Having buried my 96 yr old mother this year, it occurred to me that modern medicine is keeping us alive much longer than before, or perhaps longer than is ‘intended.’ In my mother’s case there were several other siblings, with their own opinions, attitudes and schedules. It’s not surprising that this insurance segment is in chaos. Everything the elderly person does can be scrutinized, as they often never really get any better in the chronic cases. How the worker or caretaker reacts can be scrutinized as well. If you are a family member doing the care you may or may not be appreciated by the other members, and you may take more than your share of the ‘blame.’
Please note that the vast majority of the workers in this industry are wonderful people, and I imagine they get special recognition in the next world. They regularly perform tasks that people like me could not do.
In my mother’s case we were able to keep her at home, and bring help in. Dad was a veteran so we were able to get her the “aid and attendance” benefit, which helped a lot.
Where to start …. not at the last step …. the purchase of insurance. Yep, that is the last step. The first step is the management of potential exposures. And how do we do that? The US Supreme Court has already given the map. Binding arbitration for all claims related to the goods or services provided. And please, no knee jerk comments about “right to jury trial”. What can you put in that arbitration policy? Whatever you want. Limitation on time frame to request arbitration, to heck with statutory language. Limitation on damages. Absolutely !!. Limitation / inclusion of third party actions. No problem. The Federal Arbitration Act supersedes ANY state law targeting arbitration. The US Supreme Court has ruled, many times, that such policies must be enforced as written. There’s more. Now how do I know this? Because many many years ago, I had a client with 14 nursing homes, in a litigation prone area of Texas, that would get a “threat letter” or actual suit every week. Their attorney and I designed a policy that set a one year limitation on claim filing, and a $100,000 limit on damages. We rolled it out immediately for all new residents, and gave all current residents 30 days to leave or be bound by the terms. It also went to those who held “powers of attorney”. After 90 days, the threats and suits had stopped. And, the policy also included a provision that any party opposing arbitration would be liable for the legal fees of any other party seeking to enforce arbitration. A KEY element was making sure that the person signing on behalf of the resident had legal authority to do so. Or that the resident was competent to sign. A family member is NOT automatically an authorized person. We required proof by way of a court order etc. There have been areas of the country where such policies have been rejected by the courts, but after appeal, all have been enforced. Ask the underwriters if they have even heard of this. The attorney’s I’ve worked with were proactive and designed a standard response to the plaintiff attorney. Sort of ” perhaps you are unaware that your client, heirs etc are subject to a policy of binding arbitration which limits ….”. IT WORKS.
Hey RM, as sales leader I managed a commercial broker with a senior living P&C program in Florida. You are exactly right with the arbitration policy language (that is backed up by legislative and judicial force). Since we all have bad outcomes “in the end”, it is important to manage the expectations and emotions of those outcomes. When it isn’t clear, legal, understandable and agreed upon in advance, the bad outcome that humans face at the end of life can look like malpractice, negligence and worse to emotionally attached family members. If policy language and statutes followed each other, insurance would be much less of a worry to facility operators and not the deterrent it is becoming to start up owners. As a guy who is about to turn 60, I can safely say we are going to need a lot more of these places in the very near future.
Tiger88: It is my sad experience that those most inclined to sue are those “relatives” that have not seen the resident in YEARS. Just looking for a quick buck. It is interesting to note that, with the increased use of arbitration policies, the total lack of plaintiff attorney ads soliciting nursing home claims. This should be pointed out to the underwriters.
Genius, Retired Risk Manager. I’ve worked on a large group of nursing homes only a few times in my career. Wish we had thought of that. It was eye opening to learn from adjusters that almost every lawsuit was filed by a family member that never or hardly ever, visited or cared for their elderly “loved one”.
First, whatever people have to pay for nursing home care, they always feel it is too much. Nursing home operators need to operate on tight, tight budgets.
Second, for the workers it is a demanding job. Dealing with critically ill or dying patients on a daily basis. Many who are not very sound of mind and many who are difficult patients because of that. And their pay for providing this service, typically not enough because of the first item. One has to be a saint to want this job. And with the booming economy and the low unemployment rate and so many better opportunities out there, who wants to do this and get the low pay? In many cases (not all) the only people to attract are at the people at the bottom of the employment pool.
Third, the insurance industry knowing about the lack of adequate care and possibly not the best employees out there who are all underpaid makes insuring such operations risky at best, meaning the homes cannot buy the coverage and surely not at the costs they would incur.
I don’t see a positive outcome here. It’s why I try to keep my Niece as happy as possible.
Having buried my 96 yr old mother this year, it occurred to me that modern medicine is keeping us alive much longer than before, or perhaps longer than is ‘intended.’ In my mother’s case there were several other siblings, with their own opinions, attitudes and schedules. It’s not surprising that this insurance segment is in chaos. Everything the elderly person does can be scrutinized, as they often never really get any better in the chronic cases. How the worker or caretaker reacts can be scrutinized as well. If you are a family member doing the care you may or may not be appreciated by the other members, and you may take more than your share of the ‘blame.’
Please note that the vast majority of the workers in this industry are wonderful people, and I imagine they get special recognition in the next world. They regularly perform tasks that people like me could not do.
In my mother’s case we were able to keep her at home, and bring help in. Dad was a veteran so we were able to get her the “aid and attendance” benefit, which helped a lot.
Where to start …. not at the last step …. the purchase of insurance. Yep, that is the last step. The first step is the management of potential exposures. And how do we do that? The US Supreme Court has already given the map. Binding arbitration for all claims related to the goods or services provided. And please, no knee jerk comments about “right to jury trial”. What can you put in that arbitration policy? Whatever you want. Limitation on time frame to request arbitration, to heck with statutory language. Limitation on damages. Absolutely !!. Limitation / inclusion of third party actions. No problem. The Federal Arbitration Act supersedes ANY state law targeting arbitration. The US Supreme Court has ruled, many times, that such policies must be enforced as written. There’s more. Now how do I know this? Because many many years ago, I had a client with 14 nursing homes, in a litigation prone area of Texas, that would get a “threat letter” or actual suit every week. Their attorney and I designed a policy that set a one year limitation on claim filing, and a $100,000 limit on damages. We rolled it out immediately for all new residents, and gave all current residents 30 days to leave or be bound by the terms. It also went to those who held “powers of attorney”. After 90 days, the threats and suits had stopped. And, the policy also included a provision that any party opposing arbitration would be liable for the legal fees of any other party seeking to enforce arbitration. A KEY element was making sure that the person signing on behalf of the resident had legal authority to do so. Or that the resident was competent to sign. A family member is NOT automatically an authorized person. We required proof by way of a court order etc. There have been areas of the country where such policies have been rejected by the courts, but after appeal, all have been enforced. Ask the underwriters if they have even heard of this. The attorney’s I’ve worked with were proactive and designed a standard response to the plaintiff attorney. Sort of ” perhaps you are unaware that your client, heirs etc are subject to a policy of binding arbitration which limits ….”. IT WORKS.
Hey RM, as sales leader I managed a commercial broker with a senior living P&C program in Florida. You are exactly right with the arbitration policy language (that is backed up by legislative and judicial force). Since we all have bad outcomes “in the end”, it is important to manage the expectations and emotions of those outcomes. When it isn’t clear, legal, understandable and agreed upon in advance, the bad outcome that humans face at the end of life can look like malpractice, negligence and worse to emotionally attached family members. If policy language and statutes followed each other, insurance would be much less of a worry to facility operators and not the deterrent it is becoming to start up owners. As a guy who is about to turn 60, I can safely say we are going to need a lot more of these places in the very near future.
Tiger88: It is my sad experience that those most inclined to sue are those “relatives” that have not seen the resident in YEARS. Just looking for a quick buck. It is interesting to note that, with the increased use of arbitration policies, the total lack of plaintiff attorney ads soliciting nursing home claims. This should be pointed out to the underwriters.
Genius, Retired Risk Manager. I’ve worked on a large group of nursing homes only a few times in my career. Wish we had thought of that. It was eye opening to learn from adjusters that almost every lawsuit was filed by a family member that never or hardly ever, visited or cared for their elderly “loved one”.
This is a tough, tough industry. Where to start?
First, whatever people have to pay for nursing home care, they always feel it is too much. Nursing home operators need to operate on tight, tight budgets.
Second, for the workers it is a demanding job. Dealing with critically ill or dying patients on a daily basis. Many who are not very sound of mind and many who are difficult patients because of that. And their pay for providing this service, typically not enough because of the first item. One has to be a saint to want this job. And with the booming economy and the low unemployment rate and so many better opportunities out there, who wants to do this and get the low pay? In many cases (not all) the only people to attract are at the people at the bottom of the employment pool.
Third, the insurance industry knowing about the lack of adequate care and possibly not the best employees out there who are all underpaid makes insuring such operations risky at best, meaning the homes cannot buy the coverage and surely not at the costs they would incur.
I don’t see a positive outcome here. It’s why I try to keep my Niece as happy as possible.