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March 28, 2023

Choosing Residents Wisely to Reduce Long-Term Care Facility Claims

Occupancy rates plummeted during the pandemic. According to the National Investment Center (NIC), senior housing occupancy in the U.S. fell to 78.8% in the first quarter of 2021. Assisted living occupancy dropped to 75.5%, while independent living occupancy dropped to 81.8%. Occupancy rates were even lower in certain areas. For example, in Houston, the occupancy rate was only 72.9%.

In the second quarter, NIC figures show that occupancy rates fell even further, hitting a low of 78.0%. Since then, occupancy rates have showed signs of recovery, rising to 81.4% in the second quarter of 2022.

Many facilities may be eager to recover from low occupancy rates as quickly as possible. However, accepting residents that aren’t a good fit for your facility can backfire. Although you may be able to bring your occupancy rates and revenue up in the short term, you risk higher claims down the road.

Can You Provide the Needed and Expected Level of Care?

When facilities take on residents that need a higher level of care than can be provided, they open themselves up to claims of negligence. Likewise, if family members expect more from your facility than you can provide, problems are likely to follow. While these statements seem obvious, it can be tempting to accept seniors who don’t quite fit when occupancy rates are down. From a risk management perspective, it’s very important to accurately assess potential resident needs and have candid conversations with families up-front.

Do You Have the Staffing Required?

According to a 2021 survey from the American Health Care Association & National Center for Assisted Living, nearly all facilities are facing staffing shortages, and the problem is so bad that 78% of nursing homes and 61% of assisted living communities are worried that they might have to close.

Even if you don’t have to close, staffing shortages may impact your ability to provide care, and this can lead to claims of negligence. This may be what happened at Brookdale Senior Living, according to a lawsuit that has been filed against the company. NBC Bay Area says the lawsuit, which involves 80 families, alleges “a system of understaffed assisted facilities that fails to consistently provide even the most basic level of care.”

When taking on new residents, be realistic about your current capabilities. You may want to return to pre-pandemic occupancy rates, but if your staffing levels have not recovered, this may not be possible. New and inexperienced workers may also be a concern, especially if you’re accepting residents who need higher levels of care.

Will Residents (and Their Families) Be Happy at Your Facility?

If your residents are happy – and if their families see that they are happy – you will likely have good reviews, plenty of word-of-mouth referrals and few problems. On the other hand, if your residents are unhappy or anxious, you might find that family members are scrutinizing your services more closely and looking for signs of negligence.

Lawsuits tend to come from relatives who live far away and don’t really have a realistic view of the situation. When you assess the resident, interview the family too. If the resident is coming from another facility, why is that happening? What happened at the other facility? If the resident is coming  from a facility with problems, there’s a good reason. But if they’re coming from a quality facility, ask questions to find out why.

Avoiding Discriminatory Practices

Although it’s important to find residents who are a good match for your facility, you also need to be careful not to discriminate against applicants illegally.

For example, McKnights Senior Living says that an assisted living facility in Manhattan is facing a lawsuit over claims that it discriminates against people who use wheelchairs, and NBC News says that a facility in Maine has agreed to a settlement in a case involving a transgender woman who sued over alleged discrimination.

Find a Niche Insurance Partner

By choosing residents wisely, you can help avoid claims. However, it’s still important to have robust insurance coverage and proactive risk management. We specialize in insurance for residential long-term care facilities for the elderly. Contact us to learn more.

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