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Risk Management Considerations for Senior Living Communities Combating C0VID-19

By Bette McNee, RN, NHA

As the Coronavirus Disease 2019 (COVID-19) pandemic continues to spread across the country, senior living facilities have been impacted tremendously. Because seniors are at greater risk for contracting COVID-19 due to their age or underlying health conditions, facility managers and staff must take decisive action in response to the virus to mitigate risk and safeguard residents.

Based on how COVID-19 has affected senior living facilities to date, leaders should consider the following to ensure their organizations are in the best position from a risk management perspective.

Establish a process for disseminating information.

Sharing relevant information within the facility is a key aspect of helping to combat the spread of COVID-19. Facility managers should point staff to the Centers for Disease Control and Prevention (CDC) website as resources and recommendations are being updated regularly with important information for senior living facilities.

Assigning specific staff members to review and disseminate important updates from the beginning keeps this process streamlined and ensures the full staff is educated on any new developments. These individuals should also provide periodic reminders of key information, like proper handwashing. In addition, it is important to regularly inform residents and their family members of the new protocols put in place so they are aware of how the facility is handling this threat.

Consider proactive risk mitigation strategies

Beyond the most obvious risk of residents contracting COVID-19, other challenges have emerged for senior living facilities, such as:

  1. Lack of testing: While testing for COVID-19 was initially available in hospitals or drive-through sites, these conventions may not be appropriate for senior residents.
  2. Visiting limitations: Facilities have been mandated to limit visitation to safeguard residents from those who could be contagious. This has the potential to create a liability exposure among families who are unable to visit their loved ones.
  3. Staff resiliency: Because senior living staff are working during this crisis, managers must prioritize their staff’s health and ability to cope with the mental and emotional demands of caregiving under these circumstances.

Rather than waiting until these challenges have overwhelmed the facility, risk managers should do everything in their power to proactively identify and implement solutions. Facility managers may consider working with a risk management consultant or insurance broker to help them address these challenges.

Be creative in addressing challenges but consider risks.

In this unprecedented situation, facility managers must be able to address not only the everyday risks, but the “new normal” with different challenges to keep residents and staff out of harm’s way.

For instance, staffing challenges may have shifted due to childcare needs with schools and daycares closed in many areas. Some facilities have taken the creative approach to set up temporary childcare operations, but it is critical to consider the risks and challenges of starting a new operation with a population (children) that the facility has not served before. As facilities get creative, managers should consult in-house and external risk managers to understand potential risks and whether these programs may fall under existing insurance policies.

Be aware of external pressures that may increase risk.

Organizations of all types are being called upon by public officials to provide additional assistance in the fight against COVID-19. For example, some facilities have been asked by state governments to support emergency homeless shelters, which would be a completely new operation for the organizations. If a facility is asked to provide new or different services, managers should not assume they are required to accept what is being asked. Before making any commitments, facility managers should do their due diligence by speaking with risk managers about possible exposures and potential protection through immunity or indemnification.

Keep thorough documentation.

Because this is a unique situation for the insurance industry, carriers are still grappling with how to approach COVID-19-related risks and deal with the associated claims. However, facility managers can begin to prepare now for potential workers’ compensation, general liability and professional liability claims by keeping a thorough record of staff and resident cases, tracking for positive and presumed positive test results as well as who was exposed, when they were exposed, demographics and more. Templates for appropriate documentation, developed by the CDC and other industry organizations such as the American Medical Director’s Association (AMDA) are available online.

Prepare for a potential survey and new mandates.

The Centers for Medicare and Medicaid (CMS) has created a Focused Infection Control Survey and made an Infection Control checklist available for organizations to reference. Now is the time for facility managers to gather the policies and procedures included in the checklist and ensure proper mandates are in place. In addition, should a facility be engaged in a focus survey, member association groups have released valuable information based on organizations that have already undergone the process – what types of questions were asked, how many people were interviewed, etc. Preparing in advance is the best way for facilities to set themselves up for success in this situation.

While the COVID-19 pandemic is an unprecedented challenge for senior living facilities, these key takeaways are vital to keep in mind as facility managers navigate the coming weeks and months.

ABOUT THE AUTHOR: Bette McNee, RN, NHA, is senior clinical risk management consultant at Graham Company, an insurance brokerage and consulting firm committed to enhancing employee safety and business viability through an action oriented approach to risk management.