At a Residential Care Facility for the Elderly (RCFE), you walk a bit of a thin line. You’re not a medical facility, but providing care is a core part of your mission. Your staff wants to help residents with what they need, but you need to be careful that doesn’t extend into medical care. If it does, you could be held liable.
This gets particularly tricky when you admit a resident with high medical needs. If you’re thinking about taking on this kind of resident, we want to walk you through some best practices and insurance considerations.
Why residents with high medical needs heighten your risk
Ideally, any resident coming in with extensive medical needs has a medical care team behind them. With doctors and even potentially visiting nurses in play, you may think it offsets the risk.
It can, but you need to be careful.
Specifically, you need to draw an extremely clear line between what your team will provide and what the resident will need to rely on outside medical services for.
Even then, high-needs patients can draw your team into providing medical care. If their diabetes isn’t managed, for example, the situation could get urgent quickly, and your team might rush to the resident’s aid. If they have a wound and it’s gotten infected, they might provide early treatment.
In short, your team’s desire to help can cause them to enter uncertain territory. And that could expose you to liability. To mitigate that risk, you need solid documentation paired with staff training.
Documentation: Your first line of defense
First, your resident contract should make explicit what care you provide and what you don’t.
Make sure it’s captured in writing that other parties (e.g., the resident’s doctor, any visiting nurses) provide medical care. It needs to be clear that your staff only offers support (e.g., monitoring, medication reminders), not direct medical care.
Then, maintain thorough documentation about that resident day in and day out. If you’re providing oxygen monitoring and your team observes an issue, capture it clearly, including steps you took to connect that resident with their medical provider.
From a liability perspective, it’s also helpful to maintain family communication logs. If you notify a family member that a resident needs to go see their physician, make a record of that.
Staff training: A critical asset
Make sure your staff knows what they can and can’t do.
Specifically, RCFEs benefit from offering training in what constitutes medical assistance versus direct medical care. You should also make sure they’ve received training in recognizing when medical treatment is needed (e.g., infection control, medical deterioration).
Whenever your staff gets trained, keep a record and file away any certificates. Again, documentation is your best friend if an insurance claim comes up.
Adjusting your insurance for residents with high medical needs
Talk with your RCFE insurance agent before admitting any residents with high medical needs. That individual has the potential to increase your coverage requirements. And the last thing you want is to find yourself underinsured if you end up facing a claim.
We’re here to help. Contact our team at InsureMyRCFE at (805) 413-5668 and we can review your policies against your current and potential future residents’ needs.
