Long Term Care Facilities for the elderly found themselves wrapped up in turmoil and litigation long before COVID 19. However, the Coronavirus found all the cracks in the system.
Currently, 800,000 Americans live in an assisted living facility (ALF), and there are 1 million licensed beds. While no one doubts the dedication of most facility staff and administrators, it’s an industry with many liability issues.
The average liability claim for ALFs in 2019 was just under $300,000. Elopement claims averaged almost $400,000 per incident for ALFs.
Liability claims ranged between $250,000 to $1 million. This is a good time to see if you have the right assisted living insurance.
With individual claims continuing to rise and financial issues confronting long-term care facilities, it’s time to ask “Does insurance cover assisted living facilities adequately?”
We want to assure you it does and give you the basics of liability insurance for assisted living facilities in this article.
Does Insurance Cover Assisted Living Facilities?
Yes, you can purchase several options in liability insurance to protect your business, your buildings, your staff, and your facility’s residents.
Insurance for assisted living facilities is available and covers various topics, involves many groups (including your insurance company), and has a wide range of coverage options.
When you are looking for a reliable and trustworthy insurance company, you should have three things in mind:
- Price for excellent coverage
- Risk management advice
- Types of claims your facility is likely to have
A reputable insurance company works with you on risk management mitigation and ensuring you have the coverage you need. There are various long-term care options, and your insurance agent should not lump you in a “nursing home” group simply because you house and care for the elderly.
Types of Care Facilities
There are generally four accepted categories of long-term care facilities. The first is board and care homes. These house 20 or fewer residents and generally do not provide any onsite medical care.
As a result, their liability is generally lower because they don’t have high-risk patients, issue meds, and retain staff longer.
The other end of the spectrum is a nursing home. A nursing home tends to focus mainly on geriatric patients who have a high medical need. As a result, nursing homes tend to have higher turnover and have patients who may elope.
A nursing home is more likely to experience medication mistakes due to having extensive medical care. Their insurance policy will likely be expensive due to the possible risks that are present for staff and residents.
In between those two are assisted living facilities. The residents in these facilities require help with daily care, such as dressing or bathing standby. They tend to live in their own apartments or rooms in the facility.
In an ALF, a patient has access to varying levels of care. Therefore, the rates vary with the amount of care needed. If a patient has excessive needs, an ALF may advise the family and resident that a Nursing Home is more appropriate.
Continuing Care Retirement Communities (also known as Life Care Communities) provide the full range of senior living from independent housing options to ALF to Nursing Home options.
Standard Factors Involved in Assisted Living Insurance
General liability: Can cover slip and fall type injuries of residents. This also covers bodily injury on the property of the ALF.
Professional Liability: Sometimes referred to as errors and omissions in other industries, professional liability can be thought of as your care of the residents. For example, medication administration, proper diet and care, etc.
Auto coverage for ALF vehicles: Covers transport and passengers.
You may also need to purchase other policy coverages, such as abuse & molestation, excess liability insurance, liquor liability, etc to help mitigate risk factors for your facility.
Other lesser-known policy components can include cyber policy and worker’s compensation.
Risk Management and Mitigation
While you are deciding on a policy, it’s important to think about the possible risk factors you have at your ALF. These generally stretch far beyond the simple Professional Liability coverage. Again, your agent can help you to identify areas for Risk Management improvement.
Risk Management Types of Claims
Risk management areas that often need to be monitored include the following:
- Medication Errors and Omissions
- Slip and Fall Accidents
- Staff Negligence
- Workplace Safety
- Abuse and Neglect Claims
- Accidents Occurring with Transportation
Mitigation of Risk in Assisted Living Facilities
As with everything, human error is the most often encountered risk in a senior living facility. Managing your risk through training and excellent communication is always the first (and best) way to minimize risks in your facility.
Staff retention – always a challenge in the senior living facility field – is another important way to mitigate your risk. Constant turnover increases the risk of not being able to ensure your staff is properly trained.
It also puts a strain on your existing staff when you are constantly hiring and training new staff. This can cause accidents as the staff tries to rush to get everything done. Also, the new staff is less likely to be familiar with policies, procedures, and best practices to prevent risk.
Errors and Omissions is the top area of liability for many facilities. Many seniors in facilities are taking between 12 and 14 different prescriptions for a variety of illnesses.
Even in a small facility of 6-20 beds, medication errors are easy to make when your staff has a high turnover or is overworked and understaffed. Improving hiring practices from the initial job posting through onboarding your new staff will help mitigate those human errors.
Employment Practices Liability Coverage (EPLI)
Another area of risk mitigation is the proper training of your HR staff. EPLI ensures that you have coverage in case of wrongful termination, discrimination, and sexual harassment lawsuits. However, making sure that your staff works well as a team can start as early as the interviewing process.
Excellent continuing education opportunities can help to motivate your team to keep growing (and increase retention.) It can also help your staff work on the Quality Improvement Process with more enthusiasm and knowledge.
From facilities attendants to RN and management, retaining quality staff members is the key to risk management. It will help keep your occupancy as close to full as possible. Staff retention also increases the quality of your care and your reputation as a caregiving facility.
Choosing an Insurance Company and Agent
The same standards in hiring and retention apply for choosing an insurance company and agent. You need someone reliable and trustworthy.
Someone easy to communicate with. Someone that helps you navigate the world of risk management and liability insurance with confidence.
You also don’t want to pay more than you need to. However, balancing the right amount of liability insurance for assisted living facilities with budgeting for an appropriate premium cost can be a hassle.
You want coverage for unforeseen circumstances as well as heavy risk areas (elopement and medication errors are among the most costly.)
You also want to know that once your policy is set up, it becomes as hassle-free as possible! Your time is best spent working on improving the quality of life for your residents and your staff, and your insurance agent should know that as much as you do.
Changing Times Require Great Partnerships
Keeping up with the rapid changes in the senior care provider field is a tough job at times. Knowing you have partners who appreciate that and want to make your job easier in any way they can, is priceless. Knowing that they have your back is even better.
Risk mitigation in our ever-changing world is a challenge, but you deserve an insurance company that has your business interests at heart.
Providing coverage for Errors and Omissions, Commercial Property, Negligence and Abuse Claims, Cyber Liability, Auto, and Employment Practices requires knowledge, honesty, and transparency from your insurance agent and company.
Your job is to ensure your residents’ safety, health, and welfare, and ours is to make sure that when an accident happens, you’re covered. You took on this awesome responsibility of caring for our most delicate citizens. We want to ensure that mistakes don’t keep you from delivering your services when people need them the most.
Finding the Right Insurance Company
You need to know that that the company you choose is reliable and up to speed on the changes in the senior care field to get the right assisted living insurance.
A great reputation and amazing service let you know that we are here for you and your business with a wide variety of options.
Senior care is a growing field, with 60% of all the assisted living facilities in the U.S. offering some dementia care. Unfortunately, this complicates your risks and your business stability.
We understand this. We want to help you maintain your reputation and standards while offering you the protection you need in this growing industry. Your business IS our business, and we want to help you continue your excellent service standards.
If you are in the market for an insurance company for your new or ongoing assisted living facility, we want to show you how we can help you.
We would love to answer any questions you have! From does your insurance cover assisted living facilities to how I can lower my rates, we are ready to give you a quote today!