Risk Management and Long Term Care

1
Risk Management and Long Term Care

• David Friend
• November 9, 2002
• CAS Annual Meeting
• Boston, MA

2
Challenges in the Long Term Care Industry

• Reimbursement is controlled by Medicare/Medicaid
• Insurance Premium increases cannot be passed on
  to the customer
• Obtaining proper insurance for reasonable price
• Runaway litigation cost
• Proper staffing for Risk Management Department
• Turnover effects quality of care

3
Senior Management Support

• Senior Management sets the tone for the Risk
  Management Goals and Objectives
• Risk Manager is responsible to keep Senior
  Management Appraised
• Corporate Statement on Loss Prevention
• Meet with Senior Management monthly/quarterly
  whenever possible

4
Department Structure( in the real world!)

• The History of LTCs is to have minimal staff for
  the Risk Management Department
• Loss Prevention Director (2-3)
• Claim Manager (1-2)
• Risk Analyst

5
Attacking the Problem

• Focus must be on Prevention
• Mitigate the Exposure
• Become a Salesmen/Tell the story of the company.
• Have Senior Management at the carrier road show!
• Be creative Self Insurance, Captives, swing
  plans etc.

6
Will it get better?

• Consolidated Lobby effort by the CEOs
• Tort Reform
• Some states have caps on Punitive Damages
• States are beginning to put limits on statue of
  limitations
• It Just has to!