FIVE BEST PRACTICES TO REDUCE THE RISK OF EMPLOYEE INCIDENTS


transfers. The Assurance training program can help reduce that rate to about 10 per- cent of the claims, said Rivas, who holds a doctorate in occupational therapy. The Assurance training program relies


on clinical thinking. In other words, the worker needs to determine in advance how much effort will be needed to help the res- ident. “The problem is, people change,” said Rivas. For example, a resident might be weaker after dialysis and require extra help. A resident may have vertigo or have had a stroke. Different medical conditions should be assessed and taken into account. The employee should be trained to make


a judgment call and decide how best to posi- tion the resident and whether an assistive de- vice is required, such as a wheelchair or slid- ing board, and how it should be positioned. Silverado has established training pro-


tocols for lifting and transferring residents, since these activities are responsible for a large majority of worker injuries. “We creat- ed a two-person transfer on every shift,” said Russo. If a resident has challenging behav- iors or is large, two employees are required to complete the transfer or lift. Each worker has an “accountability partner,” a colleague to help perform two-person lifts and transfers. Caregivers at Silverado have extensive


training in Alzheimer’s disease and demen- tia. It’s important for them to understand the underlying disease and the behaviors it can cause. Workers are trained to recog- nize the signs that a resident is becoming agitated. Common triggers such as sudden noises or bright lights are also explained to the caregivers. The caregivers are then taught how to


prevent or lessen the outburst by redirect- ing the resident’s attention or engaging the person in conversation. Caregivers need to be prepared to bring in another associate to help, if necessary. “It takes continuous education and training,” said Russo.


Create a consistent incident report procedure Developing a compre- hensive reporting system of employee incidents


is critical to the risk management process. Employees who feel they are being cared for


and that their complaints are being heard are much less likely to bring legal action against the company. A thorough reporting process also makes for a better working environment. Assurance helps its clients educate and


train building managers on how to correct- ly report incidents. “They need to know the rules,” said Rivas. Managers must un- derstand how to classify an incident. An incident may trigger a workers’ compensa- tion claim, but it may not be what’s called “OSHA recordable.” For example, an em- ployee who is sent to the doctor and receives first aid, and then is sent back to work does


ing system last year. Incident reporting had previously been done in-house with admin- istrators handling the paperwork. “It was difficult to track incidents,” said Rogers. “If you don’t have all the right materials in front of you, it’s easy to miss an injury and not be able to document it properly.” Now the company uses a third-party ad-


ministrator. Injured workers are immedi- ately directed to call an “800” number to speak with a nurse practitioner. If the work- er needs to go to the hospital, a building manager will accompany the employee to the hospital and then the hotline is called.


About 54 percent of workers' compensation claims by assisted living companies are related to injuries from resident transfers.


not constitute an OSHA recordable event. Generally, a recordable injury or illness


under OSHA is one that requires medical treatment beyond first aid, as well as one that causes death, days away from work, restricted work or transfer to another job, or loss of consciousness. OSHA instituted a new rule in 2017 that requires senior living to submit injury reports electronically. Assurance also recommends the use of


a telephonic triage program. Injured em- ployees call a nurse who provides guidance on medical treatment. The nurse is em- ployed by a third-party vendor, the phone calls are recorded, and the nurse generates an incident report. The nurse also creates a state specific report, depending on the requirements of the individual state or ju- risdiction. The incident report is forwarded to the treating doctor, serving as the medical authorization form. The program has several advantages,


said Rivas. The use of a third-party triage nurse increases the consistency of incident and claim reporting. “Even if the building administrator is on vacation, the process is the same,” said Rivas. Also, the third-par- ty system reduces the amount of necessary paperwork, both for the administrator and the employee, to report incidents properly. Pathway to Living simplified its report-


32 SENIOR LIVING EXECUTIVE JANUARY/FEBRUARY 2018 The nurse practitioner answers all the


employee’s questions and fills out all the necessary reports, which are forwarded to authorities, if applicable, the insurance car- rier, and the building manager. Within 24 hours, the nurse follows up with the injured employee, and then also within a week of the initial claim. “Ongoing contact with the nurse helps put team members’ minds at ease,” said Rogers. She added that the system also signals to the employee that the company is not making a judgment on the validity of the injury. The system has helped to reduce employ-


ee complaints, said Rogers. She noted that employees have fewer concerns and not as many of them are seeking legal assistance to bring an action against the company. “The employee has a touch point with the nurse practitioner immediately,” said Rogers. At Silverado, a best practice is a stan-


dard reporting protocol that includes the use of a designated occupational health clinic. Each location has a designated clin- ic that has been trained to understand the nature of the work at the community and the physical requirements of the jobs. The clinic even keeps a copy of the community’s job descriptions. Injured employees are evaluated by a doctor, certified and trained in occupational


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