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How Senior Living Communities Can Combat Rising Claims
11/30/2017

A recent report released forecasts the loss rate for long-term care facilities will continue to increase by 6% in 2018 with claim frequency and severity driving the increase at an expected 2% and 4% growth rate respectively. 

This will be the fifth year in a row that the annual cost to defend, settle or litigate claims will rise, going from $2,350 last year to $2,450 per occupied bed.

With this knowledge, what can senior living facility management do to reduce or cap their claims? Here are a few options:

  • Implement elopement drills on a quarterly basis with at least one of these being conducted during evening hours.  The report highlights this is the leading highest per claim cost with an average of $262,000 per claim.
  • Ensure that fall and pressure injury events are a core clinical metric – by tracking and trending on a monthly basis. Conduct a gap analysis of the monthly data in order to identify opportunities for clinical system improvement. Review of these two core clinical metrics should be completed by the QAPI Committee to identify opportunities for improvement; address gaps in systems or processes; develop and implement an improvement or corrective plan; continuously monitor the effectiveness of interventions.  These two areas continue to leaders in both frequency and severity.  
  • Review CMS 5-Star Quality Measures monthly as part of the ongoing QAPI process for high-risk quality measures: a. above the state and/or national percentile or b. above the 75th percentile. Establish a QAPI workgroup to identify opportunities for improvement; address gaps in systems or processes; develop and implement an improvement or corrective plan; continuously monitor the effectiveness of interventions.     
  • Educate family members on realistic expectations relative to the care and services provided in a senior living setting.  Family members need to be reassured they are making the best decision for their loved one as well as the realities of nursing home life.
  • Implement an adverse event management process which focuses on those resident events that correlate to survey deficiencies as well as potential professional liability claims or lawsuits.  This process engages a clinical risk manager to assist community staff in identifying appropriate interventions as well as documentation and family communication.  By quickly managing these events communities are able to mitigate financial risk associated with surveys and liability insurance.

With rising costs, senior living facilities should be aware of ways to improve the efficiency, safety, and success of the organization.  The right preparation can help senior living facilities cut costs stemming from claims. If you’re looking for ways to minimize risks and cut costs, or would like to receive a copy of this report, contact an AssuredPartners Senior Living Agent.

 

Source: Aon Risk Solutions - 2017 Long Term Care General Liability and Professional Liability Actuarial Analysis

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