Archives for May 2019
RISK SOLUTIONS—Your business is answering a growing need that’s important to not only its Participants, but their Families and Communities.
And whether it’s called an Adult Day Services Center, a Senior Day Care Center, an Adult Day Facility, or by another term — to ensure that your business can continue its mission — you need to be adequately protected from risk.
We’ve asked an expert Risk Management Consultant to list the policies you need to safely operate your Adult Day Services Center.
Insurance Needed For Adult Day Services Centers:
- Property Policy;
- General Liability;
- Professional Liability;
- Automobile Policy;
- Umbrella Policy;
- Workers’ Compensation;
- Directors & Officers Coverage;
- Environmental Protection Liability;
- Crime Policy;
- Pollution Policy; and
- Cyber Liability Policy.
Insurance Needs Details
A fully-built out building, with safety considerations in place, will — in most cases — result in higher construction costs. Your property should be insured to its true value and on an all-risk basis.
Buildings should also include appropriate alarms, exit plans and other safeguards.
TIP: Slip resistant floors are a must, along with an ample use of handrails.
A basic General Liability Policy, also known as Third Party Liability, is necessary to protect you from claims made by the Participants, visitors and others due to incidents, such as slips and falls or accidental food poisoning.
Your General Liability Policy should include Medical Payments, Coverage of Property of Others, Fire Legal and more.
TIP: Be prepared and have emergency plans in place. It’s not a matter of “if” someone will fall, it’s more a matter of “when.”
Because of the nature of your work and mission, a Professional Liability Policy is needed to protect your staff and your Limited Liability Company from charges of Medical Malpractice.
Coverage should include assisting Participants with the taking of their personal physician-prescribed medication, as well as Sexual Molestation and Abuse, HIPPA Protection and Subpoena Exposure.
TIP: Some Centers use pill packs, with Families and Caregivers required to refill the packs on a weekly basis.
Besides having fully-qualified and well-screened drivers, having an adequate Automobile Policy for your Center-owned fleet is of the utmost importance.
Your policy should have high limits of coverage for Bodily Injury and Property Damage to meet your Umbrella requirements, as well as Medical Payments, and Uninsured/Underinsured Liability.
TIP: Have daily, weekly and monthly maintenance schedules and keep good records, with employee names, dates and times for checking off these requirements.
An Umbrella Policy is the most economical manner in which to reach the higher liability limits required or desired for the best protection against risk.
A true Umbrella Policy provides Excess Liability Coverage for named exposures — such as General Liability, Automobile Policy, Workers’ Compensation and others — and in many cases, will also provide protection for uninsured exposures.
TIP: Make sure the basic policies you’re buying the Excess Liability for are listed and meet the underlying requirements of the Umbrella.
Workers’ Compensation Coverage is required by state law and protects your company from death or injuries to employees.
Workers’ Comp also protects employers from third party lawsuits.
TIP: Make sure your Workers’ Comp Classification Codes are correct to prevent erroneous overcharges.
Directors & Officers Coverage
Also known as D & O Coverage, this type of policy protects the Directors and Officers of your company from personal lawsuits lodged against them for their alleged wrongful acts.
Among all the policies you obtain to protect your business, this is the only one that protects you personally from charges not safeguarded by the corporate shield.
TIP: Some managers can also be included in D & O Coverage.
Employment Practices Liability Insurance
Abbreviated as EPLI, this type of policy protects your business from Employment Liability claims, which are normally initiated by the Equal Employment Opportunity Commission (EEOC).
EPLI Policies provide protection from EEOC claims such as Wrongful Discharge, Sexual Harassment, Age Discrimination and Gender Harassment, among others.
TIP: Create an Employee Handbook and have stringent employee guidelines and reporting policies. Non-harassment training can also be included in your ongoing educational efforts.
A Crime Policy will guard against the loss of business assets through criminal actions, including those involving the internet or phone.
A Crime Policy will also safeguard your company from losses of property belonging to your Participants.
TIP: Along with being required for your operating license, deep employee background checks can help protect your Participants and fellow employees, as well as you and your company.
Pollution Policies secure your company from losses due to the run-off of pollutants or seepage from your facility.
Some Pollution Policies can also be written to include coverage for clean-up costs of pre-existing polluted areas.
TIP: Have policies in place for dealing with garbage and any other refuse.
Cyber Liability Policy
A Cyber Liability Policy will defend your business from losses from computer hacking or other invasive actions taken against you via the internet.
Associated losses suffered by third parties are usually included.
TIP: Have strong anti-viruses, anti-malware and firewalls on all computers, plus a strict data policy concerning sensitive client and employee information.
Protect Your Investment
“To open your Adult Day Services Center; vast efforts, money and time have to be spent prior to seeing any return on investment,” said Walter Haney, Sr., of American Risk Managers.
“In order to protect this investment and other assets, you should obtain all of these important insurance coverages.”
Besides providing the list of insurance needs above, Mr. Walter also shares more risk information and considerations about Adult Day Services below.
General Overview & Considerations
“Most Adult Day Services Centers are, first of all, very specialized small businesses,” Mr. Walter explained. “The product (those served by the Centers) is unusual and requires extreme care and treatment.
“While the insurance requirements are generally the same as for any other small business, the product demands certain changes and accommodations of facilities and insurance programs.”
Mr. Walter explained that the product or “Participants” includes aged human beings, who are being reclaimed from solitary loneliness, dementia and depression.
“Their needs are primarily nourishment and socialization,” he said, noting that social engagement has been credited by some with helping to ward off dementia and other isolation-related illnesses.
“Some Participants will have other needs,” he added, “such as assistance in taking their doctor-prescribed medications. (Centers must have qualified persons on staff that can administer medicines according to the individuals’ doctor’s orders.)
Mr. Walter noted that some Participants may or may not need assistance in moving about. “Or just general assistance in accommodating themselves to a new and strange environment,” he said.
Isolation & Loneliness Have Tremendous Impacts On Seniors’ Health.
Many Facets Of Care, But One Primary Aim
Mr. Walter noted that Adult Day Services Centers have many facets of care for the elderly, but their primary aim is to get Participants out of situations that can lead to severe depression, dementia and other mental conditions, which, he said, can and do lead to decayed living conditions and an early death.
“Various Senior Care Facilities may have other points of treatment goals,” he said. “But a common goal is to take these Participants out of their singular lifestyles — where they may be dealing with a lack of social interchange, unhealthy eating habits and incorrect use of medications.
“All of these activities can change a vibrant individual into a depressed and disease-ridden person,” he said.
Pleasant Surroundings & Activities
To correct these problems, Mr. Walter noted that Adult Day Services Centers get Participants out of their homes, with their possibly depressing auras, into more pleasant surroundings.
“Participants are introduced to persons of similar age brackets and encouraged to engage with the other attendees in devotions, group singings, exercise classes, television viewing and group discussions,” he said.
Toward those ends, Mr. Walter noted that property for Adult Day Services Centers must be purchased and refurbished to a high level of habitational accommodation.
He stressed that buildings used for Adult Day Services Centers must provide adequate floor space for all the persons using the facility. He said efforts to ensure safe and amiable environments include having large spaces, which can then be used as separate assembly places.
“Having activity areas qualified by floor areas allows Participants to have cheerful spaces to engage in for exercising, singing, devotional activities and other group mingling,” he said.
He also noted that designated areas are easier to keep clean.
“Separate spaces also help to reduce the transmission of communicable diseases, such as colds and flus, and cut down on the possibility of falls,” he said. “Plus, spacious atmospheres also improve the mental attitudes of Participants.”
Social Activities Help Seniors Feel Valued & Treasured.
Must Match Medicaid Requirements
Mr. Walter said a vast majority of Participants are provided with the necessary funds to attend Adult Day Services Centers through their Medicaid Policies.
“Medicaid places requirements on the education and experience of the staff,” he noted. “Qualified staff must be employed prior to the facility being opened to become eligible to accept Medicaid-sponsored Participants.”
Regarding transportation, he explained that most Participants are normally picked up from their residences and transported to and from the Centers by vans owned by the Centers.
He stressed that these Center-owned vans should only be driven by highly-qualified drivers employed by the Centers. Drivers should also be well-supervised and managed, with motor vehicle records closely reviewed by Center personnel.
A Typical Day Includes Lots Of Activities
At most Centers, Participants are usually served a couple of meals per day and snacks, which include a nutritious breakfast and a healthy lunch.
Staff and Participants are encouraged to mingle and interact during the numerous activities scheduled throughout the day, with guidance provided by designated Activity Directors.
“Specialized programs must be developed to provide for the Participant’s comfort and security,” he said.
“The aim of these activity programs is to prevent the destruction of quality lives, to foster an atmosphere to recover Participants who have regressed into depression, dementia or drug and alcohol dependency, caused by being cut off from social interaction and malnutrition.
“All of these destroy a precious resource — our elderly parents, kinship and friends every year. Center activities help rescue senior adults from failing atmospheres as they enter what are supposed to be their golden years.”
Mr. Walter concluded his remarks by asking others to share the benefits of Adult Day Services to those in need.
“If you know someone who is elderly and who has limited social access, you are encouraged to help them reclaim their place in society,” he said.
The Name Game
You’ve probably already named your Adult Day Services Company (let’s abbreviate to ADS for this section).
But if you are reading this as part of your research before opening your Center, you might be interested in what Brahna Trager shared with the United States Senate in a special report dealing with the rising need for ADS back in the late 1970s.
Since that time, many states have gotten onboard with ADS and provide some sort of funding, realizing that services of this type help wave off elderly decline and cost much less than nursing home care.
But it was Ms. Brahna who helped lead the way all those decades ago.
In her report, she said many businesses were hesitant to use the term “Day Care” in an effort to avoid “The simplistic application of the childcare concept to a set of community services for adults.” She mentioned that the services provided involve “choice and full participation.”
Ms. Brahna noted that one facility objected to the comparison by stating, “We are not a place where people are left in safety as children are left, until someone is ready to ‘pick them up’ again. Our services have an objective, and those who are consumers are not children.”
She also emphasized that persons using these Centers should be called “Participants” rather than “Patients” in order to emphasize their ambulatory status and their need for a variety of services.
“They are adults who may be limited for shorter or longer periods of time in their capacities for total self-care,” she said. “But they are Participants in their own care programs, with everything that the term implies.”
She stated that ADS are a health care resource that is just as essential in communities as Hospitals, Rehabilitation Centers and other facilities.
Her report reflected positively on the need for ADS, and the importance of allowing an individual to sustain their relationship to their home environment and continue using their own bed each evening.
Your Local Area Agency On Aging Is A Great Resource For Senior Services.
For More Information
If you are seeking more information on insurance, an Independent Risk Management Professional can work with a broker as your advocate and help design the best program to fit your needs. And they’ll probably be able to save you some money in the process.
If you’re starting an ADS Center or are running one now, you may want to join the National Adult Day Services Association to find lots of resources.
And if you’re looking for material to help Participants and Families who are considering ADS, HelpGuide.org offers suggestions on how to find a center, more details about services and benefits (including benefits for Caregivers), questions to ask ADS providers, a site visit checklist and more. They have given us permission to link to one of their extensive articles here.
Please Contact Us If We Can Be Of Service.
(Photo Credits: Feature Photo of Smiling Man and Woman; rawpixel.com/Pexels; Man With Hand On Face – Gerd Altmann/Pexels; Lady In Isolation – Isabela Naiara Matlide/Pexels; Lady Smiling & Watching Participants – Luizmedeirosph/Pexels; Man in Hat Smiling – Brett Sayles/Pexels; and Hands – rawpixel.com/Pexels.)