It happens in an instant and can be devastating and life changing for countless people: ACTIVE SHOOTER! Most recently our nation has faced some social challenges that give us reason to pause. As we ponder the “why” of such situations we should also be thinking, “What can I do to prepare my center for an unexpected event while not instilling fear?”

A study conducted by the Office of the Inspector General (OIG) from 2008-2012 identified that an estimated 22 percent of Medicare beneficiaries experienced adverse events during their SNF stays. An additional 11 percent of Medicare beneficiaries experienced temporary harm events during their SNF stays. Physician reviewers determined that 59 percent of these adverse events and temporary harm events were clearly or likely preventable. They attributed much of the preventable harm to substandard treatment, inadequate resident monitoring, and failure or delay of necessary care.

More and more research and investigation has revealed the great need for quality sleep in the elderly. Evidence has shown that the outcomes of better quality sleep may encourage better healing, reduce falls, and reduce use of psychoactive medications—ultimately improving behaviors and psychosocial well-being.

Falls happen every day in senior living communities. While we may not be able to avoid falls completely, there are some smart and proven ways to significantly reduce them.

As we travel around the country visiting communities and partnering with them for improved outcomes, we often identify areas of risk associated with incident trends and tracking. In a perfect world there would be no falls, elopements, burns, or lacerations—but the world we live in isn't perfect! Unfortunately, neither are many of the systems your QAPI committee depends on to keep on track and reduce incidents with injuries.

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.

When we talk about risk management, we often overlook one important aspect of how we provide care to our residents: staffing. So, let’s talk about staffing. How do you staff your community: are you staffing by acuity, census, or “clinical acuity”?

The long term care industry has regulations that require you to be attentive to the quality of care and quality of life you deliver to your residents. Communities should place a much greater emphasis on the Quality Assurance/Performance Improvement (QAPI) process, coupled with a proactive and ongoing risk management program.

The unfortunate truth in our industry is that active shooter policies, procedures, and training are not only necessary but required, depending on your community’s level of care and licensure. There is so much information from FEMA, OSHA, Homeland Security, and other sources that it can be overwhelming to review.

It's a well-known fact that many resident falls aren't preventable. But it's still our responsibility to decrease the risk of significant injuries related to falls.

A large study from Canada showed that frail, elderly patients face a significantly increased risk of mortality in the year after undergoing major elective, non-cardiac surgery. Being frail before surgery substantially increases the risk of adverse postoperative outcomes and that frailty had the strongest impact on the risk of mortality after total joint arthroplasty.