaintiff attorneys across the U.S. are advertising about large payouts in the senior living space. The potential for high plaintiff awards is growing.
Facilities that commit to best practices and protocols and continually educate their administrators and staff are in the best position to reduce common risks and nursing home lawsuits. To that end, adopting, communicating and reinforcing a thorough risk management regimen will go a long way. Here are five places to start.
- Monitor how you are doing on quality and performance standards. There are more than 150 standards you must meet at all times if you provide services under Medicare and Medicaid. Many can be monitored internally, with walk-throughs of your facilities to spot check and address areas like the cafeteria, hallways and doorways, stairs and elevators for obstructions, lighting and other potential causes of slips, trips and falls
- Best practice tip: Leverage contracted risk management consultants to review your compliance with standards prior to the annual Centers for Medicare and Medicaid Services (CMS) survey.
- Establish procedures to ensure you meet HIPPA standards. Medical records can be a litigation landmine if not carefully managed. It’s critical to establish a medical records request process that meets HIPAA guidelines on who has the legal rights to access patient records. The issue is not just what can and can’t be shared, but how records are prepared, approved, finalized and sent. It’s critical when at least half of records requests are little more than legal fishing expeditions.
- Best practice tip: Develop a medical records request protocol with a designated individual responsible. Make sure that individual gets annual training to stay up to date.
- Be the master of your relationships. A master service agreement (MSA) is invaluable to set the stage for future dealings with all your contractors – whether janitorial services, landscapers, medical director, rehab services, or construction contractors. Specify terms for services, fees and conditions that will govern future agreements.
- Best practice tip: Create an MSA that every contractor has to sign, and provide an up to date certificate of insurance conforming to the MSA guidelines.
- Plan for the worst. Create an effective crisis management plan that addresses both operational and communications issues. This is particularly important if your organization owns multiple long-term care facilities, which can complicate the response process.
- Best practice tip: Form a response team at the corporate level that’s responsible for meeting established protocols for every occurrence and liaising with field offices on how to address issues. Don’t forget internal and external communications and designate a single, qualified spokesperson to control and provide a concise and accurate message.
- Care about the caregivers. Be smart, careful and detail minded in your hiring practices. It’s a competitive employment market, and your pool of qualified employees may be limited but prospective hires must undergo thorough background checks. They also need to be able to demonstrate their knowledge about the care they provide, which means they have the experience, a good attitude and an affinity for older people.
- Best practice tip: Create a working environment that’s attractive to good people. Your benefits program, for example, can go beyond standard health plans. It’s smart to look at holistic wellness programs adjusted to the particular interests of today’s multi-generational workforce. And develop and communicate policies and rules that show your recognition of the stresses of the work.
The long-term care industry is known for tight margins, and liability coverage is one of the larger expenses. The best way to head off litigation and claims and keep premiums in line is to be proactive and strategic in your operational practices across every front. It will pay off in the long term.
HUB International’s team of long-term care specialists will work with your organization to deliver tailored insurance and risk management solutions.