Critical Tips to Protect Your Residents and Your Facility
Every day, another nursing home finds itself the target of a lawsuit. In some cases, those lawsuits are warranted. Elder abuse is a serious problem in the United States. However, many of these lawsuits stem from other things –– miscommunication, missing documentation, a lack of responsiveness to family inquiries, and more. It’s enough to make you feel like your facility must be perfect, which is incredibly frustrating since perfection is impossible. The good news is that you don’t have to deliver flawless care 24/7. You’re human, and so are your staff members. Things are going to happen. The key to avoiding nursing home lawsuits is surprisingly simple: be responsible, be responsive, and be honest. If you follow those three rules in all aspects of facility management, you should be relatively safe from litigation . But what do those rules look like in practice? How do you protect a nursing home against lawsuits? How are you supposed to balance the complexity of nursing home management with operational efficiency? We’ll explore what facility managers and administrators need to know to avoid having your facility become the target of a lawsuit.
Risk Assessment: Identifying Potential Areas of Concern
Lawsuit prevention begins with proactive risk assessment within your facility. Let’s start with the basics.
What Is Risk Assessment?
Risk assessment is exactly what it sounds like –– a deep look at your facility and the hazards, risks, and threats within. It’s similar to what you’d do to make sure you passed a surprise DOH inspection. It’s a systematic process designed to identify potential challenges related to residents, visitors, and staff. Your assessment should include five specific steps. These are: the hazards present, who is at risk, devising and implementing safety measures/mitigation, recording your results, and regularly reviewing for additional risks. Let’s break things down. Here are the key areas to assess: Safety Hazards: These include slips, falls, poor lighting, uneven surfaces, lack of signage, and more. Gaps in Care: These include inadequate staff training, medication errors, insufficient oversight of resident health, and similar hazards. Once you’ve identified the hazards, move on to the next step, which is determining who’s at risk. In many cases, it will be your residents. However, visitors can also be at risk, as can staff members. For each hazard, ask yourself who will be harmed. How will they be harmed? Now it’s time to evaluate the risks. What is the likelihood that someone will be affected? What is the potential impact of each risk that you identified? With a better understanding of the hazards present within and around your facility, you can move on to the next step, which is developing and implementing preventative measures (mitigation)
Mitigation Strategies: Implementing Preventative Measures
Developing and implementing safety protocols and mitigation strategies is next on your list. Your approach will depend on the nature of the hazard, the severity of the risk to others, and other factors. In some cases, the fix might be simple, like replacing blown lightbulbs immediately. In others, the remedy might be more complex, such as dealing with a shortage of both staff and inadequate staff training. We’ll discuss a few important elements common to most nursing homes below.
- Developing Safety Protocols
Safety protocols can go a long way toward mitigating the risks staff, visitors, and residents face. For instance, this can include things like routine equipment checks, regular emergency preparedness drills, and fall prevention strategies.
- Staff Training
Your staff are on the front lines when it comes to nursing home lawsuit risks. It’s important that you’re fully staffed and that your staff members receive regular, comprehensive training on important things like resident care, infection prevention , emergency response, and safety procedures. Make sure that your staff members are competent when it comes to handling medical equipment, can confidently assist residents with mobility needs, and are sensitive to health issues.
- Environmental Modifications
Many of the hazards in and around your nursing home are probably related to the environment. That is, they’re not directly related to staff member capabilities. This can include things like slick surfaces, potholes in the parking lot, damaged stairs, and a lack of handrails. Identify important physical changes you need to make to your facility and then develop a plan for implementing them. Balancing Expectations and Reality Nursing home lawsuits can stem from unrealistic expectations on the part of family members about the care their loved one will receive within your facility. That’s why it’s so important that you set realistic goals for care standards and risk management. Let family members know that while perfection is the ideal, it’s rarely achievable. It’s not just about residents’ family members, however. You also need to set the right expectations for your staff members. They should never try to provide care they’re not trained for or use equipment they’re not familiar with. If they face a situation like this, they should ask for help. It’s also important that you provide ongoing training so that your staff members are as competent as possible.
Leveraging Team Strengths and Addressing Weaknesses
No team is perfect. Everyone has strengths and weaknesses. The good news is that by acknowledging that and taking stock of your staff members’ strengths and weaknesses, you can create a strategy that helps ensure excellent resident care and minimizes your risk of a lawsuit. Here are a few quick tips to help:
- Regularly review employee performance but do so from a constructive viewpoint rather than a punitive one.
- Review facility resources to make sure you have the equipment, supplies, materials, and other items needed.
- Start reviews with strengths and then find ways to help them improve on weak areas through additional training.
Communication and Responsiveness to Family Concerns
Responsiveness is one of the three primary rules we mentioned at the very beginning. It’s crucial for making family members feel seen and heard, letting them know that you take their concerns seriously and that you’re committed to giving the best possible care to their loved ones. So, how do you ensure that you’re as responsive as possible?
- Keep open lines of communication with family members. They should be welcome to call, email, or even text in some situations. They should also feel welcome to drop in anytime.
- Answer questions and address concerns as soon as possible, preferably immediately. If possible, involve their loved one in the communication.
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Be understanding. Often, family members are stressed, worried, and fearful about the health and well-being of their loved one
Maintain Appropriate Staffing Levels and Roles
What’s the quickest way to ensure that you’re delivering the level of care and attention that your residents deserve? Keeping your facility fully staffed with appropriately trained professionals. If your staffing levels don’t meet state requirements, that could land you in hot legal water. The same thing applies if your staff training isn’t up to par. Don’t forget that you need to maintain the right mix of staff to meet requirements. For instance, in California, nursing homes are required to provide 3.5 hours of nursing care per resident per day and 2.4 hours of that must come from a certified nursing assistant. In addition to your regular staff, make sure to mix in nurse practitioners and physician assistants to help with medical overside and reduce pressure on other staff. However, remember the goal here –– providing outstanding patient care. Of course, you can’t just staff your facility and then walk away. There’s no “set it and forget it” option here. That’s because your staff are human beings, and burnout is a real thing that can have a serious impact on your facility.
Documentation Best Practices
Want to protect your nursing home against lawsuits? Document everything, and we mean everything. Thorough documentation is an operational necessity, but it’s also a legal one. What should you be documenting?
- All resident care
- All incidents/accidents
- All staff evaluations
It’s also important to remember that minimal notes are not enough. For example, if a patient with a wound on their arm needs to be repositioned and refuses, documenting the refusal isn’t enough. You’ll also need to document what steps were taken to try to convince them to convince them otherwise. It’s also important that all documents are accurate. Never, ever, falsify any information. Falsifying reports comes with serious legal and ethical consequences. And don’t think that it will go unnoticed. Most documentation software today offers audit trails so it’s possible to see what was changed, when it was changed, and who changed it.
Workplace Culture and Employee Satisfaction
Your facility’s culture and employee satisfaction level play a large role in your ability to weather a lawsuit. For instance, disgruntled employees may be called who will claim that your facility is understaffed, that staff members aren’t trained, that equipment isn’t maintained, and more. How do you defend against this? While it’s impossible to ensure that all employees are happy all the time, it is possible to create a supportive workplace culture where your people feel welcomed and able to do their jobs. The key? Providing ongoing training, supplies, equipment, and materials, while also ensuring that you’re focused on maintaining adequate staffing levels. It’s also important that you act on staff complaints. Show them that you’re taking their concerns seriously. Hold people accountable for their actions and decisions. Make an effort to create a fair and equitable workplace. Again, you’ll never be able to eliminate all employee dissatisfaction, but with the right steps, you can ensure there are plenty of satisfied, supported staff members to dispute a disgruntled employee’s claims.
Put Advanced Entry through Its Paces
Advanced Entry’s cutting-edge visitor intelligence capabilities are second to none. However, our tools go far beyond temperature screening and touchless visitor check-in. In fact, your Advanced Entry system can provide you with important advantages if you’re sued and even make it less likely that you’ll be sued in the first place. For instance, we help ensure that you know where residents are at all times. Our system also makes it easy to manage third-party caregivers to ensure that residents are receiving the focus they deserve. Monitoring time and attendance, optimizing shift changes, and maintaining facility health and sanitation are just a few other key capabilities.
The Path to Avoiding Nursing Home Lawsuits
While there’s no way to guarantee that you’ll never be the target of a nursing home lawsuit, taking the right steps can drastically reduce the likelihood. Regular risk assessments, implementing accurate mitigation strategies, and focusing on open, accurate communication with family members can help you create a supportive, safe, nursing home environment. If you’ve undertaken any of these steps, share your experience with others. What are some of the hazards you’ve found in your risk assessments? How have you gotten around staffing challenges to ensure not just the right number of people, but the right mix of professionals? Let us know in the comments below!
