Highland Risk Services
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.
As a national insurance wholesaler for agents who serve allied health facilities, it is important that you understand the allied health field. One of the unique challenges faced by allied health facilities is significant and continuing growth.
Lead health professional of Public Health England, Linda Hindle, noted that allied health professionals might be the next major public health workforce in England, with more than 80,000 workers in private, government, education, and voluntary work. The growth has been significant in the United States as well, with more than 5 million workers providing 60% of the health care workforce in more than 80 different allied health professions. In addition, the number of US allied health professionals is expected to increase from 15-20% by the year 2020 according to the Bureau for Labor Statistics.
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.
As a national insurance wholesaler providing coverage for elder care facilities, it is important to stay abreast of rehabilitation methods. Dancing enhances both cognitive and physical abilities, so it is ideal as a method of rehabilitation. As people age, certain physical characteristics can change, and even decline. Staying active, both physically and mentally, can help slow the progression of disease and prevent decline in seniors.
Gait is considered the sixth vital sign. Any measure below 2 feet per second is of concern for older adults. Seniors with slow gait are more likely to be:
- Dependent on others for care
- Prone to falls and the resultant broken bones
- Dependent on pain relief medication
With this in mind, researchers at the University of St. Louis looked into dance as a way to potentially increase and stabilize gait. Additionally, they wanted to find out if dance could help reduce pain and stiffness in the hips and legs in the elderly.
In addition to providing information to our agents, we seek information our agents can use when serving the needs of their clients. With that in mind, this article will look at elopement in elder care facilities – who is most likely to do it, and what can be done to prevent it.
One of the primary risks for seniors residing in elder care facilities is their ability to put themselves in harm’s way by leaving the facility unaccompanied and unobserved. Referred to as elopement, this risk primarily affects those with dementia, who may be looking for someone or something familiar. What can an elder care facility do to prevent elopement of its residents?
Understand the Reasons
It is important to understand why a person wanders, so the facility can take appropriate steps for prevention. Many elderly individuals with cognitive issues may wander for reasons, which, on the surface, may not be clear. They may be trying to meet an elemental need such as using the bathroom or getting a drink of water. They may be reacting to something they do not like in the facility’s environment. Or, there may be medical conditions behind their wandering.
When we want to know something, we automatically do a Web search. It is quick, convenient, and provides current information. So, when a family needs to find assistance for an aging parent, or senior needs to make plans when they reach their golden years, they search the Web. They conduct searches for available options and the personal experiences of others. An Internet survey conducted by Pew indicated that 8 out of 10 caregivers have Web access, and 90% of those individuals use it for finding health information for someone else. Since seniors, their families, and caregivers utilize this resource, it makes sense for those providing elder services to create a professional, personal, and positive on-line presence.
A recent survey conducted by G5, a provider of services to senior living facilities, indicated that 75% of consumers do not trust what companies say about themselves; consumer reviews are twelve times more likely to be trusted. For this reason, a facilities website should not only include client’s positive comments and news articles related to the service you provide, but also objective informational content from external sources.
After 7 years of amazing service, Cynthia Richey has retired from Highland Risk Services. Cynthia has been with us since 2008, and her industry experience and hard work were an instrumental part in Highland Risk Services’ growth into the company you now know. We will continue to meet and exceed Cynthia’s exceptional quality of work, and we promise to take care of the relationships she has worked so hard to foster for Highland.
Cynthia’s other passions included work for her church. She was instrumental in starting the Recreational Outreach Center specifically servicing at-risk youth striving towards higher education. She has decided to pursue this passion full time, and we are happy to know her talents will be greatly appreciated in her new venture.
Cynthia’s name is synonymous with success, and we ask that everyone thank Cynthia for her support and dedication over the years.
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:
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
When it comes to home healthcare, fraud and theft are major areas of concern. Every effort must be made to prevent fraud and theft, as occurrences not only affect the well-being of patients, but can also harm a client’s reputation.
Health care fraud occurs when false information is represented as truth. Perpetrators exploit patients by entering into their medical records false diagnoses of medical conditions they do not have, or of more severe conditions than they actually do have. Then bogus insurance claims can be submitted for payment.
Home healthcare fraud claims also involve intentional incorrect billing of Medicare. According to the Senior Medicare Patrol (SMP), “An estimated $250 million is lost to purposeful health care fraud each year.” Examples of fraud that may occur include:
Owners of an assisted living facility that houses 17 or more unrelated individuals in Illinois must be licensed by the state. Additionally, 80% or more of the residents must be 55 years of age or older. The facility must also be providing personal and health services twenty-four hours a day with staff assisting with personal needs such as dressing, eating, and hygiene.
Generally speaking, assisted living facilities are not for individuals who require more than one caregiver assisting them in their daily activities. Assisted living facilities are prohibited from admitting residents who pose a threat to themselves and others. Also, residents must need only minimal assistance moving to a safe area during an emergency.
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.
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.
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:
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:
Real Estate firms face a variety of professional liability exposures while operating their business. That is why it is important for them to partner with insurance specialists that understand these exposures and can help manage the risk.
Medical imaging centers use technology to take images of the inside of the human body. Medical imaging is sometimes referred to as diagnostic imaging because it is frequently used to help doctors arrive at a diagnosis.
Medical imaging has had a tremendous effect on diagnostics and the treatment of disease. Consider the following:
- Mammography screening for breast cancer has resulted in better treatment options, improved survival rate, and a declining death rate.
- Coronary CT angiography performed to examine the heart vessels in patients with chest pain has helped guide treatment decisions with high accuracy, avoiding costly invasive procedures.
- Life expectancy in the United States has significantly increased due to incorporating advanced medical imaging procedures into healthcare.
Many families are keeping senior members at home rather than choosing an assisted living or other residential health facility. However, families need to continue with their daily activities and need assistance caring for their elderly family member during a portion of the day. Adult care facilities provide this service. It is estimated that there are currently more than 4,000 of these facilities in operation and the number keeps growing. This is due in part to the increased life expectancy and better quality of life of our aging population. As the population of older Americans increases, so does the need for adult day care facilities.
Adult day care facilities provide meals and social activities for seniors. Additionally, medical and health services are available. The facility also administers medicine and provides necessary therapy. Of course, the variety of services increases the range of risk for both the senior participants and the employees.
Common risks associated with adult day care include, but are not limited to:
Since healthcare clinics treat a wide variety of conditions, including asthma, cardiovascular disease, diabetes, and hypertension, it is imperative healthcare clinics ensure that patients receive the appropriate level of care. Additionally, many healthcare clinics also provide obstetric care, a high-risk area.
Risk management for healthcare clinics includes any activity, process, or policy designed to reduce liability exposure. This involves all aspects of a healthcare clinics infrastructure and services, including clinical care, financial matters, facility maintenance, fire safety, and compliance with applicable laws and regulations.
Top risk management issues for healthcare clinics are:
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.
There are over four hundred long-term acute care hospitals (LTACH) in the United States that house critically ill patients. Sometimes unresponsive or in comas, patients may live there for months, or even years, sustained by respirators and feeding tubes. Some, such as those recovering from accidents, eventually will leave; other patients will be there for the rest of their lives.
About $26 billion a year is spent on critical care in acute care hospitals in the United States. Some estimate that the number of patients in these facilities has more than tripled in the past decade to 380,000.
The reason for this growth is two-fold:
- The increase in our aging population increases the chances of a catastrophic illness like blood sepsis or acute respiratory distress syndrome that eventually may send patients to acute care hospitals.
- Improved medications and medical technologies are keeping people alive longer requiring an increased need for intensive care.
The result is an increase in patients who require nearly constant care; they survive intensive care, but must remain on life-support. They cannot go home and a rehabilitation facility cannot meet their needs.