CCRC and life plan
How do resident trust funds work at a CCRC?
The same way they do elsewhere, but the balances are larger. Facilities routinely hold personal funds on behalf of residents, and for facilities participating in Medicare and Medicaid the management, accounting and assurance of those funds is governed by federal requirements.
The coverage trap is that a standard crime policy insures loss of the organization own money and property. Resident personal funds are held in a fiduciary capacity, and some forms do not reach them without a specific extension. Confirm the extension is actually endorsed rather than described in a proposal, and confirm the limit is sized against the aggregate balance the account actually carries rather than a figure chosen years ago.
Then reconcile the account regularly, independently of whoever has custody. That reconciliation is what a surveyor asks for and what makes an insurance claim provable, since a facility that cannot show what the balance should have been struggles to establish the amount of its loss.
Source: CMS, 42 CFR Part 483
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More ccrc and life plan questions
What insurance exposure do refundable entrance fees create?
Residents holding refundable entrance fees are creditors as well as residents, which produces directors and officers claims the liability program will not answer.
Are volunteer trustees personally exposed?
Yes, on governance decisions about an obligation running decades forward. Many trustees were never told that is what serving involves.
Do our bond covenants dictate our insurance?
Frequently yes. Tax-exempt bond documents carry insurance covenants the same way a HUD loan or a REIT lease does, and the program drifts away from them annually.
How should the aggregate be structured on a single campus?
A per location endorsement does nothing on a campus, because the campus is one location. Size the aggregate against the whole campus claim frequency instead.
Does one policy cover all our levels of care?
It should, and the term that decides it is the professional services definition. A resident who transitions between levels should not transition out of coverage.
Do we need fiduciary liability separately from D&O?
Yes. Fiduciary covers ERISA duties for the benefit plans; D&O covers governance of the organization. Sharing a sublimit means one exhausts the other.
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