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Medicare Face-to-Face Home Health Requirement
A controversial Medicare requirement continues to cause unrest in the Home Care industry and has recently been the focus of a federal lawsuit. The Medicare “Face-to-Face” Home Health requirement is a hot topic of conversation within the industry, as it is a regulation that directly affects physicians and those in the medical field, home care and hospice agencies and those requesting home health Medicare benefits and reimbursement. What is the Medicare Face-to-Face Home Health Requirement? The Medicare Face-to-Face Home Health requirement, a regulation in accordance with the Affordable Care Act, requires an in-person physician’s visit in order to certify a patient’s home health benefit, according to cms.gov. This means that under the law, a physician must assess and document a patient’s condition and provide a brief narrative verifying their eligibility for the home health Medicare benefit. While revisions to this requirement were later made, some important initial provisions of this requirement are as follows: - A physician or allowed non-physician practitioner (NPP) must document having met with a patient face-to-face and certify them for Medicare home health benefits - The certification for service eligibility must be related to physician’s assessment of a patient’s clinical condition - Patients beginning care on or after January 1, 2011 require this documentation on their certification - Visit must occur within 90 days prior to, or within 30 days after beginning of home health care Who has been impacted by this requirement? Both physicians and home healthcare agencies have not been in agreement with the face-to-face requirement. “This new requirement caused widespread chaos, spurred a physician rebellion, and in the end deprived many seniors from receiving the care to which they were entitled under the Medicare home health benefit,” said the National Association for Home Care and Hospice (NAHC) in a January 2015 press release. In response to this public outrage, the Centers for Medicare and Medicaid Services (CMS) revised its requirement, removing the written narrative portion of the requirement. Unsatisfied with this requirement change, NAHC then filed a lawsuit in federal court seeking millions in denied claims dating from 2011 to 2014 under that provision of the requirement, according to its January press release. NAHC had previously requested CMS to pay “some $250 million owed to home health agencies for care they gave to Medicare patients between 2011-2014”. This request was denied, resulting in the lawsuit moving up to federal court. What Now? The federal lawsuit seeking compensation for denied claims has proceeded to the next stages, as a federal district court struck down the government’s requests to dismiss the case in January, according to the NAHC press release. This situation is fluid and worth monitoring, with the results of the federal lawsuit potentially making a further impact in the home care industry and spurring more conversation on the topic. Recently the federal court ruled in favor of Medicare while restricting the scope of the face to face narrative. At Manchester Specialty Programs, we understand how difficult it can be to navigate regulations while providing quality home care and hospice services. We deliver specialty insurance programs offering all the insurance coverage you need to operate in one easy to access program. Part of our product line includes regulatory audit coverage for the emerging risk and exposure of billing and working with Medicare. For more information, you or your local insurance broker can call us today at 1-855-972-9399. http://www.manchesterspecialty.com/home-healthcare-providers/medicare-face-to-face-health-requirement/
Goals for Home Care
In a previous blog post, we discussed the importance of accreditation in the home health care and hospice industry, noting that one of the factors that insurance carriers consider when it comes to the risk management of an accredited healthcare facility is adherence to National Patient Safety Goals (NPSGs). The NPSG program was established by The Joint Commission to help accredited organizations address specific areas of concern and to improve patient safety. A group of nurses, physicians, pharmacists, risk managers, clinical engineers and other healthcare professionals from what’s called the Patient Safety Advisory Group advises The Joint Commission on developing and updating the NPSGs. It’s vital that your organization’s management as well as staff understand these NPSGs to not only serve patients as best as possible, but also to be part of a robust home care risk management program. Below is a rundown of what these NPSGs are. To Correctly Identify Patients Patients should have two personal identifiers; their name and birth date for example, to ensure they receive appropriate treatment from their home health care or hospice provider. Safe Use of Medications Patients who require home health care or hospice care often may not understand their medication needs, and certainly cannot be expected to understand how different medications interact with each other. This is primarily the duty of their physician; the caregiver in the home should find out what medications the patient is taking. Infection Prevention The CDC as well as World Health Organization have strict guidelines for hand cleaning; ensuring that you and your staff follow the protocols is a basic foundation of all health care. Fall Prevention Any home health care or hospice patient faces this risk when taking medications to manage their condition that may cause ill side effects, as a result of injury, advanced age, etc. Care should be taken to assist the patient when ambulating, and to assess the home care setting for any obstacles. Identification of Specific Patient Risks Caregivers should be aware if there are any home-based risks for their patients, especially those using home medical equipment and oxygen. At Manchester Specialty Programs, we understand the unique risks faced by caregivers in the home health care and hospice industries. You will find all the insurance coverage you need to operate your business with us, and all in one program. We deliver specialty insurance programs that are specifically designed for home care and hospice firms in both medical and support roles. Our comprehensive home health care and hospice provider insurance program is designed to help these agencies continue to provide the important services they offer throughout our communities. To find out more about our operation and all our specialty insurance programs, you or your local insurance broker can give us a call today at 855-972-9399. http://www.manchesterspecialty.com/home-healthcare-providers/basics-of-the-national-patient-safety-goals-for-home-care/
Safety Checklists Help Mitigate Risks
A home health care agency should make a practice of conducting regular worksite walkthroughs to identify and control hazards in the home environment. To facilitate these walkthroughs, pre-contract and post-contract safety checklists have been found to be an effective tool in ensuring that a potential hazard is not overlooked, and that necessary remediation steps are taken when hazards are discovered. These checklists are also helpful in educating employees as well as the patients’ families about potential hazards in the home. This will enable a home health care agency to maintain that workers and clients will be safer, healthier and more productive while also helping to reduce the potential for patient injury. Hazards addressed in safety checklists for the home health care sector cover several topics, including manual tasks; slips, trips and falls; occupational violence/aggression; biological substances; hazardous substances; electrical hazards; vehicle hazards; working alone; and psychosocial issues/stress. Let’s take a look at two of these topics to see how a checklist can aid in risk assessment. Manual Tasks Manual tasks cover any activity that requires a person to use his or her physical body (musculoskeletal system) to perform work. It includes manual handling, performing repetitive actions, adopting awkward and sustained postures, etc.. Manual tasks can result in acute (immediate or sudden from a specific incident) or sometimes chronic injuries. Workers in home-based care are most at risk from transfers and handling of patients/clients; working in awkward/sustained postures (for example, in a confined bathroom while assisting a client with showering tasks) or handling heavy loads. A safety checklist that covers manual tasks will include some of the following items: Identify all manual task hazards, including driving vehicles, loading/unloading vehicles, carrying equipment to homes, client transfers, client movement (in wheelchairs, wheeled equipment, bed mobility), unsafe equipment, change in client function, moving furniture, cleaning, shopping, etc. Assess whether control measures are in place for potential risk factors. For example, is there adequate lumbar support in vehicles, trolleys for movement of equipment to/from and within homes, and sufficient and adequate client handling equipment as per assessed needs? Is home-based equipment regularly maintained and are there reporting mechanisms in place for unsafe equipment? Slips, Trips & Falls Slips, trips and falls are the second most common injury (after manual task injuries) for workers in the home care industry. Slips, trips and falls risk factors can be categorized into 10 categories: floor surface and condition, objects on the floor, cleaning/spill containment, floor contamination, ability to see floors/walkways/hazards, space and design, stairs and stepladders, work activities, pace and processes, footwear and clothing, and individual factors. A checklist that covers each risk factor under the above categories will help identify problems and assess the risk as you go down each item. For example, if you were looking at the floor surface, the checklist would include things such as whether there is too much or too little friction on the floor covering or a change in the floor type (from tiles to carpet) that could cause a trip, whether the floors are in poor repair, are the surfaces unstable, and so on. Other items on a safety checklist would include questions on the presence and condition of stairs, ramps and steps, the presence of any obstructions in walkways (mats, electrical leads, furniture, hoses) and whether there is adequate lighting of internal and external areas. Safety checklists are an easy-to-use and cost-effective tool to not only help your home health care organization in assessing the risks at a patient’s home before an employee enters the home but also to assist in methodically addressing each risk for optimum safety for employees and patients. Additionally, safety checklists will help you continue to remain in compliance with state and federal workplace regulations specific to the industry. Manchester Specialty focuses on providing comprehensive insurance protection for the home health care industry, including Workers’ Compensation insurance. Our carrier partners also offer industry-specific risk assessment tools and services to help home health care clients prevent and mitigate losses. To learn more about our programs and services, you or your local agent/broker may contact us at 855.972.9399. http://www.manchesterspecialty.com/uncategorized/safety-checklists-help-mitigate-risk/
Home Healthcare Providers Workers’ Compensation Insurance
Home health care workers provide hands-on, long-term care and personal assistance to patients with disabilities and chronic health conditions in the privacy and comfort of the patient’s own home. While these services play a vital role in ongoing patient care, the home setting can be a challenging and dangerous work environment. One of the reasons in-home care is such a challenging work setting is that the care provider has little or no regulatory control over the cleanliness, layout, and other factors of their environment. This unfortunately exposes home healthcare workers to a greater risk of injury, illness or other accidents on the job. Home health aides can easily be injured by a variety of hazards they encounter through the course of their day. Here are a few of the most common ailments suffered by home healthcare workers: Overexertion/Bodily Strain– According to the Occupational Safety and Health Administration (OSHA), healthcare workers are over seven times more likely to develop musculoskeletal disorders (MSDs) than workers in other industry sectors. The home healthcare industry can be particularly demanding, taking great physical tolls on the body due to lifting, straining and other strenuous activities. Strains and sprains affecting the shoulders, lower back, wrist and ankles are all common to home healthcare professionals. Violent injuries– The OHSA also reports that health care workers are at a higher risk of being violently assaulted at work by patients, their families, friends and even pets. Aggression and violence from patient is extremely common as home healthcare providers interact with agitated, incoherent and impaired individuals. Slips and falls- Slips, trips and falls are the number one most commonly cited workplace injury and workers’ compensation claim in America. Home health aides face countless exposure to such calamities. From crowded work spaces to fallen fluids, there a wide variety of hazards which can lead aids to lose their footing. These accidents can culminate in even greater injuries ranging from bruises and sprains to broken bones and head injuries. Infections, toxins, and diseases– Patients’ homes are very different than a sterile hospital environments and present a unique set of challenges and hazards for home healthcare providers. For example, when working in a patient’s home healthcare aides can face exposure to poor indoor air quality, lead paint, toxic substances, household mold and fungi, vermin and a number of other common domestic hazards that are associated with negative health effects. These exposures are in addition to the traditional healthcare hazards such as risk of infectious diseases, blood borne pathogens and other illnesses. When it comes to protecting workers and staff members, it is important that home healthcare providers are on top of their game. At Manchester Specialty Programs, we specialize in insuring the home health care industry and offer a comprehensive program exclusively designed for this segment. Home Healthcare Providers program offer the coverage this sector needs, including Workers’ Compensation, Professional Liability, Employment Practices Liability, and much more. To learn more about our Home Healthcare Providers Workers’ Comp coverage and all our offerings, contact us today at (855) 972-9399. http://www.manchesterspecialty.com/home-healthcare-providers/common-home-healthcare-providers-workers-comp-claims/
Home Healthcare Industry: Telemedicine
Last month Cox Communications and non-profit medical center Cleveland Clinic announced plans to collaborate on a new project called Vivre Health, in what many are calling a groundbreaking strategic alliance to bring healthcare to the homes of millions of Americans through innovative technology and home health solutions. While the adoption of telemedicine has been relatively slow in recent years, many industry members feel that the availability of these technologies are reshaping the healthcare landscape. Furthermore, there has been growing interest from consumers in technologies that will help them better facilitate their own healthcare needs. One study conducted by professional consulting group Accenture indicates that two thirds of the growing elderly population desire access to healthcare services at home, and many are looking to technology for the answers. The survey found that while 67 percent of elderly respondents said they wanted access to health services in their homes, and 66 percent reported that they preferred to use self-care technology to manage their own health. However, 66 percent of the same respondents report concerns that medical technology is not yet ready to offer full home healthcare care. Only 20 percent of respondents showed interest in virtual consultations. On the other hand, younger generations seem to be more demanding and more trusting of telemedical practices. A recent study conducted by by Software Advice, a consumer resource for technology and software buyers indicated that while 73 percent of surveyed patients had never participated in a medical consultation, 75 percent of those patients are at least “moderately interested” in telemedical practices. So how will new healthcare technology reshape the home healthcare industry? In general, telemedicine technology is most helpful and efficient when utilized for simple, straight forward, or instructional care. This can include physician or nurse consultations as well as monitoring and maintaining patients’ conditions. From wearable electronic vital monitoring systems to more complex technologies and alert systems, it seems that consumers of all ages increasingly comfortable with some of these new technologies. However, telemedical care is not right in all situations. Much of the service home healthcare providers offer is hands on care for individuals who need extra assistance managing their condition. As such, it is hard to predict the extent to which home healthcare providers and patients will be able to utilize these oncoming technologies. When it comes to caring for patients, healthcare providers don’t leave anything to chance, so why would your clients take a risk on being under insured? Manchester Specialty Programs offers a totally integrated business insurance solution for the broad spectrum of home health care, hospice and medical staffing organizations fundamental to communities throughout the country. Addressing the unique exposures of the rapidly growing and changing health care industry is our main focus. From Professional Liability and General Liability, to Regulatory Audit Coverage and Workers’ Compensation, we have the ability to create a customized insurance coverage and risk management strategies for any healthcare organization. To learn more about our operation, contact us today at (855) 972-9399. http://www.manchesterspecialty.com/home-healthcare-providers/will-telemedicine-change-home-healthcare-industry/
How to Improve a Home Health Care Agency’s Workers’ Compensation
The Bureau of Labor Statistics (BLS) predicts a 19% growth in healthcare jobs through 2024, with more than two million new jobs for physicians, registered nurses, and healthcare support occupations such as home health aides and physical therapists. Moreover, home health care, according to the BLS, is the fastest growing sector in the health care industry, offering tremendous opportunities to providers and the insurance agents and brokers who specialize in this niche. With the increasing complexity and rigor of tasks provided in the home care environment, and the increasing number of frail elderly that make up this patient population, it is important to identify risk factors that affect employee health and safety in this setting. This is particularly so because home health care workers have a higher incidence of injury compared to other health care and human services employees. In fact, the injury rate in home care settings is about 50% higher than that in hospitals, cites the BLS. By examining the various exposures involved in a home care setting, insurance agents and brokers along with their clients/insureds can help providers prevent on-the-job injuries and illnesses and improve their Workers’ Compensation risk profile. In addition, the negative consequences of a hazardous workplace impact the delivery of health care services, which includes deterioration in the quality of care provided, as well as higher health care worker turnover rates or career abandonment. These factors contribute to the increased cost for a home health care provider beyond its insurance program. Occupational Hazards in Home Health Care Let’s take a look at the principal occupational exposures home health care workers face: - Physical hazards – workplace injuries: “slips, trips, falls, overexertion, back injury, temperature extremes; unhygienic conditions (including lack of water, unclean or hostile animals, and animal waste); long commutes from worksite to worksite, adding transportation-related risks. - Psychological hazards – occupational stress, workplace violence, guns and other weapons; illegal drugs; verbal abuse and other forms of violence in the home or community. - Biological hazards – infectious diseases, blood-borne pathogens, needle stick injury. - Chemical hazards – hazardous drugs, cleaning and sterilizing agents. What can be done to help your clients reduce these risks, improve worker safety and ultimately minimize or eliminate Workers’ Compensation claims? - Be sure that the home health care agency conducts a thorough pre-visit hazard assessment. For example, assess the client/patient behavior, the home location (unsafe area, isolation, poor lighting, unlit parking, unsafe building), and the presence of dangerous items (weapons, vicious pets). - Eliminate or reduce risks based on findings from the assessment. This may include everything from implementing a case declination/refusal policy if the residence is deemed unsafe to providing comprehensive ergonomic interventions on the use of appropriate equipment and training, to providing safe patient handling instructions and establishing a transportation policy that limits travel distance. - Provide an effective communication system with employees to request immediate assistance if they become injured or ill. Be sure the communication involves one or more of the following: landline, cell phone, or two-way radio contact with designated person, and check-in points with other employees. - Ensure employees are trained and educated. This includes implementing initial and annual training comprised of safety hazard recognition and prevention, and reviewing new safety issues identified throughout the previous year. Training, for example, should include: - Use of ergonomic equipment and techniques to prevent musculoskeletal disorders - Slip and fall prevention - Information on latex allergies - Standard precautions with all blood and potentially infectious materials - How to identify stressors and techniques on reducing stress - How to recognize violent or aggressive behavior and how to defuse an angry patient Employees should also be trained in reporting any potential hazards that may exist. Manchester Specialty can assist you in securing an excellent Workers’ Compensation insurance plan for your home health care clients. Our insurance partner carriers also have a variety of loss control and prevention resources for our program policyholders. Your clients will benefit by ultimately gaining a healthier, more productive workforce, which will reduce their claims frequency and severity and help keep insurance and health care costs in line. For more information about our products and services, please contact us at (855) 972-9399. http://www.manchesterspecialty.com/hospice-care/home-health-care-agencys-workers-compensation/
Nursing Shortage Impacts Home Health Care
The U.S. has been experiencing a Registered Nurse/nursing shortage for decades, but the issue is expected to worsen with a growing aging population, the rising incidence of chronic disease, an aging Nurse workforce with more individuals retiring, and the limited capacity of nursing school enrollment. The shortage is expected to impact our hospitals, nursing homes and skilled care facilities, as well as the home health care and hospice industry. http://www.manchesterspecialty.com/home-healthcare-providers/nursing-shortage-potentially-impacts-home-health-care/
Guardianship in the Home Health Care Industry
https://www.manchesterspecialty.com/guardianship-home-health-care-industry/ There are situations where individuals who require home health care can no longer make certain decisions for themselves and don’t have family members available or capable of stepping into a guardianship role. These individuals may possibly suffer from Alzheimer’s or dementia or have had a stroke. To fill this gap, some home health care providers offer adult guardianship as part of their services.
Most Common Property Damage Claims
In our previous blog article, we gave a brief overview of the most common insurance claims we see in regards to patient-injury related losses. These are not the only home care insurance claims these organizations face, however. The following claim examples are common losses the home care industry faces related to General Liability risks. Non-Owned Auto If a home care agency employee is involved in a vehicle accident while on the job or on their way to their job, the home care agency could very well suffer a financial loss. This loss can typically be controlled by understanding the employees’ personal auto insurance limitations, and by properly screening potential employees’ driving records. In addition, participation in driver safety programs can significantly reduce insurance risks. Theft Theft is an unfortunate occurrence that cannot always be avoided. Home care agencies may mitigate their risks by screening applicants, but theft of patients’ property “third party” is not 100% avoidable. An important factor to keep in mind in regards to theft claims is that they can be brought under the agency’s Professional Liability or crime/fidelity policy, with claims of negligence in hiring, screening, background checks, or supervision. In addition to obtaining the right insurance policy, home care agencies need to discuss implementing a risk management plan to potentially reduce the chance of this type of claim from happening, or at least prevent further occurrences. For example, their risk management strategy might include training on proper hiring and screening practices. While home care employers need to ensure they are not being too invasive in their background checks, performing this training could reduce potential liability concerns. Damage to a Clients’ Property While the payout for these types of claims is typically minimal, this is actual a fairly common claim home care agencies face; even if the property damage was completely unintentional. This could mean a claim of damage to a piece of medical equipment or even something in the patient’s home. Understanding the most common insurance claims and claim loss examples can help to distinguish what the insurance needs are for this type of organization. The above mentioned losses can be addressed with professional and general liability business insurance coverage through Manchester Specialty Programs. If you have any questions about our coverages, please contact us today at 1 (855) 972 - 9399. http://www.manchesterspecialty.com/home-healthcare-providers/home-care-settings-property-damage/
What are Common Hospice Certification Errors?
http://www.manchesterspecialty.com/regulatory-audit-coverage/hospice-medicare-certification-recertification/ It’s imperative that all documentation contains the correct dates, signatures and identifying roles of the physicians. Without this correct information, Medicare can’t make suitable payment.
The Four Principles of Health Care Ethics for Home Care Providers
https://www.manchesterspecialty.com/four-principles-health-care-ethics-home-care-providers/ There are four commonly accepted principles of health care ethics that providers follow to ensure optimal patient safety: autonomy, beneficence, non-maleficence, and justice. Let’s take a closer look at the definition of each of these principles and how they are put into practice in the home health care environment.
Home Care Firms Driver Safety Tips
Home health care employees – from personal/home care aides and companions to nursing assistants or home health nurses – typically drive their own vehicles from location to location. Depending on their duties, caregivers may also transport clients to conduct personal errands or to doctors’ appointments. As these individuals are frequently on the road, often have tight time schedules and unforeseen demands, and drive in unfamiliar areas, they can be at a higher risk for experiencing motor vehicle-related hazards. In addition, distracted driving, aggressive driving, lack of seatbelt use, driving while tired, poor weather conditions, and poorly maintained vehicles can all contribute to car accidents. In 2014, according to the Labor Department, the leading cause of work-related fatalities involved vehicular accidents occurring on public roadways, a statistic which represented 23% of all workplace deaths. In addition, the estimated annual total economic cost to employers as a result of employee vehicular accidents is about $250 billion, which includes expenses for medical treatment, legal costs, property damage, increased premiums for insurance including Workers’ Compensation, and loss of productivity. To help mitigate such vehicle-related hazards, home health care agencies should have a strong driver safety program that protects them, their employees, and the clients they serve. An effective driver safety program includes the following: - Ensure drivers have appropriate insurance and valid licenses for the vehicles they operate. Make sure that the home health care agency has the proper insurance as well, including a Non-Owned & Hired Auto policy. - Maintain complete and accurate records of workers’ driving performance. In addition to driver’s license checks for prospective employees, periodic rechecks after hiring are critical. - Obtain Motor Vehicle Reports (MVRs) on all employees at hire and on an annual basis to monitor driving violations and accidents, and have a firm no tolerance policy and consequences for poor drivers. - Demonstrate to the staff that their safety is important. - Develop driving and transportation policies and set clear protocols regarding client transportation. - Advise workers of potential and actual hazards on the road. - Ensure employees know what to do in case of inclement weather, breakdown, accidents or illness. - Educate employees on vehicle safety. - Establish and enforce mandatory seatbelt use policies. - Incorporate training into safety programs on topics such as fatigue management and the dangers of distracted driving. - Make sure employees are trained to operate specialized motor vehicles, if applicable. - Provide an emergency kit containing a flashlight, extra batteries, flares, a blanket, and bottled water. - Respond promptly to complaints from other employees or clients about a worker’s driving. In addition, employees need to play an important role in their road safety. This includes never using a cell phone for calling or texting while driving; avoiding distracting activities such as eating, drinking, and adjusting the radio and other controls while driving; avoiding driving when over-tired; using detailed maps or GPS to determine their route before leaving for the destination and allowing enough time to arrive safely; having their vehicles checked and serviced regularly; checking for tire wear and tear; adhering to speed limits (30% of fatal accidents involve excessive speed); and keeping the gas tank at least a quarter full. Manchester Specialty offers end-to-end insurance solutions designed to protect help home health care agencies against the exposures they face along with their employees. Our solutions include a wide range of Liability coverage, including Non-Owned & Hired Auto insurance, which will protect a home care firm in the event an employee is in an accident involving his or her personal vehicle, and either doesn’t have adequate liability limits or has allowed the coverage to lapse, unbeknownst to you. We also provide Workers’ Compensation insurance to step in when on-the-job accidents and injuries occur. For more information about our suite of business insurance products for home health care providers, you or your local agent/broker can contact us at 855) 972 - 9399. http://www.manchesterspecialty.com/workers-comp-2/driver-safety-program/
Texas Home Health Care Workers' Compensation
Workers’ Compensation insurance is mandatory in most states with employers obtaining coverage from a private insurance carrier or a state-administered fund if available or, depending on the size of the company, self-insurance. The Lone Star State is an exception with Workers’ Compensation insurance voluntary for most private employers. Employers not providing Workers’ Compensation insurance coverage in Texas are referred to as nonsubscribers. If an employer has Workers’ Compensation insurance coverage, Texas law limits the employer’s liability for work-related injuries. Injured employees may get medical and income benefits set by state law, but generally may not sue their employers. However, according to the Texas Insurance Department, nonsubscribers lose these important legal protections, including immunity from most lawsuits by injured employees. They could also be forced to pay high damage awards if an injured employee can prove in court that the employer was negligent in any way. Employees covered by Workers’ Compensation insurance coverage in Texas receive benefits based on the type and severity of their injuries. They can receive medical benefits for medically necessary treatment of work-related injuries and illnesses; disability income benefits for a specified period of time up to a certain dollar limit set by law; compensation for burial expenses for employees killed on the job; and death benefits for dependents of employees killed on the job. If there is a Workers’ Compensation claim for benefits, an employee’s family may be entitled to additional benefits if the employee was killed and the death was caused by the employer’s gross negligence or intentional act or omission. Whether or not an employer carries Workers’ Compensation insurance, Texas laws requires that all employers comply with reporting and notification requirements under the Texas Workers’ Compensation Act. Nonsubscribers must report that they elect not to obtain Workers’ Compensation insurance coverage to the Division of Workers’ Compensation (DWC) each year. In addition, nonsubscribers with five or more employees must report to the DWC each work-related fatality, occupational disease, and injury that results in more than one day of lost time. Nonsubscriber Options to Traditional Workers’ Compensation According to a Texas Insurance Department, 33% of employers are nonsubscribers, but only 19% of Texas employees work for nonsubscribers. Among the industry sectors with the highest percentage of nonsubscribing employers is health care, including home care, hospice, medical staffing and others that make up this niche. About 71% of nonsubscribing employers offer benefit plans to employees. Most small employers will use accident insurance that pays benefits directly to the employee with a low deductible for the employer. The scope of benefits offered by accident insurance can be limited and in many cases costly injuries may be subject to a maximum dollar amount determined by a disability schedule. Mid-sized employers may opt to use a reimbursement policy that allows the employer to submit expenses to a carrier for reimbursement or a pay-on-behalf-of policy that pays on behalf of the employer. Coverage can be obtained for medical expenses, wage replacement benefits, legal costs and damages (which in some cases may include arbitration and mediation costs), occupational sickness, occupational disease and cumulative trauma. While benefits associated with reimbursement and pay-on-behalf-of policies may also be capped, the limits are usually greater than those offered by accident policies. Larger employers will offer sophisticated benefit plans that provide for wage replacement and medical care to injured workers. Their programs have extensive safety components and focus on taking care of injured employees. They may employ the use of several coverage options, including excess insurance and stop loss coverage. We specialize in offering comprehensive business insurance solutions for the broad spectrum of home health care, hospice and medical staffing organizations that serve communities throughout the country. In addition to Workers’ Comp coverage, we can also assist you in helping clients gain control over ongoing costs and rising premiums, with Return to Work programs and other risk management strategies offered by our carrier partners. If you would like additional information about our products and services, please contact us at 855.972.9399. http://www.manchesterspecialty.com/workers-comp-2/workers-compensation-insurance-solutions-for-texas/
Home Safety Assessments in the Home Care Environment
A home safety assessment is an important tool for home health care in verifying the safety of patients and their home environment, identifying and correcting deficiencies, and minimizing and preventing losses. As the majority of reimbursement for home care services is through Medicare or Medicaid, the government plays a major role in setting the quality of care standards that organizations should follow. Periodic on-site inspections are performed to ensure compliance with the laws, regulations, and standards of care. The federal government works in partnership with state agencies (including the state health department or state licensing authority for healthcare facilities), which often set additional regulations that govern the licensing of home health care providers. In addition, private insurers and the home care companies themselves may set quality standards of their own to follow. There are several categories that make up a comprehensive home safety evaluation: - Basic Home Safety and Patient Safety Issues: The home should be free of fire, health and safety hazards. Home care providers during the assessment will provide instruction in fire prevention and assist both caregivers and patients in establishing fire plans. They will provide education and training in the proper operation, maintenance, storage, and cleaning of in-home medical equipment to lower the incidence of infections caused by contaminated equipment, ensuring optimal performance of the equipment. Home care providers will also provide instruction in patient safety, including fall prevention, the correct lifting and transferring techniques for non-ambulatory patients, and proper administration and storage of medication. They’ll encourage CPR training for the family/caregiver, and provide a list of phone numbers to call in emergency situations. - Overall Home Environment: The set-up of each room will be evaluated for optimal efficiency. The home must be clean and free of excess clutter that can hamper mobility, cause accidental falls, and lead to misplaced supplies. Patients will be notified of risks associated with environmental hazards, such as untethered scatter rugs, poor lighting, slippery floor finishes, and mobile furniture. - Accessibility & Patient Mobility: The patient’s accessibility in and out of the home, between rooms, and into the bathroom will be evaluated. His or her mobility will also be assessed. For example, the assessment will evaluate if the patient is ambulatory on his or her own or whether assistance required. Does the patient need a wheelchair or walker? If the patient is not ambulatory, a list of checkpoints must be reviewed, such as the width and height of doorways, stairway usage, and carpets that may inhibit mobility, among other factors. - Patient/Family Issues: The patient’s/family’s ability to comprehend instructions will be evaluated. They will need training and education on all of the in-home medical procedures and proper use of equipment and supplies. They must be able to demonstrate competence and proficiency at performing all the required tasks, and be able to properly operate, maintain, troubleshoot, and clean the equipment. Also, the patient’s general hygiene must be observed and whether he or she is reliant on others for personal hygiene care. Additionally, any patient comments regarding abuse, neglect, lack of care, or any other problems and concerns should be addressed immediately. A home health care agency will have an established set of protocols for reporting these types of problems. Documentation of the home safety assessment and any corrective actions is imperative, with any changes or substandard safety issues noted, evaluated and solved during follow-up visits. Home assessments are an important component of home care. They determine the degree of safety, function and comfort of patients in their homes, and evaluate the need for adaptive equipment and assistive devices. Through the use of home assessments and appropriate modifications, home care providers are able to decrease the risks of patient falls and misuse of medications, improve patients’ accessibility in and around their homes, and keep patients living independently in their home environments as long as possible. Manchester Specialty provides specialized insurance and risk management solutions to the home health care and hospice industry. We work exclusively with local brokers and would be happy to review your operation and how well your insurance program addresses the various exposures your operation faces. http://www.manchesterspecialty.com/ho...
Workers’ Comp Experience Modification Factor
A common term that brokers, insureds and prospects will come across when shopping for the appropriate Healthcare Workers’ Compensation Coverage is an “experience modification factor.” In order to obtain the best coverage possible, it’s essential to understand terms such as this, and the effect it will have on individual policies. The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) defines an experience modification, also referred to as an e-mod, as a comparison of actual losses to expected losses. If a particular home care agency or other healthcare firm has a loss experience that is more costly on the average than a comparable company’s loss experience in their industry, that firm would have to pay a surcharge on their premiums, known as a debit e-mod. However if that same firm’s loss experience is less costly than the industry average, that individual firm will receive a discount, or a credit e-mod, on their premium. Where do Insurers Get Rating Information? Each state subscribes to an independent statistical organization or bureau, most often the National Council on Compensation Insurance (NCCI), in order to gather and analyze data and trends within the industry. Insurance companies are required each year to submit to the NCCI or their state bureau information for each employer that they insure. These reports are known as unit statistical reports and include classification codes, audited payrolls by class, premium information, and claim information. How Are These Ratings Determined? This will vary by state, however in general the experience rating method will use an individual’s or groups’ historic data as a proxy for risk in the future. These ratings are completed every year, and the factors used to determine them include business class codes, payrolls, and losses from the last five years. It’s important to note that if the business is sold, or if a different insurance company provides coverage for the healthcare organization, the factors that are used to determine their e-mod will remain the same. Do All Healthcare Employers Qualify For an E-Mod? In most cases, according to the Insurance Learning Center, if an employer’s premium averages $3,000 or more before discounts, they are eligible for an experience modification rating. As mentioned previously, a firm’s e-mod rating will be either determined by the NCCI or an independent agency. An insurance agent can advise the firm on where their mod is calculated and help determine if they will qualify. How Can E-Mod Ratings Be Lowered? By developing and maintaining a robust workplace safety and training program and a solid return-to-work plan, healthcare industry leaders could effectively lower their e-mod rating. Implementing appropriate loss prevent procedures is important as well, in effectively managing workers’ compensation costs and lowering an e-mod rating. It’s important to remember that the current year’s claims will typically present the greatest opportunity for cost reductions, and that the frequency and severity of workers’ compensation claims will also affect ratings. At Manchester Specialty, we specialize in offering workers’ compensation insurance coverage for the home health care, hospice, and medical staffing industries. In addition to this important coverage, we offer tools and strategies through our carriers for these industry segments, to help gain control over ongoing costs and rising premiums, assist employees in returning to work, stem fraud, and other risk management measures. To find out more about our operation and all of our specialty insurance programs, you or your local insurance broker can give us a call today at 855-972-9399. http://www.manchesterspecialty.com/workers-comp-2/workers-comp-experience-modification-factor/
Improving a Home Health Care Workers’ Compensation Risk Profile
The home health care sector, according to the Occupational Safety and Health Administration (OSHA), has the highest average workers’ compensation insurance indemnity payment from the various departments and agencies within the health care system it has profiled. This, says OSHA, is potentially driven by patient handling and higher exposure to automobile accidents among visiting nurses and home health care aides. In fact, overall in the health care industry, patient-handling accounts for one third of all workers’ compensation claims, and has the highest average indemnity payment out of all causes of loss, according to an insurance industry study. Slip/trip/fall injuries and push/pull injuries are the second and third most costly indemnity payments, respectively. Home health care employers in an effort to prevent losses and keep workers healthy and safe can implement a wide range of risk management practices and measures. By putting safety first, not only will home healthcare employers create a culture aimed at reducing the number of on-the-job injuries and accidents taking place, they will also improve their risk profile when purchasing or renewing a workers’ comp policy and ultimately drive down premium costs. Following are several risk management recommendations for a home health care agency to adopt to obtain better workers’ comp outcomes: - Institute a location/patient acceptability review policy. In performing an assessment of the location at the start of a service contract, if a supervisor or nurse determines the home to be unsafe, address where improvements need to be made in order to accept the contract. If these changes are not made and the client location is deemed unsafe, institute a case declination/refusal policy. Additionally, ensure that home health aides receive training and instruction in identifying unsafe locations and practices and are instructed to desist from and report any potential hazards encountered. - Implement a formal safe patient-handling program. The most successful safe patient-handling program is a proactive, collaborative process, and includes management leadership, employee participation, education and training, and program evaluation and improvement. According to OSHA, employers with successful safe patient-handling programs have found they can significantly reduce the number of employee injuries and lost workdays from injuries. Safe patient handling has been associated with not only fewer injuries but also a decrease in the severity of injuries. - Establish a five-block travel radius limitation for employees. If possible, implement a policy whereby home health care aides only assist patients with shopping or errands within a five-block radius. This can serve to help reduce the number of automobile claims, which make up a significant percentage of workers’ comp injuries. Depending on the location being served, this may not be possible. For example, in urban areas such as New York City, employees can use mass transit to go to and from their patient’s homes and to run errands if need be. In suburban or rural areas, this isn’t a practical solution. Some home health care agencies have also implemented a strict no automobile/no patient transport policy, prohibiting the use of employee vehicles for patient transportation in order to mitigate the risk of an automobile-related claim. - Implement an anti-slip shoe voucher program. Consider distributing anti-slip shoe vouchers to all home health care employees, paying for the cost of the shoes to help reduce slip-and- fall exposures. - Strengthen the return to work (RTW) program. Return to work programs offer several key benefits, including instilling a positive relationship between employers and employees (a well-taken-care-of employee is more likely to readily return to full duty as soon as medically feasible), controlling workers’ compensation claims costs and preventing and/or limiting lost workday cases. A successful RTW program should consist of short-term modification of work schedule/job duties to accommodate any restrictions imposed by the employee’s physician; modifications that vary based on the type of injury, the employee’s current physical ability, skills and pre-injury responsibilities; and progressive return to full duty. Manchester Specialty Programs provides the home health care industry with an end-to-end insurance solution designed to safeguard an organization’s assets, property, employees and clients. Part of our solution includes workers’ compensation insurance supported by risk management tools and strategies through our carriers to help clients gain control over ongoing costs and rising premiums and assist employees in returning to work. For more information about programs, you or your local agent/broker can contact us at 855) 972-9399. http://www.manchesterspecialty.com/home-healthcare-providers/home-health-care-workers-compensation/
Personal Caregivers Insurance
Many recent surveys indicate that the vast majority of aging individuals wish to remain in their homes, with as much autonomy as possible, for as long as possible. This is where home health care and home personal caregiver services come into play. At-home care is one of the fastest growing sectors in the healthcare and wellness industry. Some industry data show that up to 95 percent of modern elderly care is provided in a home environment. With 76 million baby boomers starting to retire at a rate of roughly 10,000 per day, the demand for in-home care will only increase. Furthermore, at-home caregivers are not solely available for the elderly, they are also commonly employed to help care for individuals with disabilities, severe illness, handicaps and other special needs. Many families hire caregivers or outside contractors, such as home aides or personal companions, to perform a variety of services to their elderly or ailing loved ones. As such, the professional liability needs of these professionals are very similar to those of the medical community. By providing emotional support, physical assistance, light housekeeping, homemaking, companionship, and other services, home caregivers help elderly, individuals with impairments, and chronically ill persons maintain a normal and comfortable life. While these professionals do not offer medical advising or assistance, they help improve the quality of life for millions of Americans every day. However, in doing so they can frequently encounter a number of complications, especially when it comes to liability concerns. It is not uncommon for caregivers to face legal complications from dissatisfied family members or clients. Even when allegations are unfounded, personal caregivers frequently face allegations of negligence, failure to preform contractual obligations or stated duties, harassment and many other claims. Whether your clients own a personal care agency and or are a personal care assistant, it is essential that they secure adequate protection for their personal and business assets. At Manchester Specialty Programs, we deliver specialty insurance programs that are specifically designed for specialty home care providers in both medical and support roles. Our comprehensive personal caregivers insurance program is designed to help these agencies continue to provide the important services they offer throughout our communities. To find out more about our operation and all our specialty insurance programs, please give us a call today at 855-972-9399. http://www.manchesterspecialty.com/home-healthcare-providers/why-do-personal-caregivers-need-insurance/
Inside the Hospice Industry
https://www.manchesterspecialty.com/inside-hospice-industry/ Hospice care focuses on quality at the end of life, providing humane and compassionate care for people in the last phases of an incurable disease so that they may live as comfortably as possible. It provides patients with supportive or palliative care, which is treatment to help relieve symptoms caused by serious illness – things such as nausea, pain, fatigue, or shortness of breath – but it does not cure the disease.
Home Health Care Insurance
The growth of the home health care industry over the last several years is due to a number of factors, including the desire of seniors to receive medical care in the comfort of their home coupled with the growing elderly population in the U.S. In fact, receiving health care at home represents a lifeline for millions of Americans, especially for the aging and chronically ill, who are looking for support and health care services throughout their continuum of life. Professional staff delivers home health care routinely, helping patients and their families manage preventive care as well as chronic conditions such as diabetes and cardiac care, managing wounds and prescription medications, and administering essential therapies. In the course of providing their services, home health care agencies face unique and complex exposures. At Manchester Specialty, we specialize in insuring the home health care industry and offer a comprehensive program exclusively designed for this segment. Our program includes: Professional Liability, Workers’ Compensation, General Liability/Package Policy, Non-Owned and Hired Auto, Directors’ & Officers’ Liability (D&O), Employment Practices Liability Insurance (EPLI) and Regulatory Audit (RAC) Insurance Coverage. With Manchester Specialty’s Home Health Care Program, we offer our brokers and their clients/insureds several key benefits: - National Program available in all 50 states and DC - 25+ Years of Extensive Expertise in the Home Health Care Sector - Coverage Available on an Occurrence or Claims Made Form; Admitted or Non-Admitted Basis - An All-Lines Integrated Program with a Select Group of Top-Tier Carriers - Flexible Coverages and Forms Tailored to the Home Health Care Exposure - Easy Installment Payment Options Our commitment to insuring the home health care industry is for the long-term. We began addressing the special insurance needs of this vital sector more than two decades ago, and will continue to do so as the different organizations that make up the industry face new and evolving challenges. Our underwriting and product development staff is dedicated to keeping ahead of how regulatory and other delivery of care changes pose new risks, and to developing and enhancing insurance coverage with our carriers to respond to these exposures. We offer an all-lines solution with customized coverage for home health care agencies from select top-tier insurance companies. You also get the benefit of our underwriting expertise and integrity, and the ability to “cross-underwrite” exposures – key in the home health care industry which provides a number of different services. In addition, we offer easy payment options with no finance charges, which is vital to these organizations and their budgetary concerns. http://www.manchesterspecialty.com/programs/home-health-care-providers/
Are Your Home Care Workers Ready for Disaster Response?
http://www.manchesterspecialty.com/home-care-workers-ready-disaster-response/ Many of the disaster preparedness resources available over the years have been developed for institutional healthcare providers, but home care and hospice workers—and their agencies—need to have working plans as well.
The Importance of Background Checks
Background checks in the home care industry are used to help find the best candidate for the job available. They verify that the applicants are who they claim to be, and typically include education, employment history, civil records, references – and, yes, criminal history. Having access to a candidate’s (and existing employees’) criminal history helps home care organizations keep their patients, other employees and even the business itself safe and secure. Elderly and disabled patients are particularly vulnerable to those with nefarious intentions who are providing at-home services, which are often unsupervised. Unfortunately, patients have been the victims of theft and violence by home care workers that were not properly screened in the hiring process, opening home health care agencies to liability exposures along with a damaged reputation. It’s important to note that although there is no one federal requirement for criminal background checks for home health workers, there are 40 states offering some form of vetting with laws, varying widely from one state to another in how and when criminal convictions can be used. For instance, many states utilize “ban-the-box” initiatives to eliminate employment barriers for qualified job seekers with criminal backgrounds. Furthermore, in certain states, ban-the-box laws prohibit inquiries about criminal history on job applications and prevent use of a background check until the final stages of hiring. Additionally, some states are going further to regulate a segment of home health care workers, such as in California, which passed the Home Care Services Consumer Protection Act, effective January 2016. This law impacts the people who use home care services, the workers who provide them, and the companies that hire those workers. It requires new state licensing of some companies that provide non-medical home care. The companies that hire home care aides must use only workers who have been background-checked and registered by the state. The companies and employees affected by the California law are those that provide services involving transportation, telephone calls, correspondence, laundry, shopping for personal care products and groceries, meal preparation and planning, and housekeeping. The list of services also includes ambulating, positioning, transferring, exercising, and performing hygiene-related activities such as personal grooming, and toileting issues such as incontinence, dressing, and bathing. The law mandates that companies that employ home care aides must obtain licensing in order to hire such employees. These companies are called home care organizations. (Note: Companies exempt from this regulation include licensed home health care agencies, hospice agencies, retirement communities providing continuing care, residential care facilities that care for the elderly, employment agencies, county service providers, and health facilities.) When conducting background checks, it’s also important that a home health organization follow guidelines released by the Equal Employment Opportunity Commission and the Federal Trade Commission (FTC). Basically, these guidelines mandate that an organization must obtain prior written authorization from applicants and employees to conduct a background check. The employer must describe the scope of the background check, and inform applicants and employees that information received from the background check may result in adverse employment action. If adverse employment action is to be taken based on any part of the results of the background check, the applicant or employee must be provided with written notice at least seven days in advance, along with a copy of the background check. It is critical that home health providers – whether they are providing medical and/or non-medical services – conduct background checks prior to hiring individuals and to periodically conduct background checks after an individual has been hired to help mitigate both professional and employment practices liability exposures and safeguard their reputation in the community. Equally important is for organizations to be well versed in the laws and regulations involving background checks in the jurisdictions where they conduct business. Bottom line: It’s good risk management for a home care business to screen their employees – within the parameters of the law – whether or not it is mandated. Manchester Specialty provides home health care organizations with comprehensive insurance solutions to protect against the various exposures they face, including Entity Professional Liability and Employment Practices Liability coverage. We also have access to discounted background check services to assist your insureds with this important practice in minimizing their risk. For more information about our programs, please contact us at 855.972.9399. http://www.manchesterspecialty.com/uncategorized/importance-background-checks-insuring-home-care-firms/
Working with Insurance Broker -  (855) 972-9399 - Manchester Specialty Programs
https://www.manchesterspecialty.com/working-with-an-insurance-program-broker-that-specializes-in-the-home-care-industry/ Working with an Insurance Program/Broker that Specializes in the Home Care Industry Manchester Specialty Programs is a program administrator that works with insurance agents and brokers throughout the country, providing them with the insurance solutions, underwriting expertise and markets they require to properly protect home health care clients. Home health care is a growing sector driven in part by an aging population, preference, and economic factors as a result of the high cost of long-term care facilities. https://www.youtube.com/channel/UC8q61kzwNhtk37OW2bv6OKA/videos https://www.youtube.com/watch?v=Q9OK6sbCQNU Visit us on Social Media https://www.facebook.com/manchesterspecialtyprograms/?ref=hl https://twitter.com/ManchesterSpec https://plus.google.com/u/0/106865242607029400017?hl=en https://www.linkedin.com/company/manchester-specialty-programs-inc./ Manchester Specialty Programs 1000 Elm St. Ste. 1900 Manchester NH 03101 (855) 972 - 9399
Diabetes Management in Home Health Care
https://www.manchesterspecialty.com/diabetes-management-home-health-care/ As home health care professionals care for an aging population, they are increasingly becoming an essential part of the daily management of patients’ diabetes. When caring for a diabetic patient, it’s important the home health care provider ensure that both the patient and his or her family understand the goals of any diabetes management program.
Hospice Care - (855) 972-9399 - Manchester Specialty Programs
https://www.manchesterspecialty.com/ensuring-emergency-preparedness-for-hospice-providers/ Ensuring Emergency Preparedness for Hospice Providers Manchester Specialty Programs provides hospice providers with a complete range of insurance solutions. For more information about our business and insurance lines, you or your local agent/broker may contact us. With hurricane season around the corner, we thought it would be a good idea to address the need for hospice providers to ensure that their emergency preparedness plans are in compliance and ready to respond in the event of both natural and man-made disasters. https://www.youtube.com/channel/UC8q61kzwNhtk37OW2bv6OKA?guided_help_flow=3 https://www.youtube.com/watch?v=O1EtK_WBB9k Visit Us on Social https://www.facebook.com/manchesterspecialtyprograms/?ref=hl https://twitter.com/ManchesterSpec https://plus.google.com/u/0/106865242607029400017?hl=en https://www.linkedin.com/company/manchester-specialty-programs-inc./ Manchester Specialty Programs 1000 Elm Street Suite 1900 Manchester NH 03101 (855) 972-9399
Carrier Stability in Workers’ Compensation
http://www.manchesterspecialty.com/workers-comp-2/importance-carrier-stability-workers-compensation/ Workers’ Compensation insurers should provide solid protection for employers and their employees who get injured at work. Part of the job of a specialty underwriting and insurance program management firm is to select and contract with insurers that demonstrate these attributes of stability.
EPLI - (855) 972 - 9399 - Manchester Specialty Programs
https://www.manchesterspecialty.com/the-need-for-employment-practices-liability-insurance-in-todays-environment/ The Need for Employment Practices Liability Insurance in Today’s Environment Manchester Specialty specializes in insuring the home health care and hospice industry, and offers EPLI solutions to help protect organizations in the event of employment-related allegations. Employers, including those in the home health care industry, should take another look at their company culture and all of their practices to ensure that there is zero tolerance for certain behavior in the workplace and that proper procedures are indeed in place. Businesses should also be taking a fresh look at their Employment Practices Liability Insurance (EPLI). https://www.youtube.com/channel/UC8q61kzwNhtk37OW2bv6OKA?guided_help_flow=3 https://www.youtube.com/channel/UC8q61kzwNhtk37OW2bv6OKA/videos Visit Us on Social https://www.facebook.com/manchesterspecialtyprograms/?ref=hl https://twitter.com/ManchesterSpec https://plus.google.com/u/0/106865242607029400017?hl=en https://www.linkedin.com/company/manchester-specialty-programs-inc./ Manchester Specialty Programs 1000 Elm Street Suite 1900 Manchester NH 03101 (855) 972 - 9399
Non Owned & Hired Auto Liability - (855) 972 - 9399 - Manchester Specialty Programs
https://www.manchesterspecialty.com/the-need-for-non-owned-hired-auto-liability-coverage-in-home-health-care-insurance-programs/ The Need for Non-Owned & Hired Auto Liability Coverage in Home Health Care Insurance Programs Manchester Specialty specializes in providing total insurance solutions for home health care providers and can help you in placing the necessary coverages to address your insured’s risk profile. Reviewing the ins and outs of Non-Owned & Hired Auto coverage with insureds and the importance of securing this coverage serves to mitigate the risks that come with employees using their own vehicles for work – a common practice in the home health care industry. https://www.youtube.com/channel/UC8q61kzwNhtk37OW2bv6OKA?guided_help_flow=3 https://www.youtube.com/watch?v=j1dfM1bH9B4 Visit Us on Social Media https://www.facebook.com/manchesterspecialtyprograms/?ref=hl https://twitter.com/ManchesterSpec https://plus.google.com/u/0/106865242607029400017?hl=en https://www.linkedin.com/company/manchester-specialty-programs-inc./ Manchester Specialty Programs 1000 Elm St. Ste. 1900 Manchester NH 03101 (855) 972 - 9399
About Us -  (855) 972-9399 - Manchester Specialty
https://www.manchesterspecialty.com/ Total Business Insurance Solution for Home Care, Hospice & Medical Staffing We continue to be committed to being the leading source of insurance coverage in this market for the next 40 years and beyond. We can work with you and your local insurance broker to provide customized coverage solutions for your home health care, hospice or medical staffing business. https://www.youtube.com/channel/UC8q61kzwNhtk37OW2bv6OKA/videos https://www.youtube.com/watch?v=x_-1wVVur8M Visit us on Social Media https://www.facebook.com/manchesterspecialtyprograms/?ref=hl https://twitter.com/ManchesterSpec https://plus.google.com/u/0/106865242607029400017?hl=en https://www.linkedin.com/company/manchester-specialty-programs-inc./ Manchester Specialty 1000 Elm St. Ste. 1900 Manchester NH 03101 (855) 972 - 9399
Home Care 5-Star Rating Manchester Specialty Programs
https://www.manchesterspecialty.com/what-is-a-5-star-rating-for-home-care/ What Is A 5-Star Rating for Home Care? Manchester Specialty provides total business insurance solutions for home health care agencies. We can help you provide the following insurance lines to your clients: General Liability, Professional Liability, Workers’ Compensation, Management Liability, Cyber Liability and Non-Owned & Hired Auto insurance, among other key coverages. About 5% of U.S. home health care agencies earned a 5-star rating for quality of patient care in the April update to the HHC website, which represents an uptick from 4% as of January 2018. The percentage of 4.5-star agencies also increased in that time period, from 10% to 12%, according to an analysis of the data by a consulting firm specializing in home health and hospice. The national average rating has remained at 3.5 stars. https://www.youtube.com/channel/UC8q61kzwNhtk37OW2bv6OKA/videos https://www.youtube.com/watch?v=zAV4wCED4ro Visit us on Social Media https://www.facebook.com/manchesterspecialtyprograms/?ref=hl https://twitter.com/ManchesterSpec https://manchester-specialty-programs-inc.business.site/?m=true https://www.linkedin.com/company/manchester-specialty-programs-inc./ Manchester Specialty Programs 1000 Elm St. Ste. 1900 Manchester NH 03101
Create a Culture of Safety
http://www.manchesterspecialty.com/create-culture-safety-home-care-agency/ Safety and wellness are not just policies a home care agency lists in its business manual. They should be part of a culture of best practices that benefit both employees and patients. Ingraining the behaviors that create and perpetuate these virtues is an ongoing process, but one that will potentially assist in reducing Workers’ Compensation, health care and Liability claims.
Cyber Liability Inusrance
Cyber threats today are among the top risks for organizations of all types and sizes, with the health care industry and its diverse segments particularly vulnerable due to the high value placed on stolen patient records in the criminal market. In fact, the FBI estimates that one patient record goes for $50 on the black market, much more than the few dollars often obtained for credit card numbers. Moreover, according to a 2015 study conducted by the Ponemon Institute, an independent research organization on privacy, data protection and information security policy, data breaches could be costing the health care industry $6 billion. Despite this, many organizations have little or no confidence in their ability to detect all patient data loss or theft. They are also unprepared to meet the changing cyber threat environment with a comprehensive incident response plan comprised of forensics analysis, mandatory patient notification, identity theft protection, remediation and resolution services and crisis and reputational management. Added to this is the fact that a data breach could be in violation of HIPAA laws and result in fines and penalties if not reported properly, jeopardizing the reputation of the organization itself. Cyber Liability/Privacy & Network Liability Risk insurance is designed to respond when a data breach or other cyber incident occurs, providing the safety net and resources that health care organizations need to protect their operation. Manchester Specialty Programs offers a comprehensive Cyber solution to home health care providers, personal care, companion care and support services, visiting nurse associations (VNAs), hospices and medical staffing firms. There are also additional policy enhancements available such as specialized coverage for “rogue” employees or regulatory proceedings expenses. In addition, we provide access to invaluable cyber management and loss prevention assistance through our carriers and third-party consultants that includes services such as computer forensics to vet the source of the breach and assess the damage, mandatory breach notification, remediation and resolution services, and crisis communication expertise. http://www.manchesterspecialty.com/coverages/cyber-liability/
Employment Practices Liability Insurance
http://www.manchesterspecialty.com/employment-practices-liability/abcs-employment-practices-liability-insurance/ Today’s litigious landscape and evolving business regulations require that a comprehensive insurance program includes Employment Practices Liability Insurance (EPLI) to protect against employment-related claims. EPLI insurance is designed to respond to allegations involving employment-related issues from employees, job candidates, and former employers.
Healthcare Cyber Liability
It’s no secret that “cyber liability” has become a popular term in the news, and cyber-attacks seem to be more and more frequent. In fact, just a few short months ago Anthem made headlines when they discovered that hackers had implemented a cyber-attack in order to gain unauthorized access to their IT system and obtain personal patient information. Anthem is not the only health care related organization to have suffered a data breach or cyber-attack, and they certainly won’t be the last. This is why having the right Healthcare Cyber Liability prevention procedures in place and related insurance coverage is imperative. It’s vital to remember that any type of healthcare facility, provider or related organization can suffer a data breach, which is increasingly being used to obtain Personal (or protected) Health Information (PHI). Patient billing and insurance records are particularly attractive as they contain valuable data such as social security numbers, addresses and payment details. According a recent Data Breach Category Summary provided by the Identity Theft Resource Center, health care organizations account for more than 40% of all data security breaches reported across all industry segments nationwide. While obtaining the right insurance protection is essential to protecting your firm financially, it’s also prudent to do everything in your power to prevent a breach from happening, including: - Conducting a risk assessment to identify factors such as current online security policies, systems configuration, password protocols, threats, and vulnerabilities. - Providing consistent HIPAA education to employees and ensuring they are aware of all HIPAA rules and regulations. - Monitoring all devices (including mobile) used by the firm for business purposes. - Encrypting internal data and hardware, and developing a very strict BYOD (Bring Your Own Device) policy, where employees are allowed to use their own personal devices to conduct business. - Examining service-level agreements carefully to prevent third-party vendor cyber-attacks. These are just some of the ways your organization can take action to prevent data breaches and cyber-attacks. It’s also important to review your insurance coverage and make sure you are properly protected should an online attack occur. A cyber-attack has both financial and reputational effects on your business. At Manchester Specialty Programs, you will find all the insurance coverage you need to operate your business, and all in one program. We deliver specialty insurance programs that are specifically designed for home care and hospice firms in both medical and support roles. We can offer cyber liability coverage to eligible firms as part of our professional liability coverage, management liability, health care suite or on a “stand alone” full coverage basis. Our comprehensive home health care and hospice provider insurance program is designed to help these agencies continue to provide the important services they offer throughout our communities. To find out more about our operation and all our specialty insurance programs, you or your local insurance broker can give us a call today at 855-972-9399. http://www.manchesterspecialty.com/cyber-liability/health-care-cyber-liability-risk/
General Liability Insurance
General Liability insurance along with securing the proper limits for all health care organizations is essential to protect their assets and allow them to continue to keep their doors open and make their services available. Visitors and patients can get injured on the premises and property can be damaged while carrying out an agency’s services, just to name a couple of the liability risks that exist. We provide General Liability insurance as part our program for the home health care, hospice and medical staffing market to protect against third-party lawsuits in the event of bodily injury, property damage and personal injury claims. Our program can compensate an insured for lawyer’s fees, settlement or judgment costs, and other court expenses. We also offer Excess Liability coverage to extend the underlying coverage in the event of a catastrophic injury or accident. Our package policy can also cover the insured’s medical equipment and supplies, furnishings, fixtures, and owned office building. Our Business Interruption coverage will reimburse an insured for lost earnings when a firm must temporarily close after a covered property event. http://www.manchesterspecialty.com/coverages/general-liabilitypackage/
Wellness Programs Can Reduce Workplace Accidents
http://www.manchesterspecialty.com/workers-comp-2/wellness-programs-can-reduce-workplace-accidents-lower-workers-comp-premiums/ A wellness program, if properly implemented, can make a positive impact on an organization’s Workers’ Compensation premiums. Wellness programs have been an integral component of health plans for many organizations.
Private Duty Care
As increasingly more senior adults are choosing to remain in their own homes as they grow older, it’s important to understand the type of services available should they have to deal with a health care issue, especially when it comes to private duty care versus home health care. http://www.manchesterspecialty.com/home-healthcare-providers/understanding-private-duty-care/
Home Health Care: Reducing Mobile Device Security Risks
https://www.manchesterspecialty.com/home-health-care-reducing-mobile-device-security-risks/ Health care organizations of all types, including home health care providers, hospice and others, are increasingly using mobile devices – apps on tablets and smart phones – to improve operational efficiencies and patient health outcomes, access clinical information, enhance staff communications, and serve as an additional educational resource.
D&O Insurance -  (855) 972-9399 - Manchester Specialty Programs
https://www.manchesterspecialty.com/are-your-home-health-care-hospice-insureds-covered-for-do-risks/ Are Your Home Health Care & Hospice Insureds Covered for D&O Risks? Manchester Specialty Programs specializes in designing a comprehensive Management Liability program that not only covers the needs of directors and officers, but also home care employment practices liability risks. Executives of non-profit health care organizations, including home health care and hospice providers, are increasingly being held personally legally liable for wrong business decisions by employees, patients, competitors and regulators. https://www.youtube.com/channel/UC8q61kzwNhtk37OW2bv6OKA?guided_help_flow=3 https://www.youtube.com/watch?v=RP-PU-PLmbQ Visit Us on Social Media https://www.facebook.com/manchesterspecialtyprograms/?ref=hl https://twitter.com/ManchesterSpec https://plus.google.com/u/0/106865242607029400017?hl=en https://www.linkedin.com/company/manchester-specialty-programs-inc./ Manchester Specialty Programs 1000 Elm St. Ste. 1900 Manchester NH 03101 (855) 972 - 9399
New Proposed Rule Opens Path to Association Health Insurance Plans
https://www.manchesterspecialty.com/new-proposed-rule-opens-path-association-health-insurance-plans/ Last fall, the Trump Administration proposed several changes to the Affordable Care Act (ACA), which was signed into law in 2010. One of the proposed rules involves making it easier for trade groups, small businesses and associations to band together and purchase the type of health insurance coverage that large companies offer their employees. The goal is to create more insurance competition and drive down premiums.
Preventing Cyber Breaches
http://www.manchesterspecialty.com/cyber-liability/home-health-care-providers-beware-hackers-want-data-money-access/ Depending on the damage done, such as privacy violations (think HIPAA), a home healthcare provider that fails to protect its data could face stiff regulatory penalties on top of the other costs. And, if physical harm were to come to a patient because of a home care company’s cyber errors or negligence, the company could also face a personal injury lawsuit—one that typically falls outside General Liability insurance coverage if there is a cyber exclusion clause.
NH Workers' Compensation Insurance
Workers’ Compensation coverage for home health care providers, personal care and support services, Visiting Nurse Associations (VNAs), hospices, medical staffing firms and durable medical equipment (DME) suppliers represents a significant expense in addition to payroll. Losses are often inevitable in this industry, especially for those with employees lifting or transporting patients or working with medical devices on a regular basis. At Manchester Specialty Programs, as a result of our long-term commitment and experience in this area, we have numerous avenues available to us to secure Workers’ Compensation coverage for your firm. We hold the underwriting pen with many of our program partners for Workers’ Compensation. We can also access monoline Workers’ Compensation capacity on a placement basis if our standard program carriers are not available to write a particular risk. This gives us the flexibility to assist our agent and broker partners in securing coverage and rounding out the insurance solutions being offered. Additionally, we understand that securing a Workers’ Comp program to provide coverage for an employee’s occupational injuries is not enough. We also offer tools and strategies through our carriers for these industry segments to help gain control over ongoing costs and rising premiums, assist employees in returning to work, stem fraud, and other risk management measures. With Manchester Specialty’s Home Health Care Program, we offer our brokers and their clients/insureds several key benefits: - Medical costs for employees’ occupational injuries - Lost wages during recovery from a job-related injury - Disability payments and funeral expenses if a work injury ends in permanent harm or death - Legal expenses if an injured employee sues your business for the injury (covered by Employer’s Liability Insurance) - Return to work programs to proactively move employees back into the workforce http://www.manchesterspecialty.com/coverages/workers-compensation/
Caregivers - (855) 972-9399 - Manchester Specialty Programs
https://www.manchesterspecialty.com/the-increasing-need-for-caregivers-as-americans-age/ The Increasing Need for Caregivers As Americans Age Manchester Specialty Programs is committed to the home health care industry as a provider of business insurance solutions that address the unique exposures of this rapidly growing and vital sector. A recent article in the Wall Street Journal discussed the caregiver shortage we are experiencing in the U.S. as baby boomers age and find themselves in need of care. This comes at a time when median incomes, including Social Security and retirement funds, haven’t risen in years, and many boomers are strapped with higher debt, sometimes as result of taking care of their own parents. https://www.youtube.com/channel/UC8q61kzwNhtk37OW2bv6OKA/videos https://www.youtube.com/watch?v=gSXmAtSPvl4 Visit us on Social Media https://www.facebook.com/manchesterspecialtyprograms/?ref=hl https://twitter.com/ManchesterSpec https://plus.google.com/u/0/106865242607029400017?hl=en https://www.linkedin.com/company/manchester-specialty-programs-inc./ Manchester Specialty Programs 1000 Elm St. Ste. 1900 Manchester NH 03101 (855) 972 - 9399
Workers' Compensation
Workers’ Compensation coverage for home health care providers, companion care and support services, Visiting Nurse Associations (VNAs), hospices, medical staffing firms and durable medical equipment (DME) suppliers represents a significant expense in addition to payroll. Losses are often inevitable in this industry, especially for those with employees lifting or transporting patients or working with medical devices on a regular basis. At Manchester Specialty Programs, as a result of our long-term commitment and experience in this area, we have numerous avenues available to us to secure Workers’ Compensation coverage for your firm. We hold the underwriting pen with many of our program partners for Workers’ Compensation. We can also access monoline Workers’ Compensation capacity on a placement basis if our standard program carriers are not available to write a particular risk. This gives us the flexibility to assist our agent and broker partners in securing coverage and rounding out the insurance solutions being offered. Additionally, we understand that securing a Workers’ Comp program to provide coverage for an employee’s occupational injuries is not enough. We also offer tools and strategies through our carriers for these industry segments to help gain control over ongoing costs and rising premiums, assist employees in returning to work, stem fraud, and other risk management measures. With Manchester Specialty’s Home Health Care Program, we offer our brokers and their clients/insureds several key benefits: - Medical costs for employees’ occupational injuries - Lost wages during recovery from a job-related injury - Disability payments and funeral expenses if a work injury ends in permanent harm or death - Legal expenses if an injured employee sues your business for the injury (covered by Employer’s Liability Insurance) - Return to work programs to proactively move employees back into the workforce http://www.manchesterspecialty.com/co...
D&O Coverage for Home Care Non-Profits
In our previous blog post, we discussed the necessary insurance coverages for home care firms. One of the coverages mentioned was Directors’ and Officers’ (D&O) Liability. This type of Management Liability for Home Care Firms may often be overlooked, especially in the case of non-profit firms. Directors’ & Officers’ Liability offers protection to the directors and officers of public, private, and non-profit organizations for decisions they may have made regarding the operation of the business. Coverage Basics D&O Liability insurance protects the individual directors and officers of a health care firm; however it is the duty of the home care organization as a whole to pay for this coverage. It’s also the firm itself that will be held financially responsible for any wrongdoing or claim of wrongdoing on the part of a director or officer. Non-profit D&O insurance can include coverage for defense costs, settlements and judgments, and also helps to protect the personal assets of board members (a good tool to attract and retain quality board members.) Naturally, not everybody will agree with the decisions made by directors and officers. These decisions may be in the best interest of the organization; however that won’t always stop a displeased third party from bringing a lawsuit against an individual or the entity. Non-profit board members can be held personally liable for the actions and oversight of the organization. Why Should Directors and Officers Be Insured? A common misconception many non-profit home care providers believe is that their general liability or business umbrella policy will cover any director or officer wrongdoing. Therefore, they view D&O coverage as an unnecessary expense. Unfortunately, a standard general liability or umbrella policy doesn’t have the ability to respond to a management liability lawsuit, which could be detrimental to an already financially-stretched non-profit home care firm. Another myth about D&O insurance is that only a large, financially lucrative company needs it. A business of any size will typically employ an officer or director. Any type of business leader could potentially be targeted by third-party lawsuits due to the way they manage or oversee their company. Why Non-Profits are Especially Vulnerable The key function of directors or officers in a non-profit home care entity is to maintain the organization’s financial stability as well as provide the needed resources to accomplish the firm’s overall goals and purposes; in this case to provide quality care to patients. Typically, these non-profit organizations are limited in the support and funds they can provide for a director or officer, making their directors more vulnerable to mistakes, as well as legal claims that could be financially damaging. Common D&O Liability Claims Typical legal claims that directors and officers face include: - Misusing the organization’s funds - Misrepresenting company assets - Medicare/Medicaid billing and audit issues - Failure to comply with healthcare rules and regulations - Lack of corporate governance These legal claims can come from an organization or business, as well as patients and their families. These are not the only individuals who can sue a director or officer, however. Lawsuits can also arise from: Third-party healthcare providers - Creditors - Regulators - Employees - Competitors At Manchester Specialty Programs, we understand that no two home care non-profits are the same, and that means that their insurance needs will differ as well. We specialize in designing a comprehensive management liability program for you that not only covers the needs of directors and officers, but also home care employment practices liability risks, which we discuss here. Our coverage protects the financial health of an organization in addition to the personal assets of the health care organization’s directors and officers. For more information about our products and services, you or your local insurance broker may contact us at 855-972-9399. http://www.manchesterspecialty.com/home-healthcare-providers/d-o-coverage-home-care-non-profits/
EPL Trends Affecting Home Health Care
Earlier this year, the Equal Employment Opportunity Commission (EEOC) released its litigation and enforcement statistics for the fiscal year 2015, providing us with insight on the types of employment practices liability (EPL) lawsuits faced by businesses across diverse industries, including the home health care sector. Illegal background checks, health-related employment and pregnancy discrimination and unpaid internships are top-trending employment practices litigation cases, according to EEOC stats and insurance industry experts. Employment-related risks rank among a business’ most potentially damaging exposures, with employers of all sizes facing possible damage from EPL lawsuits, including financial disaster and/or irreparable damage to an organization’s reputation. Let’s take a look at some of the trending EPL litigation affecting businesses: Illegal Background Checks Anytime a business uses an applicant’s or employee’s background information to make an employment decision, the employer must comply with federal laws that protect applicants and employees from discrimination. This includes discrimination based on race, color, national origin, sex, or religion; disability; genetic information (including family medical history); and age (40 or older). These laws are enforced by the EEOC. In addition, when you run background checks through a company in the business of compiling background information, you must comply with the Fair Credit Reporting Act (FCRA). Genetic Discrimination The Genetic Information Nondiscrimination Act of 2008 (GINA) took effect in November 2009 and prohibits the use of genetic information to discriminate in employment while also puts restrictions on employers requesting, requiring, or purchasing genetic information on their employees. GINA governs the privacy of a person’s genetic information, which is sometimes released with family medical histories. “Genetic information” includes, among other things, information about the “manifestation of a disease or disorder in family members of an individual.” Family members include certain blood relatives, such as parents, grandparents, and children, but also include spouses and adopted children. Pregnancy Discrimination The Pregnancy Discrimination Act (PDA) is an amendment to Title VII of the Civil Rights Act of 1964 and prohibits discrimination on the basis of pregnancy, childbirth, or related medical conditions by employers with 15 or more employees, including state and local governments. Women who are pregnant or affected by related conditions must be treated in the same manner as other applicants or employees with similar abilities or limitations. Employers may not refuse to hire a woman because of her pregnancy, a pregnancy-related condition, or the prejudices of co-workers, clients, or customers. Since the start of the fiscal year 2011, EEOC has filed more than 45 lawsuits involving pregnancy discrimination. During that time, the federal agency has recovered approximately $3.5 million. An example of a pregnancy discrimination case in the home health care sector involved a home health aide who sued her employer last year after she was told to obtain a doctor’s note stating that she could perform all job duties with the only limitation being that she should not lift or pull more than 25 lbs. Despite the medical release to work, the home health care employer terminated her employment just minutes after she furnished the required note. The laws involving employment practices are complex and continually evolving and require legal and HR expertise to ensure that your organization remains in compliance. In addition, having proper best practices in place as well as an insurance program that addresses the varied exposures that come into play with employment-related risks is critical. Manchester Specialty provides a total insurance solution for the home health care industry, including Employment Practices Liability Insurance (EPLI), which covers wrongful acts arising from the employment process, including wrongful termination, discrimination, sexual harassment, and retaliation. EPLI is available as a stand-alone coverage, and can also be a part of a management liability package policy. For more information about our insurance solutions, you or your local agent/broker may contact us at 855.972.9399. http://www.manchesterspecialty.com/home-healthcare-providers/employment-practices-liability-trends-affecting-home-health-care/
What is Employment Practices Liability?
Many health care employers are finding that employment-related legal claims have been on the rise in recent years. These claims can come from current, former, and even prospective staff, and can affect all types of employers within this field. This includes home care agencies, hospice firms, and even medical staffing firms. Understanding where employment claims may come from, and what employment practices liability insurance (EPLI) entails, is just as important as being covered with the right Health Care Management Liability policy. What is Employment Practices Liability Insurance? This insurance policy financially protects health care organizations against claims from workers and applicants that allege their legal rights have been violated by the employer. According to the Insurance Information Institute (iii), most suits of this nature to date have been filed against larger businesses. This does not mean that small to mid-sized companies are immune, and EPLI coverage is a necessary component of an overall management liability program for any size health care organization. What Does EPLI Protect Against? There are a variety of employee lawsuits that health care agencies may face, including claims of: - Sexual Harassment - Discrimination - Wrongful Termination - Breach of Employment Contract - Negligent Evaluation - Failure to Employ or Promote - Wrongful Discipline - Deprivation of Career Opportunity - Wrongful Infliction of Emotional Distress EPLI often provides the insured home care or hospice firm with financial reimbursement for defense costs and other legal fees should a claim make it to court, in addition to any damages or settlement that may be owed to the claimant. How can EPLI Claims be Prevented? There are certainly steps that health care employers can take to significantly lower risk, including but not limited to: - Reviewing employment loss exposures with their insurance broker/carrier - Developing a detailed employee policy handbook - Creating clear job descriptions - Conducting periodic performance reviews - Conducting background checks on incoming staff - Creating an effective record-keeping system to document employee issues as they arise. - Adhering to federal and state regulations and guidelines regarding employment How Much Does EPLI Cost? This depends on a variety of factors. How many people does the health care organization employ? What type of formal Human Resources department do they have? Have there been Any prior lawsuits? What does employee turnover look like? These factors as well as if the health care firm has established documentation of rules and regulations will factor into determining the cost of an EPLI policy. At Manchester Specialty Programs, we understand the management liability risks employers face when running a home care agency, hospice care facility, or medical staffing firm. As changes take place within this industry and with health care overall, it’s imperative for these organizations to ensure they are financially protected from any legal claims that may occur. Our comprehensive home health care and hospice provider insurance program is designed to help these agencies continue to provide the important services they offer throughout our communities. We deliver specialty insurance programs that are specifically designed for home care and hospice firms in both medical and support roles. Our employment practices liability insurance carriers are well versed and experienced in this coverage, and offer excellent wrap around loss control services such as online HR tools and handbooks. To find out more about our operation and all our specialty insurance programs, you or your local insurance broker can give us a call today at 855-972-9399. http://www.manchesterspecialty.com/employment-practices-liability/employment-practices-liability/

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