Managing the Unique Risks of Hospice Care

Hospice Care

Volunteers are a necessity in a successful hospice program. With this realization, Federal regulations actually require a specific level of volunteer activity at each hospice receiving Medicare and Medicaid funding. Although these dedicated and caring volunteers are important assets to a successful hospice program, they provide a unique area of risk management.

Liability Issues

In addition to the liability for the acts and omissions of employees, hospices are also liable for acts and omissions of its volunteers. Not only does this liability affect the willingness of hospices to use volunteers, but also volunteers might be reluctant to assume liability. Fortunately, the Federal Volunteer Protection Act of 1997 promoted the idea of volunteer participation by attempting to immunize volunteers at charitable and nonprofit organizations from liability for their acts and omissions if performed within their volunteer duties. The requirements of the act are:

  • If appropriate or required, the volunteer must have been properly licensed, certified, or authorized by the appropriate authorities in the state in which the harm occurred.
  • The harm was not caused by the volunteer operating a motor vehicle for which the state requires the operator to possess an operator's license or maintain insurance.
  • The harm was not caused by willful or criminal misconduct, gross negligence, reckless misconduct, or a conscious, flagrant indifference to the rights or safety of the individual harmed by the volunteer.
  • The volunteer must have been acting within the scope of his or her responsibilities when the act or omission occurred.

However, the statute does not apply to misconduct which:

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Home Health Care Risk Management Part 2 – Risk Associated with Home Health Care

Home Healthcare Commercial Insurance

Home health care provides some unique challenges for those working in this environment. Not only are many of the same risks associated with hospitals and nursing homes present, but household related hazards such as poor air quality, toxic substances, and aggressive pets may also be issues. Additionally, the homecare health setting cannot be controlled. Finally, many home health care providers may have limited training and experience in providing patient safety and there is no direct supervision of their daily activities.

Some of the risks associated with home health care are:

General security/personal safety hazards:

  • Unsafe neighborhoods
  • Violence from patients or family members
  • Potentially dangerous household pets

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Home Health Care Risk Management Part 1 – The Growth of Home Health Care

Home Healthcare Commercial Insurance

Home health care is defined as skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury. At last count, there were 12,445 Medicare-certified home health agencies and 20,660 other home care companies in the United States. Indeed, home health care is the fastest growing sector in the industry serving those who require elderly health care. This is due to a number of reasons:

  • The enactment of Medicare in 1965
  • The 1987 revisions to Medicare, which introduced reimbursement to home care agencies
  • The continual growth of our aging population
  • The increased life expectancy of seniors
  • The willingness to decrease the length of hospital stays and provide early discharge of many patients to home care

Classification of Home Care Agencies

Freestanding proprietary agencies provide most formal home care. Home care is also provided by hospital-based agencies, with nonprofit public and private health agencies providing a smaller portion. There are three major classifications of home health care agencies:

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Risk Management for Healthcare Staffing Agencies

healthcare staffing agency insurance

Healthcare staffing agencies employ physicians, nurses, medical technicians, and healthcare professionals to work as contractors. Some major liability issues need to be taken into consideration due to a healthcare staffing agency’s operational dynamics.

  • Contracts may transfer risk or responsibility to the agency.
  • The agency ultimately lacks control over the day to day operations of the health care setting, which includes setting’s standards and policies; their coordination of services, and records; the quality of their other workers; and compliance with regulations.
  • Maintaining a positive relationship with the contracted client can often influence not only the staffing agency’s ability to report or address areas of concern and adverse events; the ability to investigate; but also the agency’s ability to defend itself.
  • If there are liability issues, it may be difficult to coordinate a defense because there are multiple defendants.

In order to meet the risk management needs of a healthcare staffing agency, there are some best practices for your healthcare staffing agency.

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Allied Health Care Experiences Continual Growth

Allied Health Professional

Allied health care includes professionals – excluding doctors, nurses, dentists, and podiatrists – serving in medical facilities and occupations. The majority of healthcare workers serve in the 85 different professions identified as allied health. According to a University of California study, about 60% (8.4 million jobs) of all healthcare workers are in allied health professions, and this number continues to grow.

Reasons for the Growth of Allied Health Care

  • The aging baby boomer population - The eighty million seniors referred to as the baby boomer generation are beginning to reach retirement age. This is influencing allied healthcare by creating many openings in the industry. Additionally, baby boomers will need more health care as they age.
  • Increased longevity - Due to the improved quality of medical care, seniors are expected to live longer. This leads to an increased need for allied healthcare workers.
  • Shortage of doctors and nurses - In the next fifteen years, we will see a shortage of doctors and nurses, driving a need for more allied health professionals to provide necessary specialized services.
  • Advances in technology - Modern medical care is far more advanced than in the past. Now there is a demand for specialization in every health care field. Additionally, as new methodologies and equipment improve medical care; specialized positions will continue to be added.
  • National emphasis on the importance on wellness and need to reduce high obesity rate - As the United States pursues preventative and corrective measures to make our population healthier, more allied healthcare professionals, such as nutritionists, will be needed.

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