3 Ps to Consider When Managing the Risks of Assisted Living Facilities

By | November 16, 2020

Assisted living facilities provide a necessary service to our aging population, but operating them comes with risks. When you consider that they are designed to provide care for our loved ones in ways that many of us are not able to, you understand just how important these facilities can be.

An assisted living facility is not a hospital, nor is it a nursing home. An assisted living facility provides a place for people to live when they need some help dealing with their daily lives.

It’s not that they are fully confined to a bed or need 24/7 care. They just need a hand with some things, and some need more help than others.

A particular type of assisted living facility is the Continuing Care Retirement Community. This type of assisted living arrangement includes several different living situations ranging from folks that need minimal help to couples living together that simply have access to services all the way to those who are living in a more traditional nursing home situation.

Whether you are considering bringing an assisted living facility on as a client, or you’re already insuring some, you should be aware that they have particular risks that are associated with them.

People: The risk of dealing with people.

Businesses deal with people. That’s not news. However, when you have a client that is dealing with a specific group of people, that group brings its own risks. Assisted living facilities exist to help our older population to continue to live their lives as independently as their situations allow.

Some only need a little help. It can be as small as help with household tasks that they cannot physically do anymore and reminders here and there to supplement their failing memories. Some residents may need a significant amount of help as their health deteriorates over time.

As they deal with their clients, they must have properly certified and trained personnel on staff. This includes the need for groundskeeping and maintenance staff around the premises since it can include multiple buildings with different functions. Beyond that, there is the nutritional staff, which would have to include cooks, possibly nutritionists, and all of those who will help in serving the residents and keeping the common dining facilities cleaned and ready for use.

There are other staff members that these facilities need, such as the medical staff, the staff who work with and help the residents directly, and transportation groups who help to take residents around to appointments or off premises to go shopping. Remember that their goal is to allow their residents to live their lives as normally as they can for as long as they can.

In dealing with the selection and training of staff, we should ensure that the client is selecting the appropriate staff members. They need to be certified in their jobs, as needed. Of course, a shuttle van driver doesn’t need a CDL (maybe), but they should be licensed and have a good driving record. That goes for every different area, especially when staff interacts with residents. I’ll just mention that the dieticians or nutritionists should be certified in their field, there should be certified nurse assistants, and other medical professionals with the appropriate credentials.

More than that, there should be appropriate background checks done to make sure that the staff is made up of people who are not going to cause harm to the residents. After all, when you’re dealing with people who need help, their helpers need to be verifiably trustworthy (as much as you can verify that) and capable of helping people who will need their help.

They should also receive training on how to deal with people who are having emotional reactions to their current situations. Remember that they are dealing with people who have lived full lives. Many of them still remember themselves as the young strong person that they once were. They don’t always want to live in this situation, so they might become difficult to deal with. Those who are hired to help them should be well trained in helping those who might not always act like they want that help.

Property: The risk of dealing with property.

The property at an assisted living facility can be extensive. Yet, it can also be small. I have seen some assisted living facilities housed in converted single family dwellings. Imagine a five-bedroom, four-bathroom house converted into a building that is housing 8-12 residents. Now imagine the owner of the building (and business) trying to insure that building on a homeowners’ policy.

It doesn’t take long to imagine that the insured would be woefully underinsured for both property and liability, not to mention that the risk doesn’t qualify for a homeowners’ policy.

Even if the assisted living facility is a converted single-family dwelling, or even a converted apartment complex, there is more to it than just making sure that there is a high enough limit to cover the property.

‘Whether you are considering bringing an assisted living facility on as a client, or you’re already insuring some, you should be aware that they have particular risks that are associated with them.’

Getting the proper insurance in place is only part of the issue. That insurance should include commercial property policies with appropriate endorsements to make sure that the insured is covered in the best way they can be. Consider that these facilities will have certain business personal property that is unique to a medical situation. Even some of the beds in these facilities aren’t normal beds. They will have hospital beds in some rooms. They will have other equipment and property that you would expect to see in a medical facility.

Beyond that, consider that they may assume some level of responsibility for the residents’ personal property. It’s more likely that they would ask residents to care for their property and that they might even have a signed waiver of responsibility for damaged property. But do they require residents to have some kind of insurance on their property?

Add to the risk to property that you have residents who have varying degrees of independence and acceptance of their own limitations. It would be worth reviewing the facilities’ residential cooking facilities and their rules about who gets to cook and where and when.

Public: The risk of dealing with the public.

The residents of assisted living facilities are our parents and grandparents and that in itself touches a nerve with us. For those who are entrusting their family members to live here, they are all feeling a mix of emotions. Some feel guilty that they couldn’t take care of their parent. Others want to take care of them, but mom or dad won’t have it so there’s some sadness, maybe anger there. Some are simply sad to see their first heroes and superheroes in their lives brought back down to being human like the rest of us. Add to that the history of some facilities that have dealt with patient abuse allegations, and you have an environment where there is great risk to the facilities.

In this light, it’s even more important that the facility have strict policies regarding the selection, hiring, training and continued employment of all staff. Look at this from a reputational risk standpoint. If there aren’t strict policies in place related to all personnel, and something happens or is alleged to have happened, it makes it possible in the minds of the public that something bad could have happened.

It could be worse if there are policies in place, but they are selectively enforced for some staff and not others. Remember that even those staff members whose jobs don’t deal directly with residents can still come in contact with them, and that creates an exposure of staff who shouldn’t have contact with residents for many different reasons, including their prior criminal records.

Consider also what steps the insured may be taking to create positive reputational moments. This could range from partnerships with other organizations that support the mission of helping the residents live their lives as fully as possible to ways that the facility is giving back to the community. These sort of positive touches put the facility in a better position to deal with any potential negative impact of an allegation.

Another item to consider is the facility’s plan to react to any negative situation. Will it be proactive with the public if something happens, sharing the information that it has as soon as is practical? Will it hide information until someone asks about it? How will it react to allegations of abuse or mistreatment by staff? How will it support and help any residents that are victims of any mistreatment? These questions need to be answered early and revisited often as part of a disaster preparedness plan because disasters are more than storms, floods and fires.

This is certainly not a full treatment of the risks to be managed when the client is an assisted living facility, but it’s a good place to start the conversation.

Nothing beats having conversations and getting to know your clients so that you can better help them in their insurance purchases and in their overall risk management.

About Patrick Wraight

Patrick Wraight, CIC, CRM, AU, is director of Insurance Journal's Academy of Insurance. He can be reached at pwraight@ijacademy.com.

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Insurance Journal West November 16, 2020
November 16, 2020
Insurance Journal West Magazine

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