Skilled nursing
Is the medical director covered under our policy?
Often neither policy clearly does, which is the problem. A certified skilled nursing facility must have a designated medical director under federal requirements, so the role exists whether or not anyone has decided how it is insured.
The role is defined largely in administrative terms: oversight of clinical policy, coordination of care, quality assurance. When a claim alleges facility clinical policy was inadequate, it lands on the medical director in that administrative capacity, and the malpractice policy carried by the physician may exclude administrative or medical director services entirely.
Resolve it explicitly rather than by assumption. Either endorse the medical director onto the facility program for administrative acts, or obtain written confirmation that the physician carrier covers medical director duties, and make whichever answer applies a recorded term of the medical director agreement.
Source: CMS, 42 CFR Part 483
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More skilled nursing questions
How much liability limit does a nursing home need?
There is no universal number. The answer is driven by your states, your own severity history, your acuity mix, and whether defense costs erode the limit.
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.
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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