Partnering with the right Managing General Underwriter (MGU) can ensure that an independent agent can help his or her clients obtain the best insurance coverage at the best price. This means that the MGU, in this case, Caitlin Morgan, will also provide claims management and risk management services as well as other pertinent programs for those that service the growing long-term care (LTC) industry. With the ever-present epidemic of litigation against nursing facilities and their personnel, risk management is, and always will be, an important aspect of daily patient care.
Most LTC facilities provide a variety of services to residents, and in the frail, elderly population they serve the potential for injury is unfortunately significant. Caregivers on all levels must understand their specific responsibilities as required under the Omnibus Budget Reconciliation Act (OBRA) of 1987, along with the monitoring of areas of high litigation risk.
Number of lawsuits against facilities on the rise
The boom in nursing home litigation has adversely affected the way that many LTCs practice because of the significant increase in lawsuits as a result of LTC facilities expanding their participation in sub acute care programs for sicker patients. This, coupled with offering increased medical services, including patient-controlled analgesia, bariatric care, peritoneal dialysis, wound care, and chemotherapy has increased the potential for litigious situations to occur.
A major concern for many medical directors is that they often are not covered for their administrative duties, leaving them vulnerable when litigation occurs. Situations along these lines have threatened the quality of, and access to care for frail elderly persons. Effective risk management requires identification of litigation-prone areas and implementation of preventive or corrective actions throughout a facility.
Most cases brought against nursing homes involve pressure ulcers, malnutrition and dehydration, and falls resulting in major injuries to clients. In addition, there is a lot of litigation due to elopement, adverse drug events, or untreated or undiagnosed changes in a medical condition, and also improper discharge of residents. Claims of negligence against nursing facilities may also involve assault by staff or another resident (resident-to-resident abuse), misuse of physical or chemical restraint, and violation of a resident’s rights, such as failure to obtain informed consent.
Once in court, the goal is for the plaintiff’s attorney to uncover documentation discrepancies and other faults with the medical record, or call witnesses to any wrongdoing. The plaintiff attorney’s strategy can include suing the medical director for breaches of the standard by nurses and primary care physicians. Caitlin Morgan will assist you in providing coverage for your insureds to help them better manage situations of this nature.