The best claim is the claim you never have to file—so reducing risk is a big deal for us. Our parent company, HealthCap, visits nearly every member on their premises every year to help them deliver better quality to their residents, families, and employees. The visits involve a mix of consultation, data gathering, and analytics. As a by-product, we help reduce claims.
After 15 years of working with member communities, we've consistently seen four top ways to reduce risk across communities.
1) Staff Appropriately
That sounds pretty obvious, but our risk managers visit over 1,000 communities a year and some communities simply don't staff appropriately. Several factors make it increasingly difficult. It's hard to find the right people with the proper skills and attitudes, and reimbursements are under increasing pressure. But the most overlooked aspect of staffing is matching the right staff with your residents’ acuity.
In litigation against senior living communities, the anthem that plaintiff attorneys sing is, “Profits Over People.” It's really easy for them to sing it if your communities are chronically understaffed. There is currently a trend in the industry where certain ownership groups try to solve their financial problems by cutting staff. With personnel costs being such a large part of your overall cost structure, it makes sense. But because staffing data is now publicly available, you're an open book.
2) Protect Your Star Rating
We all cursed the dreaded star rating system when it was introduced and we will be cursing the changes to it. One thing is sure: the star rating system is here to stay. Inhale. Exhale.
By maintaining your star rating at three or higher, you will get sued less often – substantially less often, even if the quality of care you provide is the same. That's the data talking and the data says that one-star and two-star communities get sued much more. Staffing data is public and your star rating is public. If you were a plaintiff attorney and your cupboard was bare, would you take the fall case from the two-star community or the four-star community? Enough said.
3) Create a Great Culture
Culture is like yeast or yogurt. The beginning determines the end. Culture has to start in the home office because, like yeast, what starts in the home office will spread.
I saw a great example of this at a golf outing for a provider’s charitable foundation. Now this isn’t any provider, but the poster child for quality operations and corporate culture in the senior living industry. At the golf outing, it was a bright, sunny day and the staff volunteers were incredibly cheerful and gracious. Later in the day, the company CFO introduced me to their newest community twenty miles away. When we walked inside, the staff at the new community behaved exactly the same as the staff at the golf outing. They were to a person incredibly cheerful, gracious, and energetic. Even the ones who didn’t see the CFO coming. This is a clear-minded, high-performing, demanding organization – but they are both firm and friendly – they have high expectations as well as high accountability.
You can run a high-performing organization with a cheerful disposition and your team will be all the happier for it. On top of that, a happy and engaged staff is the best advertising you can have. They are your best risk management as well.
4) Know Exactly What's Going on Across Communities
So how do you do that? You can start by staying in touch with your administrators and DONs. That's good, solid management, but there's a limit to what you can glean from the different accounts. We are by nature story tellers. So it's easy for us to get a feeling about one community versus another based on how we feel about the administrator of each. It's also easy for a little bias to intrude. According to a statistician friend, the plural of anecdote is "not data."
How do we get good data about risk? It's ordinarily tough, time consuming, or expensive. Your EHR system is designed to help you provide excellent individual care, but it really doesn’t provide you with a community-wide or multi-community view. You can compile – or better yet, get someone else to compile – your paper incident reports and drop them into a spreadsheet. Besides being expensive, you can have really inconsistent reporting between shifts, and especially between communities, and that can be worse than a bad anecdote.
One way to overcome the expense and difficulty of aggregating incident data is to access a ready-made system that does it for you. QA Reader is an incident reporting and analytics application that allows you to easily forward your incident reports, inputs your data for you, and provides you with multiple easy-to-access reports and analytics. And it benchmarks your communities against each other and the industry.
QA Reader lets the administrator or CFO of one community see what days of the week, shifts, or units have the most incidents. For those responsible for multiple communities, they get the same perspective and can also clearly see how communities compare to each other.
Providing great care through a great culture is the best way to protect your reputation and lower your risk. Targeting your focus using data analytics further insulates your residents and team from the impact of adverse events.
Next Steps
- Get more great content—subscribe to our blog
- Find out how QA Reader helps make you a top LTPAC management team
- See QA Reader in action—request a live demo
