Skilled nursing
How much liability limit does a nursing home need?
There is no defensible universal number, and anyone offering one has not looked at your states. The legal environment where your beds sit does more to determine claim value in this industry than bed count does, because senior care residents typically have no lost earnings, so nearly all of a claim value sits in noneconomic and, where available, punitive damages.
Size it from four inputs: your own severity history, meaning the largest claims you have actually had and how they developed rather than your average; your jurisdictions weighted by bed count; your acuity and short-stay rehabilitation mix; and your defense treatment.
That last input is arithmetic rather than judgment. On a policy where defense costs erode the limit, the stated limit has to fund defense and settlement together, so the limit that would have been adequate on a defense-outside basis is not adequate here.
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More skilled nursing questions
Does insurance pay CMS civil money penalties?
Generally no. Penalties are treated as uninsurable on public policy grounds. What is insurable is the cost of defending the proceeding.
Who is liable when an agency nurse makes an error?
You will be named regardless. The question is whether your policy covers you for the acts of contract clinical staff, and whether the agency actually carries what its contract promised.
Is the medical director covered under our policy?
Medical director duties are administrative and frequently fall between the facility program and the malpractice coverage carried by the physician, with each assuming the other responds.
What does one bad loss year do to our pricing?
More than the totals suggest, because underwriters read loss development rather than loss totals, and development is what carries forward.
Do we need billing errors and omissions coverage?
It covers the defense of a post-payment review, not the repayment. The defense cost is what operators underestimate.
Should general and professional liability be on the same policy?
Yes. A fall claim alleges both a premises condition and a care failure, and splitting the coverages creates a dispute between your own two insurers.
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