Highland Risk Services
For seniors living on their savings built over a lifetime, moving to a continuing care retirement community (CCRC) may offer exactly the stability that they want and need. The devaluation of the housing market and concern over our economic instability may play an important role in this decision. In fact, choosing a CCRC can actually reduce financial risk for seniors.
A CCRC is a particular type of retirement community that offers several levels of health care on one campus.
- Independent Living - Also referred to as “residential living,” these freestanding units and independent living apartments are for residents who do not need personal assistance.
- Assisted Living - Also referred to as “extended living,” this serves those who require some help with the activities of daily living.
- Memory Care - Sometimes referred to as “special care,” these units provide for those suffering from Alzheimer or other memory impairing conditions that need attention that is more intensive.
- Skilled Nursing and Rehabilitation - This option provides both short and long-term acre in an on-campus healthcare center.
A CCRC is a financially wise decision for a number of reasons.
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:
There are many stops along the aging path and independent living is only one of them. With an average stay of three to five years, independent living facilities are in a constant state of turnover. Independent living attracts seniors traveling along the care continuum, offering what residents desire, which means either affordable or increasingly upscale options. They also want health-care access when and where needed.
The aging of the independent living population presents some unique financial challenges. People are living longer, so the average resident is older now when they move into an independent living facility than they were five years ago. The average resident is more than 80 years old, more fragile, and has more health concerns. Over half live with some sort of assistive device – a cane, wheelchair, or walker.
In order to provide the best service to your clients, it is necessary to know Medicare Requirements for skilled nursing facilities. The nursing home reform law, the Omnibus Reconciliation Act of 1987 (OBRA '87), and Advancing Excellence in America's Nursing Homes (a campaign launched by a coalition of consumers, health care providers, and nursing home professionals), as well as other campaigns serve as the foundation for the Medicare Five-Star Quality Rating System.
In order to assess the rating of a skilled nursing facility, three sources of data are used:
When an occurrence happens that puts your facility at risk, is not the time to begin to be concerned about risk management. The best protection for your facility considers three areas: 1) good management 2) up-to-date, reviewed personnel policies and 3) well-designed insurance coverage.
All the efforts taken to manage a facility well contribute to sound risk management. Fully attentive administrative staff with a wide range of skills may be the most important guard against major risks.
Careful strategic planning and effective supervision helps ensure organizational resources is closely aligned to accomplishing the facility’s mission, and that staff and volunteers are treated fairly and comply with rules and regulations.
Management skills needed for nursing home supervision include:
Facilities for seniors have some unique security challenges. Residents require protection along with the care and comfort they are provided. As a broker who provides service to agents addressing the coverage needs of elder care facilities, it is important for you to understand the security problems and requirements these facilities must address.
Violence has increased in our society. This has increased the challenge to provide a safe and secure environment for elder care facility residents. Additionally, technological advances have allowed facilities to employ sophisticated monitoring equipment, alarms, and security systems. Litigation also has had an impact on the security functions of personnel in elder care facilities.
Senior care facilities present some unique security challenges. When the elder care facility is establishing security, the following areas must be addressed to meet these challenges:
Seniors with chronic conditions who are not able to live independently and do not need constant care can use the services of an intermediate care facility. First established in the 1980s to help transition hospitalized elderly to their home within a few months, intermediate care facilities provide nursing care and rehabilitation. It is interesting to note that initially, only half of the elderly discharged patients were able to return home and nearly 25% stayed in the intermediate care facility for over one year.
Intermediate care facilities provide supportive care and nursing supervision under medical direction twenty-four hours per day. The goal is to use rehabilitation therapy to enable individuals to return to a home setting and regain/retain the functions of daily living if possible. To that end, a full range of medical, social, recreational, and support services are also provided. Intermediate Care Facilities are also known as Rest Homes with Nursing Supervision.
As an agent, your clients may be asking about their insurance rates: “Why did my insurance premium go up? , or “Since I have never had a loss, why didn’t my insurance rates go down this year?” Insurance rates, for the most part, have gone up anywhere from 6% to 15%. There are a number of reasons for this increase.
A “Hard” Market
After about five to six years of a “soft” market, we are starting to see the market turn “hard”. Mortgage rates and government bond rates have hardly ever been as low as they have been for the past few years. Previously, when government rates were in the five to seven percent range, insurance companies were able to offset the claims they were paying out by parking a percentage of their premiums in these bonds, which in turn, helped keep rates low. Now, with government bonds yielding barely one percent, insurance companies no longer has that cushion to help with insurance claims.
An incident report is a form filled out to record details of an unusual event that occurs at an assisted living facility involving a patient. Guidelines usually require an incident report when an event occurs that harms an individual, illustrates a potential for harm, or evidences serious dissatisfaction by patients, visitors, or staff. An example of an incident requiring a report would be if a patient's visiting family member helps him out of bed despite directions to the contrary by staff members and the patient falls and is injured.
Incident reports must be completed promptly with all the circumstances surrounding the event, while the details are