Currently browsing Blog

Helpline Spotlight: How do I approach COVID-19 vaccinations with staff?

Ask OmniSure is a series that answers real risk and safety questions from policyholders and insurers all over the country.

Some staff at my nursing home have elected to turn down the first round of COVID vaccinations, leading residents and families to voice concerns about those staff members. Should we mandate vaccination?

While most of the world is anxiously awaiting their COVID-19 vaccination and with it a dose of normalcy, not everyone is keen on being the first in line. Some healthcare workers have expressed concerns about being among the first to receive the new, quickly approved vaccine. What employers and staff need to know is that while it is completely legal to require staff to get a COVID-19 vaccination, that course of action may not yield the best results.

Strict vaccination requirements can lead to staff shortages or pushback from employees and media. Brett Coburn, an attorney with Alston & Bird in Atlanta, recommends, “Rather than implementing mandates that could lead to such difficult decisions, employers may wish to focus on steps they can take to encourage and incentivize employees to get vaccinated.”

Facilities can implement the following before turning to a mandate:

Vaccination education campaigns
Improving access to vaccination
Cover costs associated with the vaccination
Provide paid time off for employees to get the vaccine and need to recover from any potential side effects

Companies like Trader Joes, Dollar General, and Aldi have introduced incentives for employees who opt to get the vaccination. Many groups that would offer incentives but haven’t yet are urging the EEOC to to clarify legality of vaccine incentives so as not to violate any rights per the ADA.

As the number of staff receiving vaccination increases, facilities should continue to stay in communication with residents and family members. It’s important that involved parties know what steps you are taking to ensure the safety of all staff and residents.

OmniSure Specialist on Senior Living and Home Health Care, Diana Patten, LNFA, CALM, CDP, HHA recommends thoughtful and frequent communication to residents re-iterating that the facility is continuing to follow guidance from the CDC which still includes using appropriate PPE and practicing strict infection control practices.

OmniSure offers 24/7 on-demand advice for policyholders through our helpline. In 2020 our helpline saved our insurance partners an estimated $15.5 Million — reach out to an expert today to learn how you can prevent risk and improve care for your policyholders.

5 Reasons Insurers Need OmniSure

Successful insurers attract, bind, and retain the right business at the right price with the combined ratio they desire. OmniSure can assist in all these areas with our invaluable resources and many years of industry expertise resulting in a more profitable book of business for you. Here are the top five reasons you need OmniSure:

1. Attract Better Risks

You want to attract quality providers and operators to your insurance program. Quality providers of healthcare and human services are less likely to have losses because they are eager to reduce risk and improve outcomes, and they expect their insurance partner to provide the supportive services needed to help them achieve their risk management goals. OmniSure provides training, resources, on-demand advice from experts, and comprehensive assessments to help your policyholders avoid, reduce, and better manage the risk of claims.

2. Select and Write the Best Risks

Our technical expertise and dedicated specialists help you craft better policies by more deeply understanding and staying up to date on the latest trends, regulatory changes, and service offerings in healthcare and human services. Whether it’s deep insights on emerging risks, training related to a specific business niche, or prebind risk consults on potential new business, our specialty-specific clinical knowledge is your key to selecting, underwriting and properly pricing the best risks.

3. Maintain Better Relationships

We go beyond the initial risk assessment and recommendations to help you stay profitable. OmniSure produces co-branded educational materials and stays engaged with your policyholders on your behalf, equipping them with a library of tools, training videos, and the ongoing support they need to avoid losses and improve outcomes, at no additional expense. Policyholder engagement not only reduces losses, it builds relationships and drives retention.

4. Reduce Risk and Control Losses

Risk assessments provide a snapshot widescale look at your policyholders’ operations but it’s what happens during the policy period that determines the outcome. Because OmniSure stays engaged with your policyholders throughout the policy period, we help identify and address issues in real time, as they arise. Policyholders get monthly risk tips are continuously encouraged to take advantage of our confidential helpline for advice-on-demand, which is answered live 24/7. And they do! OmniSure’s deep bench and nationwide network of diverse specialists mean your policyholders get personalized pre-claim loss prevention advice from consultants who speak their language because they’ve worked directly with their unique profession or business.

5. Retain and Refine the Risks You Want

Long term success in this business is the result of valuable relationships built on mutual trust and exceptional service. You want to know that your policyholders are doing what you expect of them and they want to know you are there when they need you most. We are key to building that relationship; a trusted set of outside eyes and an advisor for you when it comes whether and at what terms to renew; and a caring professional for the policyholder with the advice they need when they need it. Many policyholders are happy to renew, even if it means paying higher rates than they could get elsewhere, because of the service they’ve received from their carrier by way of OmniSure.

BONUS: Better care. Saving lives.

If you are in the business of insuring healthcare and human service organizations, and you provide your policyholders with OmniSure’s services, you are extending more than professional liability policies. Your offering extends the benefit of better care and saving lives. Policyholders tell us regularly that our risk assessments and recommendations, advice-on-demand, and proactive risk and safety resources have saved their patients’ lives and in some cases their very careers.

If you’re interested in learning more about partnering with OmniSure to build a successful book of business, prevent losses and improve care, get in touch with one of our experts today.

Advice for Healthcare Professionals After an Adverse Event

Caregivers are often emotionally vulnerable after an unanticipated or adverse outcome. They may experience fear, guilt, frustration, defensiveness, and general distress. This can cause them to do things that are inconsistent with their standard protocols. It’s important to remember that negative outcomes happen in patient care and it’s rarely because of any intention on the part of the healthcare provider.

In the event of an adverse outcome, keep this advice top of mind to avoid further harm to you, your patient, or your organization:

Avoid doing anything that is not in line with your standard protocols, such as completing extra written statements or summaries of the patient’s care, handling the medical record differently, or rewriting anything. Discuss all of these with your risk manager first. In other words, do not alter, add, or delete anything in the clinical record or business files.
Create a separate incident file for quality assurance, litigation, or claim correspondence.
When processing a medical record request, send copies only. Make sure that the copy you send is clear and legible. You should never release original documents from the patient chart.
If you are contacted by the media, outside attorneys, physicians, or other providers, contact your Risk Management Helpline or insurance company designee before responding.

Once an event becomes a claim or a lawsuit, it’s predominantly the responsibility of your insurance company’s risk manager, claims specialist, or the appointed attorney to manage and lead the process. Lean on them and feel free to ask as many questions as you need to along the way.

Finally, if you are asked to provide testimony, be sure to think through each of the critical issues. We also recommend practicing verbalizing your position on each of those critical issues. Be prepared to handle criticism and respond to argumentative questions. By preparing for these high-pressure scenarios, you are better equipped to present yourself calmly and professionally.

While no healthcare provider expects that they will find themselves in this situation, staying informed and calm is the best way to protect all parties involved. Have questions or need help making a plan? OmniSure experts are available for On-Demand advice. Contact us to learn how you can gain access to on-demand support and a library of helpful resources.

COVID-19 is on the Rise. What Does This Mean for Dentistry?

As COVID-19 cases continue to increase throughout the United States, many of those who work in healthcare remain at high risk, however, the pandemic presents a unique set of challenges for dentistry professionals. Because it is necessary for dental professionals to work in an un-masked mouth, they are at much higher risk for contracting respiratory viruses such as COVID-19 from their patients. So, what can dentists do to protect their patients, their employees, themselves, and their business?

The best available safeguard for dentists right now is through education and informed consent. “Dentists should remain aware of recommended practices that are likely to change over time related to the prevention of COVID-19 transmission”, said Laura Luck Martinez, Chief Risk Officer & Executive Vice President of OmniSure. Restrictions and guidelines can vary geographically. Some areas may have restrictions that only allow for emergency dental care while other regions may have fewer restrictions that allow for increased dental care services. This requires all persons to monitor recommended practice guidelines for their location closely.

The Centers for Disease Control and Prevention (CDC) recommends infection prevention and control practices for routine dental healthcare. Prioritize the most critical dental services, proactively communicate to staff and patients to stay home if sick, and know what steps to take if a patient with COVID-19 symptoms enters the facility.

Dentists must share treatment options, risks and benefits, and obtain informed consent before proceeding with any type of care. As always, healthcare professions must always respect the patient’s right to informed consent or informed refusal. However, during COVID-19 the ramifications of not fully disclosing information or obtaining informed consent can lead to serious health and safety risks for staff and patients.

The most important thing to understand about informed consent is that it is a process, not just a form. Dentists should provide written materials that are helpful to each patient and treatment plan as an aide during informed consent discussions. The patient must fully understand the risks they are taking with any treatment plan, especially during the pandemic. This process takes as long as the patient needs.

OmniSure wants to keep you and your employees safe. For more guidance and tips, contact one of our risk managers. We’re here to help you manage risk and improve outcomes.

Malpractice Claims are on the Rise in Home Health, Making Risk Management a Top Priority

In 2015, the CDC reported that 4.5 million people received home health care, and experts argue that this number has only risen in recent years. The rise in the frequency of hospital-at-home models, compounded by the COVID-19 pandemic, has contributed to dramatic growth in the sector. While home health is widely considered to be a great alternative to hospitals and nursing facilities, one overlooked area is that the industry is struggling to keep pace with demand, seeing a steady increase in liability claims since 2011.

Home health made up more than 20% of total closed claims against nurses in 2020, while professional liability for nurses in other areas of aging services only accounted for 11.2% of claims in 2020.

There are a variety of factors that can cause home health care workers to be at higher risk for liability claims, including lacking institutional support from hospitals, skilled nursing facilities, and other health care organizations. However, the main cause is more likely the rapid shift towards home health, including hospital-at-home programs, skilled nursing facilities (SNF) at-home models, in-home cancer care initiatives, and specialized at-home offerings. As the demand for home care rockets, workers are struggling to keep up and potential risks increase.

In addition to demand for care, the type of workers that take on home health positions also plays an important role. The majority of care in the home is delivered by unlicensed assistive personnel and certified nursing assistants (CNAs), placing more responsibility on home-based nurses for overall patient care.

Demand for workers in the field is expected to increase by 41% by 2026, which will outpace job growth, only expected to increase by 18%. The industry has been challenged by difficulties in hiring and training, and there has been some concern that recent immigration legislation could lead to additional staffing shortages, as a significant number of workers are traditionally foreign-born.

The current situation facing home health workers makes risk management a priority for the industry. A combination of focused hiring and training procedures and close relationships with risk management consultants, like OmniSure, are key for home health care agencies now and in the future.

As an expert in the field, OmniSure recommends maintaining regular oversight practices to monitor activities of in-home care staff along with making sure that nurses stay on top of documentation and communicate regularly with physicians involved in patient care. It’s also important that home health workers and nurses stay within their own scope of practice. Through efforts from workers, nurses, their agencies, and their risk management partners like OmniSure, the industry can stay on top of this rise in malpractice claims and continue to be seen as a key player in the field.

OmniSure is ready to support your team–see how we can help here.

Watch our home health video for more tips:

Prepping for Flu Season in a Pandemic

Healthcare workers are at risk for exposure to diseases of all kinds, and because they work with patients and handle materials that can spread infections, it is important to get appropriate vaccines to reduce the risk of spreading vaccine-preventable diseases.

This flu season, the CDC is recommending that all healthcare workers get a flu vaccine because both flu viruses and the virus that causes COVID-19 will be spreading during the fall and winter. Encouraging all people to get vaccinated will reduce respiratory illness-related medical visits and a result, the strain on the healthcare system. In this chart, you can learn more about the differences between the flu and COVID-19.

Carol Marshall, an OmniSure consultant, pointed out that flu vaccinations in the healthcare world are fairly commonplace. Mandatory flu vaccination policies differ from state to state and many leave it up to local health departments or hospitals, but it is common for nursing homes to require the flu vaccine. In a situation where an individual is unable to or refuses to be vaccinated, most nursing homes and hospitals require constant use of personal protective equipment while on shift. As a result of the current COVID-19 outbreak, constant use of PPE is already standard practice, which will hopefully reduce the spread of flu in healthcare facilities.

Requirements for COVID testing for healthcare workers who have been exposed to the virus or are symptomatic have been issued federally by Health and Human Services, and some states mandate regular submission of proof of testing. If some healthcare workers refuse to be tested, that is within their rights, and OmniSure recommends creating a policy to handle those difficult situations. If you are looking to make a plan for your facility, the OmniSure team is ready to help you through the process and answer any questions you may have.

This flu season, testing for both COVID-19 and the flu is vital because symptoms for both viruses are quite similar. OmniSure encourages clients to start ordering new testing equipment which can discern between the flu and COVID-19 early, to make sure they have supplies on hand.

Some medical malpractice insurance professionals are speculating about potential malpractice claims due to wrong diagnoses, delay in treatment, or possibility of COVID-19 or the flu symptoms masking or causing other illnesses.

On a hopeful note, there are some who think that the flu will be less of a threat this year than in previous years due to widespread preventative measures taken in healthcare environments and in public, including distancing and higher use of PPE. Marshall mentioned how many flu outbreaks start in schools, and because children are wearing masks in schools, it is possible that this risk will go down significantly.

OmniSure asserts, however, that flu vaccinations for staff and patients are just as important as in previous years to decrease the risk of contracting the flu and spreading it. In the instance of a healthcare worker declining a flu vaccination or being unable to be vaccinated, OmniSure encourages employers to follow predetermined protocols: mandatory PPE and regularly checking for symptoms. So far, worldwide the flu hasn’t spiked this year, but we will be monitoring the situation to best advise our clients. If you’re struggling with a specific scenario and are concerned about the risks involved, we encourage you to start a conversation with your consultant, and if you aren’t already working with OmniSure, we’d love to be a part of your risk management team.

Oxygen Safety Therapy

OmniSure goes over oxygen therapy safety tips providing the best home health care. With simple lists for Don’ts and the Do’s of using oxygen therapy, you can provide better care and ensure the safety of patients, friends and families, and employees.

Ombudsman Nursing Home Access in COVID-19

Recent rulings from the Centers for Medicare & Medicaid Services (CMS) protect the rights of nursing home residents by continuing to require nursing homes to give ombudsmen access to residents during COVID-19. How that access is provided, however, depends on a variety of factors.

Nursing home ombudsmen act as liaisons between residents, residents’ families, and nursing home management to ensure that residents’ rights are protected. Legally, nursing homes are required to give ombudsmen access. Because of the public health emergency that COVID-19 has presented, CMS acknowledged that in-person access to residents may be limited. In cases where infection control and transmission of COVID-19 concerns are present, in-person meetings may be inadvisable; however, facilities must still facilitate communication between the residents and ombudsmen.

How that access will be provided is a hot topic among facilities as they try to decide whether those meetings should be held in person, virtually, or on the phone, and if in person, what precautions can be taken to protect both parties. HIPAA does not allow facilities to require an ombudsman to share their COVID-19 testing results; however, the facilities are allowed to ask ombudsmen routine screening questions, including their symptoms, and use this information to develop a plan for resident access.

Carol Marshall, OmniSure consultant, encourages her clients to conduct preemptive meetings with their ombudsmen to assess risk and then plan whether to allow virtual or in-person visits. Some of her clients have used in-person methods such as outdoor visiting or plexiglass walls in a room to protect residents from possible exposure.

As a reminder to all Medicare and Medicaid certified nursing homes, they are required under law to allow residents access to ombudsmen, whether it be through direct contact or virtually. Nursing homes are also required to allow an ombudsman to examine a resident’s medical, social, and administrative records, a policy that continues to stand during this public health emergency.

For information on how to decide whether to allow in-person access, see this memorandum from CMS. In general, CMS advises the following to be considered when making a plan:

Case status in the surrounding community
Case status in the nursing home(s)
Staffing levels
Access to adequate testing for residents and staff
Personal protective equipment supplies
Local hospital bed capacity

If you’re looking for guidance on how to handle ombudsmen access to residents, OmniSure is here to help. Navigating risk during this public health emergency isn’t easy, and we’re ready to guide you.

COVID-19 Places Added Stress on Home Health Workers

Over 4.5 million people in the U.S. were receiving home health care in 2015, a number which is estimated to have grown dramatically in recent years, especially since the start of COVID-19. An already tapped workforce has only become more necessary in recent months, as care for those with suspected and confirmed COVID-19 remain at home, as well as those recovering from the virus. However, unlike many other health professions, home health workers spend extended periods of time with a patient which increases their risk for contracting the virus.

Home health workers are also particularly vulnerable because of their demographics. Nearly 60% belong to racial or ethnic minority groups with disproportionately higher rates of illness and death from COVID-19 and more than 1 in 4 have no health coverage for themselves.

A recent study on home healthcare professionals in New York City reported that a shortage of PPE and a heavy reliance on public transportation made an already stressful situation even worse, however were unable to stop working because of the economic strain it would place on their families. Home health workers are suffering from many of the same mental health impacts of COVID-19 as other healthcare professionals, but are frequently overlooked.

Due to the unique role home health workers play in their patients’ lives, they are also exposed to more of the inner dynamics of a household. Substance abuse and domestic violence have risen dramatically during the outbreak, as well as depression and anxiety, which place increased stress on many households and make home healthcare professionals who may be working these environments at risk of not only contracting COVID, but also to violence and unsafe situations.

To alleviate much of the stress placed on home health workers, an increase in staff and training is necessary to prepare professionals for the demand and unique situations that COVID-19 has caused. Additionally, lean on your agencies to support you in unsafe situations and help you navigate an ever-changing workplace environment.

In addition to leaning on your agency resources, arm yourself with knowledge of the uniquely challenging aspects of home healthcare and how to combat common risky situations such as animals in the home or home violence. Watch the videos below to learn more about home health risks.

HIPAA and the Pandemic: How Speaking Up About Working Conditions Can Be Tricky for Healthcare Workers

It’s no secret that healthcare workers are under stressful conditions as the pandemic continues to create challenges in worker safety, resource supply, and working conditions. Workers are voicing their perspectives on social media about their COVID-19 experiences, the lack of PPE, being understaffed, and their working conditions, and while many of these frontline workers have helped to bring attention to the public crisis at hand, resulting in lives saved, it’s also important for healthcare workers to be mindful of the rights of their patients and the risk of lawsuits.

With larger platforms and voices, medical professionals are also finding themselves with more responsibility than ever to be vigilant about what they are posting while taking measures to insure patient information safety. As healthcare professionals post and practice their freedom of speech, they must remember not to violate the Health Insurance Portability and Accountability Act (HIPAA) by exposing a patient’s protected health information (PHI). They also need to be aware that plaintiff attorneys may find ways to use such posts against them or their organization in lawsuits.

The accessibility of social media platforms are great for staying connected to friends and peers, but they can also lead to the dissemination of misinformation or poor quality of information. They can lead to damages to a person’s professional reputation and an organization’s reputation, as well as legal issues, licensing issues, and HIPAA violations.

Even before the pandemic, social media incidents accounted for more than 56 percent of 4.5 billion compromised data records in the first half of 2018, according to the Breach Level Index. This included HIPAA violations. To mitigate these risks, a company or organization should have professional guidelines for social media as a reminder for its employees to stay in line with HIPAA privacy rules and PHI.

In the social media guidelines and policies, the employer should address these following best practices:

Describe expectations regarding employee behavior outside of employment
Reiterate company policy on discrimination, harassment, wrongful termination, leaking of confidential or proprietary information, damage to the organization’s reputation, productivity, and other issues
Define employees’ responsibilities regarding inappropriate use of social media
Define repercussions for inappropriate use of social media
Reiterate HIPAA, federal and state guidelines on patients’ privacy

As a rule of thumb, before you post, think about the repercussions — will you violate HIPAA, will this make you look unprofessional, will this help improve care or awareness, or will this do harm to your organization’s reputation? Sometimes there is a lot of grey area, but OmniSure is here to help you manage risk, prevent lawsuits, and improve outcomes.

Consider the tips in this video about how to protect yourself and your patients’ confidential information while using social media.