Posted by Mike Arnold, Commercial Lines Insurance, March 24, 2020

Follow Evolving Guidelines, Review Your Insurance Policies

Residents in long-term care facilities are one of the most vulnerable populations affected by the Coronavirus pandemic. However, the senior living community has had infection control protocols in place for many years. From an insurance perspective, following, adhering to, and monitoring current and evolving guidelines from local and federal government entities is essential. Failing to do so could impact your patients and your operations.

Keep in mind your policy may contain a liability exclusion for bodily injury arising out of the actual or alleged transmission of a communicable disease. Don’t hesitate to check with your broker to review your coverage or interpret new guidelines.

Our friends at CRC Group discussed issues pertaining to the long-term care community as it relates to insurance in their latest podcast: Keep Calm & Act Now: Long-Term Care Facilities Brace for Coronavirus Impact.

Updated Survey Prioritization Fact Sheet (Source: CMS)

On March 23, 2020 CMS released its updated Survey Prioritization Fact Sheet, which includes a focused survey process in response to COVID-19 that includes:

  • Complaint Inspections: State survey agencies will continue to conduct inspections related to complaints and facility-reported incidents that are triaged at the Immediate Jeopardy level. These include allegations such as physical or sexual abuse, neglect, or other conditions that may create an imminent threat to the health and safety or patients and residents. Inspectors will use a streamlined Infection Control Review tool, regardless of the Immediate Jeopardy allegation.
  • Targeted Infection Control Inspections: Federal and state inspectors will conduct targeted infection control inspections of providers identified through CMS collaboration with the Centers for Disease Control and Prevention (CDC). These inspectors will use a streamlined targeted review checklist to minimize the impact on provider activities, while ensuring providers are implementing actions to protect health and safety. The goal of these inspections will be to provide a quick, focused assessment of a provider’s infection control practices in those areas where such increased oversight will be most effective. Providers will then receive immediate feedback to allow them to address any potential gaps or shortcomings.
  • Self-Assessments: The Infection Control checklist referenced above will also be shared with providers and suppliers to allow for self-assessment of their Infection Control plans. This may be the best solution in some cases when there is a lack of personal protective equipment or state surveyors available.

During this time frame, the following inspections will not be conducted:

  • Standard inspections for nursing homes, hospitals, home health agencies, intermediate care facilities for individuals with intellectual disabilities, and hospices; and
  • Revisit inspections not associated with Immediate Jeopardy.

Your Partner & Go-To Resource for COVID-19

Please don’t hesitate to reach out to your TPG team for further guidance and resources during this time. Be sure to visit our COVID-19 Client Resource Hub for daily updates and critical information. As your trusted advisor, we are committed to helping you solve problems and grow—especially in challenging times.