4 Ways to Mitigate the Risks of Home Health Care

More and more elderly patients are opting to stay in their homes longer before moving to assisted living and nursing homes. As a result, the number of home health aides working in the U.S. is steadily rising, with over 3 million today and another million+ expected to be added in the next 10 years.

And while health care organizations —from hospitals to nursing homes — see huge benefits in reaching out to communities to care for patients in their homes, employing a workforce whose job entails driving to patient’s homes in their own cars presents a host of liability problems.

On a typical day, a home health aide might drive to five different homes to care for patients. With an average wage of a $11.98 per hour, most carry the minimum state limit on their personal auto policies. When an accident occurs, the individual’s auto policy activates first to cover the claim, then the employer’s policy is charged to make up the rest.

Until now, auto insurance for health care organizations has been relatively easy to place, but costly claims and reimbursements have led to a hardening of the market. Carriers are now restricting coverage and placing onerous requirements on home health providers, many of whom aren’t able to comply with the new requirements. For example, many underwriters now require that all drivers carry a minimum limit of $100K/$300K on their personal auto policies, which is far above the average state minimum.

Solutions

Having policies and procedures to control risk is the best way for health care organizations to both qualify for insurance programs and mitigate their exposure. We recommend the following actions.

• Implement a robust onboarding process. This should include collecting and validating a copy of every aide’s Auto ID card, checking that they have the right minimums and confirming that they’re a licensed driver.  
• Conduct Motor Vehicle Reports (MVRs) on an annual basis. Organizations need to know when their employees are involved in accidents and violations. Running an MVR during the onboarding process is important, but staying up-to-date by running MVRs annually is critical.
• Outline auto policies in your employee handbook. Stating the company’s policies and procedures for driving helps home health aides understand their responsibilities and adds a layer of protection for the organization. This is an area where experienced brokers can apply their deep knowledge base to help craft state-of-the-art language in employee handbooks.
• See if your state offers automated alerts. Some state RMVs or DMVs supply important driving information directly to employers. The New York License Event Notification Service, for example, sends alerts in real-time to employers when their drivers have license events, such as suspensions, traffic convictions or reportable accidents.

Providing home health care impacts many areas of insurance beyond auto, including D&O, workers’ compensation and professional liability.

Implementing a proper onboarding process and reviewing insurance cards can be an added expense, but organizations that fail to do so risk even greater exposure when it comes to worst-case scenarios. Let’s say a home health aide working for a hospital causes a fatal accident while driving to a patient’s home and that aide was driving on a suspended license for a recent DUI. If the hospital hasn’t run an MVR and is unaware of the suspension, a lawsuit could go after more than just the hospital and the driver. The directors and officers of the hospital could be held liable for mismanagement.

Organizations that implement stop-loss measures and adopt policies to minimize risk will have an easier time securing coverage. Brokers may also be able to package auto with other lines of insurance.

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Connect with the Risk Strategies Health Care team at healthcare@risk-strategies.com.

Email me directly at sscheuermann@risk-strategies.com.