RISK MANAGEMENT

How ancillary and agency staff affect litigation risks

The impact of ancillary and agency staff in senior living for possible litigation centers on increased risks related to understaffing, inadequate training, continuity of care issues, and negligence claims. Facilities that rely heavily on agency staff or ancillary workers without ensuring proper staffing levels and skill competency may face legal exposure due to harm caused by neglect or poor care, leading to lawsuits for personal injury, negligence, or wrongful death.

Key Litigation Risks Specific to Agency and Ancillary Staff

• Agency staff and ancillary staff are often used to fill staffing gaps but may not have the same familiarity with residents or facility protocols, increasing the risk of errors or neglect.
• Heavy reliance on temporary or agency staff can contribute to staffing inconsistencies and gaps in supervision, raising the likelihood of resident harm that can prompt litigation.

Legal and Regulatory Considerations

• Facilities can face civil lawsuits, regulatory penalties, fines, and license restrictions if staffing deficiencies lead to resident harm.
• Regulatory bodies may impose sanctions if staffing requirements are not met, but enforcement gaps can sometimes allow chronic understaffing and agency reliance to persist until litigation occurs.
• Facility management and operators bear responsibility for ensuring adequate, competent staffing, whether permanent, ancillary, or agency.

The use of ancillary and agency staff in senior living carries important litigation risks primarily linked to staffing adequacy, continuity of care, and duty of care breaches. Facilities that do not carefully manage and integrate these workers may face lawsuits from neglect or injury incidents attributable to staffing failures.

RISK MANAGEMENT

Enterprise risk management in long-term care

Increasing resident acuity, continuing workforce shortages, looming government staffing mandates, evolving technology, and rising claim values. This shifting landscape for long-term care providers presents many challenges and managing these risks requires a holistic approach to ensure residents are provided safe and high-quality care.

Assessing risks on a departmental level is not sufficient in today’s environment. Long-term care providers must adopt overall strategies, or Enterprise Risk Management (ERM) strategies, which include clear documentation and communication protocols, attention to customer service, strong hiring and training practices, leadership oversight and visibility, compliance with admission and discharge practices to ensure caregivers can meet needs, setting realistic expectations for residents and families, taking responsibility for incidents, and building relationships.

Key components of Enterprise Risk Management

One approach used for ERM across industries is based on the framework published by The Committee of Sponsoring Organizations (COSO), which considers risk in strategy-setting and in driving performance. COSO notes ERM is not a “function or department.” They define the components of ERM as:
– Governance and Culture
– Strategy and Objective-Setting
– Performance
– Review and Revision
– Information, Communication, and Reporting

How Excelas supports Enterprise Risk Management

Excelas supports our clients’ ERM programs through data abstraction, audits of medical and related records, and record production support. These audits can reveal gaps in documentation, provide documentation support for claim submissions, and compliance with regulatory requirements. Excelas’ experienced legal nurse analysts can evaluate your facility’s compliance with your current risk management guidelines as well as provide recommendations for documentation improvement.

As we enter the fourth quarter, to ensure everything is finalized well before year-end, now is the ideal time to submit your work for review. Contact Excelas today!

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Excelas helps organizations respond accurately and quickly to claims and litigation brought against them

Partnering with attorneys, health care organizations, and insurance companies since 1995, Excelas provides medical legal analyses and tools for building winning defense strategies. When expertise, accuracy, reliability, and on-time delivery count, you can count on Excelas.