Assisted Living Facility Insurance

How Liable Are Assisted Living Facilities for Patients with Dementia?

Throughout the United States, millions of people receive care and accommodations at assisted living facilities. These facilities have a duty to provide competent medical and mental health care for their residents. With a growing number of seniors experiencing cognitive declines, including Alzheimer’s disease, America’s care facilities face mounting liability risks. Assisted living facility insurance is designed to protect against a broad range of risks, but facility owners and managers must be ready to address the liability exposures presented by patients with dementia. By doing so, they can continue to provide adequate care for residents, helping to keep residents and the facility safe from liability risks. 

Dementia: A Growing Concern in Assisted Living Facilities

According to a brochure published by the Alzheimer’s Association, over 50% of all residents in nursing homes and assisted living facilities have some form of cognitive impairment, including dementia. The percentage is growing as America’s population ages. 

Unfortunately, caregiver training in caring for patients with dementia lags behind the rising dementia rates. Not all assisted living facilities are equipped for the demands these residents require, including supervision, safety, and adequate nutritional support. Facilities that accept dementia patients as residents without the proper training and preparation put themselves and their residents at risk, potentially increasing liability exposures, including lawsuits for negligence, neglect, and personal injury of affected residents.

Arguing Against Liability for Dementia Patients: A Heartbreaking Case

On September 10, 2018, an elderly resident of the Tamworth Community Living facility in West Ossipee, New Hampshire wandered away from the facility. 84-year old Dwain Poulin was never seen again, and remains missing to this day

According to the missing man’s children, facility managers assured them that their father was safe before he disappeared, and that he did not require an advanced level of care for his dementia at the facility. Mr. Poulin had eloped from the facility previously, and was found after a brief search. His doctor recommended that he be kept in a locked unit to prevent further elopement. Mr. Poulin’s children also provided the facility with a GPS tracker for their father, but it was returned by the facility along with claims that it “did not meet expectations”.

In a lawsuit filed by Mr. Poulin’s children, Tamworth Community Living is accused of negligent acts that led to the disappearance of their father. Attorneys for the facility claim that they are not liable for the incident, asserting that they provided adequate care and that they had not received sufficient information about Mr. Poulin and his condition from his medical team. 

Are Assisted Living Facilities Liable for Dementia Patients?

If a resident of an assisted living facility has dementia and is injured or dies unexpectedly, is the facility liable for that injury or death? The answer is “maybe”. In certain cases, clear-cut evidence that the facility was negligent in providing security and care for the victim has led to successful legal action on the part of the victim and his or her family. In other cases, the evidence may not be so clear. 

Legal loopholes may also exist that favor assisted living facilities in liability cases. ALFs have undergone an extensive rebranding campaign, with more facilities referring to themselves as “memory care centers” in the face of increasing dementia patients. If a resident of such a facility should become injured or dies, those same facilities quickly absolve themselves of all responsibility, arguing that such patients should be in a more advanced treatment environment like a nursing home or skilled care facility. The legal loophole exploited by ALFs is that they are not a skilled care facility, and have a correspondingly lower care level. Unfortunately, this loophole means that liable facilities often escape legal action. Collecting the evidence needed to prove negligence or neglect may also be extremely difficult for family members.

Protecting Against Liability Risks: Best Practices for Assisted Living Facilities

In addition to the risk management protection of assisted living facility insurance, ALFs must adopt several best practices. These practices reduce liability risks while protecting residents and staff. Practices include:

  • Training and retraining of staff on appropriate techniques for dementia care, including medication, restraint, and de-escalation training. 
  • Improved security, including automatic-locking doors and alarm systems to reduce elopement risks.
  • Ensuring adequate round-the-clock staffing levels.
  • Adherence to established regulations and guidelines governing care of dementia patients. 
  • Reduction or elimination of common hazards, such as those that can lead to slip and fall injuries within the facility.
  • Including family members into the care plan. Engaged family members serve as a valuable component to dementia care, and the best facilities encourage this type of engagement. 
  • Evaluating potential residents for Alzheimer’s and similar dementia disorders before determining the level of care a resident may require. If needs exceed a certain threshold, ALFs should direct the candidate to a higher level of care. 

Most importantly, facilities must ensure their assisted living facility insurance plans are up to date and reflect the risks the facility faces, including liability exposures. With this insurance and with proven care practices, ALFs can continue to provide safe accommodations for America’s aging population. 

About Caitlin Morgan

Caitlin Morgan specializes in insuring assisted living facilities and nursing homes and can assist you in providing insurance and risk management services for this niche market. Give us a call to learn more about our programs at 877.226.1027.