Nursing Home Insurance Costs and Risk Management

Your clients that own and operate nursing homes need to implement good risk management planning to help stabilize or reduce nursing home insurance costs. Their strategy should be to prevent any type of situation that may pose a threat to the health and well being of residents, as well as the workers and visitors to the facility.

Such risks include not only physical injuries but mental health and the threat of financial loss as well. It is the duty of the staff, management and supervisors to take the steps necessary to accomplish these goals. Nursing home risk management will only succeed if everyone contributes by understanding and implementing safety procedures.

Identifying risk

Workers should diligently report any concerns or issues they witness or are made aware of. Reporting such incidents is one way in which to help prevent serious problems from developing. Once risks are identified and preventive measures put into place, the facility will run smoother and more efficiently. This is a great way to keep those same risks from occurring again in the future.

Eliminating a risk, or “risk avoidance” is the only sure way to avoid an identified risk. Risk treatment should include purchasing liability insurance, (including a professional liability policy) which will generally cover the workers and health care providers of the facility.

Risk evaluation requires reviewing any and all prior steps taken in the previous risk management process to determine if any progress has been made toward mitigating these issues. When possible, making positive changes will help to further meet the objectives identified by staff and management.

Risk management is usually accomplished by implementing a department that works closely with managers to ensure that all necessary steps have been taken and are being properly followed with the desired results being achieved. The roles of everyone involved in a nursing home risk management program are essential to its success. By monitoring and evaluating patient care, everyone, from the nurses to the managers to other essential workers, can work together towards the goal of quality patient care that will benefit the facility as a whole.

Incident and occurrence reports should be utilized as a means to correcting nursing care that does not meet the patient’s needs and that could result in a serious injury, or worse, the possible death of a patient. By maintaining quality patient care, nursing home insurance costs can be kept manageable.


Hip Protectors, Risk Management and Nursing Home Coverage

Your company provides services to the elderly and as such has a lot of potential exposures to consider. A sound risk management program is vital to you as a nursing home facilitator in order to reduce the possibility of claims stemming from injuries, claims of mistreatment, theft, or other crimes that may be committed by persons on the premises. Keeping your patients safe from injury should be your number one priority. This should be balanced with sustaining the highest levels of clinical care, but you also need to realize that the need to protect patients from harm of any sort is very important from a financial point of view.

In addition to the probable financial impact this may bear there is the also likelihood of tarnishing your reputation in what is known to be a highly competitive environment. Any loss of faith in you as a provider can be quite devastating and proper nursing home coverage is needed to help protect your interests as well as the interests of your clients and their families.

Hip fractures are a common concern among the elderly

Safety is especially important when dealing with individuals of a certain age. Hip fractures often result from fall-related injuries in nursing homes. The prevention of hip fractures can be a rather critical challenge and because of the limited success of dealing with falls associated with hip injuries, and many facilities are increasingly turning to fracture prevention strategies that include the use of hip protectors.

With this being just one of your concerns, and given the overall economic challenges of managing long-term care facilities, a rigorous safety program and extensive safety training for all nurses and caregivers shall help to reduce the number of incidents, including fall-related injuries, and in particular hip fractures, in the nursing home environment.

Such programs have shown a decrease in litigation cases against facilities. As a result, a growing number of long-term care facilities consider the use of hip protectors as the best defense against hip fractures and thus an essential component of their care for residents at risk for hip fractures. This type of risk management in nursing homes can provide greater security for owners and their residents as well. Having nursing home coverage will help deal with any claims that do arise from incidents that still may occur.

Nursing Home Workers Compensation Brokers and Insurance Rates

Many may think that nursing homes are a low-risk work environment, but this is far from the case. In fact, according to the Bureau of Labor Statistics, nursing homes experience some of the highest rates of injuries when compared to other industries such as mining, construction, and manufacturing. Part of the reason for the high workers’ compensation risk for nursing homes is the manual lifting of patients — moving residents to and from bed, assisting with bathing and positioning patients in chairs — that can cause micro-injuries to the spine and trigger moderate to severe musculoskeletal disorders. These injuries, in turn, not only wreak havoc on the health and earning potential of workers but also on the turnover rate and financial health of nursing home operators.

How workers’ compensation policy rates are determined

 In determining a facility’s premium, insurance companies prepare loss history reports. The loss history reflects the workers’ comp claims a company has had over a designated period of time, typically one year. It includes all of the claims that have been filed with the insurer as well as what has been paid and expected payments in the future. Those facilities with higher amounts of loss typically pay higher premiums.

What’s more, few people realize it, but when you buy an existing nursing home facility, you inherit that facility’s loss history, even if your own losses are minimal — and you’re doing everything you can to lower the exposure to the new facility. You’ll still pay the higher premium, and continue to do so for at least three years. To make matters worse, in some instances, you may have no control over claims from a prior owner, and the prior owner may have no incentive to manage the claims. So your premium could get worse over time.

Your experience modification rate specifically relates to your workers’ comp premium. A facility’s experience modification is based on the number and severity of workers’ comp claims filed. Insurance companies use this rate to gauge past injuries and potential risk to predict future losses and calculate workers’ comp premiums.

A workers compensation insurance broker can go over in more detail all that goes into determining your insurance rates and provide you with assistance in reducing the frequency and severity and claims and ultimately your premium.

Providing Insurance for Nursing Homes

Understanding the risks your clients face requires a tremendous amount of expertise on the part of you, the broker. Agencies hoping to aid nursing homes and assisted living centers with their expansive need for insurance for nursing homes need to do a thorough job of listing the many risks that exist. In this way they can then provide the coverage required for the many exposures associated with running this sort of enterprise.

Nursing homes in particular seem to find their organizations constantly under investigation for claims that they were not providing adequate care to their residents, and while that may not be the actual case, the perception is really all that’s required for the media to highlight a facility coming under such accusations, whether abuse, or any other complaints when issues occur with residents.

Nursing homes often unfairly targeted

There may be a higher likelihood of nursing homes experiencing claims due to the nature of the services they offer and the clientele they serve. It’s quite easy to find news stories on nursing home scandals and attorneys heavily target this class of business as well. While the focus may primarily involve the professional liability side, other lines of insurance can also play into the equation, having great potential for brokers.

While nursing homes come in various sizes to accommodate groups of residents both small and large, the coverages needed are invariably the same. The fact remains that insuring nursing homes requires a high degree of expertise and extreme attention to detail. The reason being that this market represents some unique exposures and has the potential to experience significant losses.

Agents should be aware that education and training are crucial, so it is strongly suggested that brokers handling this class receive all of the tools necessary to ensure their success. As with many classes of business, there are always carriers looking to get into new segments, therefore they’ll need to show a commitment to this market and explain which risks they are willing to insure, as well as what makes their product offering unique in comparison.

While liability is probably the major issue, property losses also do occur from time to time. Ensuring that property values are current is a very important aspect in determining policy needs. Brokers should go over any and all available lines of insurance for nursing homes.

Improved Conditions and Nursing Home Insurance Rates

Your client understands the issues and concerns of the elderly, which is why they opened a nursing home in the first place. Their intention was to provide the highest level of care for older adults outside of a hospital environment. Many nursing homes provide what is called custodial care, including aides who provide services such as helping residents to get in and out of bed, and also provide assistance with feeding, bathing, and dressing.

However, nursing homes differ from other senior housing facilities in that they also provide a high level of medical care. A licensed physician supervises each patient’s care and a nurse or other medical professional is almost always on the premises. This obviously creates added risks pertaining to claims of neglect, misdiagnoses, and other medical-related issues. This is further reason to look into obtaining the best nursing home insurance rates for your clientele.

On-site advanced care aids residents with health issues

For many of these facilities, skilled nursing care is available on site, usually 24 hours a day. Other medical professionals, such as occupational or physical therapists, are usually also available at scheduled intervals. This helps allow for the delivery of medical procedures and therapies on site that would not be made possible in other housing situations.

A major concern for families of residents is the often-misconstrued image of nursing homes as residencies that are poorly run, and as a place that doesn’t provide adequate care. While it is key to research homes thoroughly and visit as frequently as possible, it’s certainly not true that all nursing homes provide poor care.

In fact, just the opposite is generally true. There are currently more safeguards in place, due perhaps to televised reports of residents receiving poor treatment, or being mistreated, and facility’s have made an effort to do extensive screening of potential staff members, along with providing staffing information to the public in order to help gain public trust.

While many nursing homes have focused on making patient care their primary goal, some homes have gone even further by reducing the number of residents, creating smaller communities of 10 to 30 people within each home, with private kitchens, and communal areas for recreational activities, and improving continuity of staff. These types of improved conditions have had a positive impact on nursing home insurance rates as well.

Crime and Insurance for Nursing Homes

With an aging population, many people end up moving into a skilled nursing facility. They can receive round the clock care according to their needs, have access to meals and medications, and are able to socialize with companions. Skilled nursing facilities provide these and other services to their residents, but in the course of doing so, they are also subjected to many risks.

Criminals have targeted nursing homes and assisted living centers for some time, believing them to be easily preyed upon due to a lack of security along with occupants that can be easily victimized. Brokers who provide insurance for nursing homes have a difficult job in trying to help owners stem the amount of theft that permeates these facilities.

Nursing Homes often targeted for crimes

Nursing homes/assisted living centers seem to be one of those classes with a higher likelihood of a loss occurring. It’s extremely easy to find articles that indicate that this class of business is heavily targeted. There are of course the professional liability issues as well as crimes occurring, but finding the solutions to these problems should be at the forefront of everyone involved.

This type of exposure can greatly affect the bottom line of owners who could very well end up with a lower census due to move outs when the safety of their residents becomes an issue. These types of crimes often occur from the inside, performed by workers and interns looking to hoist a few valuables undetected. But outside elements are also often responsible for these types of losses.

For example, a resident’s jewelry or possessions could be stolen from their room. If they can rule out other residents, and if there are no suspects outside of staff and other on-site employees and vendors, then there is possibly an issue with hiring and not doing sufficient background checks.

To protect their operations and staff in case of a claim or financial loss, they need nursing facility insurance coverage. As an independent insurance agent who has worked with companies in the elder care and long-term care businesses, you can guide directors and owners of skilled nursing facilities in choosing the proper insurance for nursing homes policy for their needs.

Prescribe Safety to Keep Nursing Home Workers on the Job

It is rather ironic that the employees who make their living providing caregiving services to senior citizens may find themselves on the other side of the hospital bed all too frequently. Such is the situation due to the special circumstances under which these workers must operate, with risks and a culture that are unique to the healthcare industry. For these reasons and more, insurance for nursing homes is central to safeguarding a facility from the dangers they face. On top of a comprehensive mix of coverage, the cultivation of a safety-focused environment cannot happen quickly enough. Here are just a few reasons why:

They believe in the concept of “first, do no harm”

Employees in this line of work often take on feelings of responsibility for the residents they are caring for–they literally start to care for them, and can develop emotional attachments. Whether out of a bond they’ve formed or simply acting out of a sense of ethical obligation, workers may compromise their own health and safety in the process of assisting a resident in need. What’s more, a calm day can erupt into a tense, adrenaline-filled emergency in the blink of an eye, requiring workers to make critical decisions on a split second–decisions that may cause an injury.

As a rule, these employees often spend their days bending, lifting, pulling, pushing, and stretching to assist or reposition their charges who may not be capable of movement on their own. With sharp needles commonplace in the environment, the danger of punctures and resulting infections are always a danger.

Verbal and physical violence can be directed at the worker–both by distraught or angry family members who lash out at the person who is unfortunate enough to be in proximity at the time–or by the residents themselves, who may be angry, confused, or frightened.

Powerful prescription drugs are on site at the facility, which can present a life-threatening or even lethal danger if incorrect dosages or medications are administered to residents. Likewise, workers are at risk (presenting a danger to themselves and those they care for) should they be substance abusers who steal medication, hide, or otherwise misdirect it from the intended recipient so they can take it themselves. With all of this and more to contend with, is it any wonder that injuries in the industry outpace those in construction or manufacturing in terms of lost-time case rates?

Talk to a professional insurance agent about insurance for nursing homes, as well as ways that you can help reduce injuries in the workplace.

Risk Planning and Nursing Home Insurance

The overall goal of risk management planning is to reduce or prevent any type of risk to the facility itself, the staff, and of course the residents of the nursing home. Such risks include financial loss, preventable patient injuries, and the occurrence of accidents. Nursing Home Insurance helps to deal in the aftermath of issues, but certain steps to accomplish the goal of lessening exposures can also help dramatically. There are four main categories and steps to risk management that have been identified, which includes:

  • Risk identification
  • Risk analysis
  • Risk treatment and
  • Risk avoidance

Risk identification is done in many ways. One aspect of risk management has to do with filing an incident report pursuant to the facility’s reporting policy. Although important, there are many other aspects of risk management that affect your daily nursing practice.
Using those incident reports as a way to identify current risks that have occurred during patient care and put into place preventive measures to avoid those risks in the future is an important early step for the organization.

Risk analysis consists of prioritizing the risks that have been identified and determining which ones need to be dealt with immediately. Risk treatment, on the other hand, applies risk control and risk financing to identify how a risk should be treated. For example, a facility might decide that because there are plenty of risks involved in providing transportation services to certain events, may then make a decision to no longer provide this service to the public. Eliminating a risk is called risk avoidance, which is the only sure way to avoid an identified risk.

In addition, risk treatment also involves purchasing liability coverage as part of the overall Nursing Home Insurance program in order to cover health care providers of the facility. Risk evaluation requires a review of the prior steps in the risk management process to determine if the objectives set have been met. If necessary, changes should be made in order to further meet those objectives as identified.

Initiating or participating in research on patient care issues is also another way in which workers can contribute to reducing patient care risks in their facility. Identifying that change is needed to reduce potential risk to patients, and making those changes through facility processes, contributes to quality care, along with aiding in risk reduction.

Why Nursing Home Operators Need Insurance

Nursing homes have evolved with the times. They are no longer focused on only providing the most basic care to the elderly such as physical care. Many nursing homes now offer expanded services with the goal of providing seniors the highest quality of life. Having comprehensive nursing home insurance for agents can assist nursing home operators in managing risk, and help them to run a more professional, safe and profitable facility.

Important Way to Manage Risk

The services nursing homes and assisted living facilities offer have rapidly grown in recent years. Seniors are often able to live a much fuller life. From increased onsite and offsite activities and excursions to staff that provide more options for care to greater dining choices; the scale of operations at nursing homes has dramatically increased. With all of the expansion, comes an increased level of liability.

Older Population is Rapidly Increasing

There has never been a greater need for nursing homes and assisted living facilities; seniors are living longer and the baby boomers are getting older and requiring more care. It is particularly important for nursing homes to be thoughtful in their risk management planning as a result of the growing need for their services.
Nursing home insurance for agents is an essential way for nursing home operators to protect their interests and allow them to offer expanded services to growing senior population.


photo credit: peter burge cc