The Concept of Risk Management For the Long Term Care Industry

The concept of risk management with all its current implications is a relatively new one. As recently as a few years ago, risk management meant little more than having a safety program. If a facility organized a safety committee which met occasionally to discuss incidents that had occurred, then it felt assured that all of the important risks were being controlled. While injury/accident prevention is a vital aspect of safety, more and more health care institutions, including those dealing with long term care, are recognizing the necessity of adopting a broader perspective toward safety. Risk management, however, is more than safety. It is a process that identifies and controls all sources of risk and loss in the facility.

A principal difference, between the historical emphasis of nursing home safety programs and the concept of risk management is the enhanced scope of the latter. Risk management deals with all areas of the facility's operation, including compliance with federal and state requirements, management, marketing, nursing, dietary, housekeeping, maintenance, team building, personnel protection, asset protection, fire prevention, injury/accident prevention, emergency preparedness, training, and evaluation.

As these topics illustrate, two other differences are risk management's emphases on protecting the facility's residents, visitors, staff, and assets, and on preventing any potentially damaging situations. Thus, most of the energy of those involved is spent on avoiding the occurrences to which traditional safety programs only react. This preventative approach is possible and effective because risks to the long term care facility are mostly internal and controllable. They often arise out of a lack of awareness, training and commitment. When personnel are instructed and encouraged in the ways to prevent dangerous situations and the discomfort and pain that safety failures cause, then a major task of risk management has been accomplished.

Risk management is an integrated process of delineating specific areas of risk, developing a comprehensive plan, integrating the plan, and conducting ongoing evaluation. 

However, risk management is not just a new way of looking at safety. It can be an all-inclusive method of operating the facility. Due to the litigious nature of American society, the long term care facility is under a serious financial risk. The facility must provide a reasonably safe environment for its residents, visitors and workers, because everyone has a right under the law to an environment that is as risk-free as possible. However, creating this environment is no simple task. Risks range from the easily detected , such as those causing workers' compensation claims, to those more hidden, such as negligent nursing or the lack of an organized emergency preparedness plan.

In addition to the financial risks involved in the daily operation of the long term care facility, there are also very real human risks to the people living and working there. There is an especially acute danger of injury to the residents because they are elderly. For instance, falls are all to common and are very serious injuries with many causes, such as too few grab bars on the walls, no footstools by beds, or extension cords in walkways. Violations of Residents' Rights, negligent nursing practices and physical and mental abuse are some other situations that can cause physical and emotional harm to residents. Their causes and effects indicate the need for different attitudes and methods when dealing with elderly residents. BRMS can assist by identifying the risks and provide, implement and monitor innovative and effective risk strategies.

The safety of the employee is also a priority. Employee accidents range widely, from the needle stick to the serious back injury or burn. With so many distinct areas of operation-food service, maintenance, nursing, housekeeping, offices-risks are multiple and diverse. These injuries can be very costly to the institution when damages from work-related injury or illness are filed. Instead of reacting to these risks, the long term care facility can take action to prevent them and the losses they cause. 

With the use of expert assessment procedures and innovative risk management strategies, BRMS will assist you in reducing insurance premiums, reduce claims (both in number and severity), increase quality of care, increase productivity, increase employee retention, reduce regulatory deficiencies, increase public opinion and provide ongoing monitoring of risk management programs.