Lack of information, unmet needs and expectations, and lack of staff education and training, are the main drivers of claims in senior living. But one industry expert is launching a risk management and culture change solution that she says can reduce organizational risk.
Rebecca Adelman, founder of Adelman Law Firm and Claims Management in Memphis, TN, previewed a white paper to be released this week about a three-month pilot program in six long-term care communities — assisted living, memory care and skilled nursing — that implemented her Guide Path Resident and Family Insights, or RFI, survey.
Baby boomers are increasing their expectations related to personalized care and services, Adelman said, so understanding and addressing those expectations is crucial to building trust with residents and families.
“Setting and managing realistic expectations with residents and families fosters trust and transparency, leading to improved quality of life and reduced complaints, grievances and risks,” a summary of the white paper reads. “The program supports the reduction of adverse consequences, empowers staff and promotes growth and change in the ecosystem.”
The Guide Path program is an expectations-management and process-improvement certification program designed to mitigate risk, improve quality of life and solve staffing issues. The approach includes the RFI survey, resident and family education, and staff member education and certification.
The RFI survey covers five areas of interest:
- Communication: Frequency of communication and care concerns.
- Family systems: Resident and family dynamics.
- Quality of life / goals of care: Circumstances of residence and advance care planning.
- Aging process: Knowledge of medical conditions and progress, and understanding of future care needs and activities of daily living.
- Emotional / spiritual health: spiritual and emotional support needs and their influence on healthcare decision-making.
The survey tool, Adelman said, is an opportunity for operators to begin communicating with residents and their families in all those areas. The goal, she added, is to create important industry data related to risk mitigation and risk management.
One interesting finding from the test of the program, she said, was participants’ preference for hard-copy surveys instead of online surveys. Communities reported better family and resident engagement when they shared a hard copy of the survey, Adelman said.
“Families really appreciated being heard, being seen, the initiation of difficult conversations,” she said, adding that the emotional / spiritual health topic elicited the most feedback from families. “Families appreciated the additional understanding around so many areas of interest.”
Emotional / spiritual health also was among the most significant high-risk rating areas, according to the survey, along with the aging process and communication. Those areas, Adelman said, are where most claims are derived from. She recommended that communities take protective steps to enhance communication and overall quality of care.
Guide Path national certification
Another part of the Guide Path program is the two-year national certification for senior living, which Adelman calls “a solution for the industry’s pain points.”
The certification program provides a community training curriculum created by subject matter experts for staff members at all levels. The certification, Adelman said, can provide a competitive market advantage for those communities.
“I believe this is going to be a significant staff recruitment and retention tool, to have Guide Path certification, to create a cultural exchange environment by addressing expectations early on that creates a more grievance-free environment and much more employee satisfaction,” she said. “It allows us to engage with residents and families to manage set expectations along the whole continuum of care.”
The curriculum is designed to be sets of skills, talents, education and resources that staff members need to help them engage with residents and families in the five areas of interest, Adelman said.
The certification program involves nine hour-long modules focused on culture change, communication, expectations management, empathic leadership, trauma-informed care, advance care planning and goals of care, palliative care, risk management, and diversity, equity, inclusion and belonging. The formal certification program begins Oct. 1 and will include 15 to 20 communities, with a new cohort beginning every three months.
Adelman said that the value in certification is an improved risk profile, better risk management and marketplace differentiation through leadership accountability, decreased staff member turnover and improved culture.
“It’s a game-charger for organizations in partnership with our regulators,” she said, adding that the program will feed into a Guide Path collective that will offer shared experiences, mentorship, support and resources that will lead to improved standards to address quality of care and other risks in the industry.
