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Reduce Nursing Home General Liability Insurance

Updated on November 27, 2009
Reduce nursing home general liability insurance
Reduce nursing home general liability insurance

Nursing homes care for the most vulnerable of our citizens; the elderly who, due to age or chronic medical conditions, are no longer able to care for their own daily needs.  Because residents of nursing homes are often frail or lack mobility, general liability issues (such as good housekeeping procedures and practiced emergency response) become highly important.  Other elements of a good general liability loss control program include security, facility maintenance, and proper supervision of off-site resident outings.  The following recommendations will help you establish the framework and possible help reduce your general liability insurance costs.

Establish a house keeping schedule
Establish a house keeping schedule

House keeping

Establish and follow a written housekeeping program. Make a schedule of daily, weekly, monthly, quarterly, and annual tasks and document all efforts to maintain the schedule. For example, floors should be inspected and swept or vacuumed daily to reduce the potential for slips and falls, one of the most common injuries to residents, visitors, and staff in a nursing home. Reapplication of non-slip floor coatings might be made a quarterly task, while replacement of worn floor tiles or carpet is scheduled annually. Of course floors that are frequently wet, such as in bathrooms, should be mopped dry as often as necessary. Ensure that your housekeeping staff follows the cleaning schedule and supervisors inspect the work.

Preventive maintenance

Implement a facility and equipment maintenance program similar to your housekeeping plan. Schedule routine and preventive maintenance for all your mechanical, electrical, and plumbing systems to ensure they remain in good operating order. You certainly don’t want the heating system to break down during the coldest month of the year or your air conditioning to go out on a sweltering day. Have staff routinely inspect resident’s safety equipment, such as shower and toilet grab bars, in-room call buttons, and furniture; make sure they are sturdy, functioning, and do not present hazard exposures. Ensure there are ground fault interrupters on all electrical outlets within six feet of a sink.

Life safety

Implement a detailed emergency action plan. The plan should provide response procedures in the event of fire, disruptive intruders or residents, and power failures. Other provisions should cover events that may be anticipated in your geographic regions such as blizzards, hurricanes, floods, earthquake, or civil disturbances. Train your staff at least annually in emergency response procedures and conduct practice drills at least quarterly or as required by local ordinance.

Inspect your facility weekly for life safety code compliance.  Exits should be clearly marked and free of obstacles.  Panic hardware on doors should operate freely.  There should be an adequate number of fire extinguishers.  Fire doors should not be propped open.  Alarms, sensors, monitors should be tested and maintained as recommended by their manufacturer.  Additionally, fire suppression systems must be inspected and tested annually by a licensed contractor.


Maintain proper security and visitor control. Arrange your facility lay-out so all visitors must come through a central lobby to be greeted and identified by staff. Don’t allow visitors to just wander through; they should at least state their business such as “I am here to visit my mother Mrs. Smith”. Ensure that exterior doors are locked on the outside. Many nursing homes using video surveillance cameras in parking lots, exterior walkways, and interior corridors and common areas to provide an extra measure of security.

Residents should have emergency call buttons within reach of their beds and in bathrooms. Consider installing “panic buttons” for staff that will summon help if they are attacked by an intruder or disturbed resident. Staff can also carry personal alarms that will emit a shrill sound if they need emergency help.

Pet therapy
Pet therapy

Off site outings

Be careful planning off-site outings for residents. Be sure you have a safe way to transport residents to off-site venues and enough staff or volunteers to assist and supervise them. Residents with memory problems are more apt to become disoriented and wander off if they are in an unfamiliar place. Plan ahead for residents with special needs, such as wheelchairs or oxygen. Be sure the venue can accommodate these needs before you take residents there. Also plan and prepare for rapid emergency response. Know how you will summon responder if it becomes necessary.

Remember that on-site entertainers and volunteers present a general liability exposure as well. Entertainers (such as musicians, lecturers, magicians, dance groups, etc.) should provide evidence of their own general liability coverage if there is a potential their equipment or props might cause an injury. Pet therapy programs generally will have their own insurance coverage. Carefully consider the offer of a private citizen who volunteers to bring in his or her dog or cat for visits with residents. Ensure the animal is very docile and under control at all times.


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