Assisted living facilities provide sensitive services, making them subject to increased scrutiny from multiple angles. It can come from residents and their families, workers, or even regulatory agencies. This is because many necessary daily activities in assisted living facilities pose high risks to residents and employees. These risks point to a significant need for strategic insurance planning, customized to the facility’s needs.
| In This Blog: We’ll cover the top types of claims that assisted living facility operators deal with, as well as insurance strategies to help them prepare. Our goal is to give managers, owners, and operators a roadmap for their insurance policy coverage to follow to prevent risks where possible and respond to incidents when they occur. |
Injuries Caused by Assisted Living Facility Workers
National studies indicate that 22% of residential care community members experienced a fall in the previous year. Additionally, 19% of those who fell were hospitalized for their injuries.
Common evidence of neglect, including bedsores, unexplained bruises, and infections, can fuel a patient injury or neglect lawsuit, exposing the facility’s hiring, staffing, and safety practices to increased scrutiny. Related claims of medication errors or mismanagement are also common.
How to Prepare
Frequent safety updates with employees go a long way toward maintaining accountability and transparency in the facility’s resident care strategies. This should include maintaining an up-to-date electronic database of administrative safety and medication records, promoting safe dispensing, and conducting performance audits on employee safety practices.
General liability insurance covers damages, including legal fees, resulting from injury lawsuits. Facility operators should try to personalize the liability limits and policy types around their projected needs based on historical claims data, their employees’ experience level, and general trends in resident health.
Claims of Resident Abuse
In addition to accidental malpractice and on-site injury claims, claims of abuse, even up to wrongful death lawsuits, are all too common for assisted living facilities. Additionally, physical and emotional abuse are not the only possible claims. Claims may also be filed against facility employees for financial abuse, including the illegal use of the resident’s credit cards.
Other possible claims include ignoring or improperly addressing abuse by another resident, such as in a sexual assault case, or neglecting a resident’s care to the point of malicious intent. These and other instances lead to legal and settlement costs that can overwhelm an assisted living facility without the right insurance protections.
How to Prepare
Residents and their families must believe that the assisted living facility has their best interests at heart. Even if the claim is unfounded, the simple act of making the claim against the facility can lead to reputational damage and legal fees. A combination of general liability and professional liability insurance can protect facilities from the legal costs of abuse settlements.
Workers’ Compensation Claims
Assisted living facilities handle far more workers’ compensation cases due to work-related injuries than the average industry, as recognized by the Bureau of Labor Statistics. In 2023, the national rate of nonfatal work injuries in all industries was 2.4 per 100 workers, and 6.4 per 100 workers for care facilities.
This discrepancy is likely caused by multiple factors, including the risks of physically lifting residents with disabilities, the potential to catch illnesses at facilities, and the possibility of burnout due to staffing shortages. Workers’ compensation claims commonly include medical expenses, lost wages, and settlement costs, which can overwhelm a facility without coverage.
How to Prepare
Workers’ compensation coverage is required in most states, but the required minimum liability limit may not fully protect an assisted living facility from the costs of employee injuries, burnout, and other claims.
However, a facility can also provide support to help prevent workers’ compensation claims, such as updated safety and ergonomics training, lift-assist equipment, and clear incident-reporting pipelines for employees to use. This data should be assessed at least annually to spot safety coverage gaps and improve internal processes to resolve them.
Best Practices for Assisted Living Facilities
From this general claims data, assisted living facility operators should recognize the need for more customized and robust insurance policies. However, this list of business practices can provide a foundation for assisted living facilities to maintain proper oversight and potentially prevent incidents before they have a chance to occur:
- Perform frequent safety audits
- Maintain ergonomics training protocols
- Survey and monitor abuse awareness protocols
- Manage medication awareness and training processes
- Communicate clearly with employees
- Refrain from understaffing
- Enforce safe-lifting and fall prevention programs
- Keep residents and their families in the communication loop
- Assess cybersecurity infrastructure
- Maintain relevant documentation
Customize Your Facility’s Policies with Experienced Insurance Brokers
At Pro Insurance Group, our experienced agents help assisted living facility operators prepare for the top insurance claims in their industry. With the right safety protocols, documentation, training strategies, and customized insurance policies, operators can protect their assets, workers, and residents from common claims.
Contact our team today and schedule an insurance consultation to learn how to prepare for the top insurance claims in the assisted living industry.