Improving a Home Health Care Workers’ Compensation Risk Profile

The home health care sector, according to the Occupational Safety and Health Administration (OSHA), has the highest average workers’ compensation insurance indemnity payment from the various departments and agencies within the health care system it has profiled. This, says OSHA, is potentially driven by patient handling and higher exposure to automobile accidents among visiting nurses and home health care aides. In fact, overall in the health care industry, patient-handling accounts for one third of all workers’ compensation claims, and has the highest average indemnity payment out of all causes of loss, according to an insurance industry study. Slip/trip/fall injuries and push/pull injuries are the second and third most costly indemnity payments, respectively.

Home health care employers in an effort to prevent losses and keep workers healthy and safe can implement a wide range of risk management practices and measures. By putting safety first, not only will home healthcare employers create a culture aimed at reducing the number of on-the-job injuries and accidents taking place, they will also improve their risk profile when purchasing or renewing a workers’ comp policy and ultimately drive down premium costs.

Following are several risk management recommendations for a home health care agency to adopt to obtain better workers’ comp outcomes:

  • Institute a location/patient acceptability review policy. In performing an assessment of the location at the start of a service contract, if a supervisor or nurse determines the home to be unsafe, address where improvements need to be made in order to accept the contract. If these changes are not made and the client location is deemed unsafe, institute a case declination/refusal policy. Additionally, ensure that home health aides receive training and instruction in identifying unsafe locations and practices and are instructed to desist from and report any potential hazards encountered.
  • Implement a formal safe patient-handling program. The most successful safe patient-handling program is a proactive, collaborative process, and includes management leadership, employee participation, education and training, and program evaluation and improvement. According to OSHA, employers with successful safe patient-handling programs have found they can significantly reduce the number of employee injuries and lost workdays from injuries. Safe patient handling has been associated with not only fewer injuries but also a decrease in the severity of injuries.
  • Establish a five-block travel radius limitation for employees. If possible, implement a policy whereby home health care aides only assist patients with shopping or errands within a five-block radius. This can serve to help reduce the number of automobile claims, which make up a significant percentage of workers’ comp injuries. Depending on the location being served, this may not be possible. For example, in urban areas such as New York City, employees can use mass transit to go to and from their patient’s homes and to run errands if need be. In suburban or rural areas, this isn’t a practical solution. Some home health care agencies have also implemented a strict no automobile/no patient transport policy, prohibiting the use of employee vehicles for patient transportation in order to mitigate the risk of an automobile-related claim.
  • Implement an anti-slip shoe voucher program. Consider distributing anti-slip shoe vouchers to all home health care employees, paying for the cost of the shoes to help reduce slip-and- fall exposures.
  • Strengthen the return to work (RTW) program. Return to work programs offer several key benefits, including instilling a positive relationship between employers and employees (a well-taken-care-of employee is more likely to readily return to full duty as soon as medically feasible), controlling workers’ compensation claims costs and preventing and/or limiting lost workday cases. A successful RTW program should consist of short-term modification of work schedule/job duties to accommodate any restrictions imposed by the employee’s physician; modifications that vary based on the type of injury, the employee’s current physical ability, skills and pre-injury responsibilities; and progressive return to full duty. Additionally, to evaluate the effectiveness of a return to work program, it’s essential to have metrics in place. For example, benchmark the effectiveness of the RTW program by separating claims where employees waited until they could resume their regular job duties from those where proactive assistance allowed employees to return sooner, with a reduced work schedule or modified/transitional duties.

Manchester Specialty Programs provides the home health care industry with an end-to-end insurance solution designed to safeguard an organization’s assets, property, employees and clients. Part of our solution includes workers’ compensation insurance supported by risk management tools and strategies through our carriers to help clients gain control over ongoing costs and rising premiums and assist employees in returning to work. For more information about programs, you or your local agent/broker can contact us at 855.972.9399.