Senior Housing Investors

The Human Side of Risk Management in Senior Living Facilities with Steve Groth

August 28, 2024 Haven Senior Investments Season 4 Episode 6
The Human Side of Risk Management in Senior Living Facilities with Steve Groth
Senior Housing Investors
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Senior Housing Investors
The Human Side of Risk Management in Senior Living Facilities with Steve Groth
Aug 28, 2024 Season 4 Episode 6
Haven Senior Investments

In today's episode of the Senior Housing Investors Podcast, we sit down with Steve Groth, a seasoned property and casualty risk consultant with INSURICA, who provides enlightening insights into this critical issue. Through a heartfelt recount of his grandmother's hospice care, Steve shares how this personal experience reshaped his perspective on the profound impact of risk management and safety in healthcare and senior living sectors. 

Steve walks us through the startling reality of high injury rates among employees in skilled nursing and assisted living facilities. Drawing parallels to industries like construction and manufacturing, he identifies key injury causes and their far-reaching effects on resident care, employee well-being, and staffing. Our conversation reveals the importance of communicating these impacts beyond just financial metrics, advocating for a holistic approach to support senior living operators.

We also explore the ripple effects of workplace injuries on organizational culture and caregiver-resident relationships. Steve's personal anecdotes and professional experiences highlight the significance of fostering a positive and safe work environment. From strategies for improving safety programs to leveraging leadership's role in mitigating risks, this episode is packed with practical advice for anyone involved in senior housing. Listen in for a thought-provoking discussion that underscores the necessity of prioritizing employee safety to enhance the quality of care in assisted living communities.

Show Notes Transcript Chapter Markers

In today's episode of the Senior Housing Investors Podcast, we sit down with Steve Groth, a seasoned property and casualty risk consultant with INSURICA, who provides enlightening insights into this critical issue. Through a heartfelt recount of his grandmother's hospice care, Steve shares how this personal experience reshaped his perspective on the profound impact of risk management and safety in healthcare and senior living sectors. 

Steve walks us through the startling reality of high injury rates among employees in skilled nursing and assisted living facilities. Drawing parallels to industries like construction and manufacturing, he identifies key injury causes and their far-reaching effects on resident care, employee well-being, and staffing. Our conversation reveals the importance of communicating these impacts beyond just financial metrics, advocating for a holistic approach to support senior living operators.

We also explore the ripple effects of workplace injuries on organizational culture and caregiver-resident relationships. Steve's personal anecdotes and professional experiences highlight the significance of fostering a positive and safe work environment. From strategies for improving safety programs to leveraging leadership's role in mitigating risks, this episode is packed with practical advice for anyone involved in senior housing. Listen in for a thought-provoking discussion that underscores the necessity of prioritizing employee safety to enhance the quality of care in assisted living communities.

Speaker 1:

The moment my job became a career, it's when my grandmother was on hospice care. Because a guy in my 20s and around 30, my job was a job. I wanted to pay the rent, I wanted to have fun with friends, but it was a job. I didn't really see the connection to what I was doing to other people's lives. When my grandmother was on hospice care, I was able to visit her about three times. So I drove and I opened her door. I walked in. The first words out of her mouth were not hi, steve. First thing she said is you have to meet Julie. Julie was her hospice nurse. You know my grandmother, somebody not easy to gain her trust, but once you had it it was a really precious thing. And when I drove home and I had a lot of thinking on my mind, one of the things that was just sticking with me is what if something prevents Julie from being with my grandmother during the remaining days of her life? That is the moment that I realized how much this mattered.

Speaker 2:

Welcome to the Senior Housing Investors Podcast. If you are an owner operator, investor, developer or buyer of senior housing, you've come to the right place. The best way to stay connected with us is to sign up for our weekly newsletter at havenseniorinvestmentscom. This podcast doesn't exist without you, our community. Thank you for listening and reach out to us anytime.

Speaker 3:

Welcome back everyone. I am so excited to introduce you to our newest podcast. Today our host, john Haber, is having a great conversation with Steve Roth. He is a property and casualty risk consultant with Insurica. Tune in and listen to their great conversation.

Speaker 4:

John. Thanks, kelsey. Today we have Steve Roth and Steve is with Insurica and we're going to be speaking about safety leadership that drive key business indicators. Steve, welcome to the show. Thank you, john. Tell us a little bit about yourself, your background and such, and look forward to getting to know you.

Speaker 1:

Sure, yeah, I'm approaching 20 years in risk management and commercial insurance. I've had a pretty unique and diverse career, which I think is a good introduction to this topic. I began doing risk control inspections really across every industry trucking, manufacturing, construction, healthcare and then, like a lot of people, I was laid off in the housing bubble and turned out to be a complete blessing for me. I was interviewing with the company looking for my next chapter, and the gentleman who became my manager said we specialize in health care and senior living. How comfortable are you training people on how to use a gait belt? And my answer was what's a gate belt? And he laughed and he explained and he said we have PTs, we have nurses on our team. We'll give you all the training you need if you're interested in learning. And, of course, that was a tough recession and I was in need of a job, so I said sure, I'd love to learn. Turned out to be one of the best decisions and career moves in my life. So I spent the next five years doing health and safety consulting in hospitals, assisted living communities, skilled nursing home, health and hospice. You know several hundred gatebelt training sessions later, you know, working alongside the staff on the floor observing toileting transfers and it was such a great opportunity to learn the business. But also it's where I kind of developed my personal connection with those who provide care for a living.

Speaker 1:

Next, I was actually in a leadership role for four years. I oversaw staff that handled services being provided in seven states. Then I actually decided I wanted to be a commercial insurance broker. I missed working with the clients but I wanted to do it in a different way. So I thought you know what, I know safety, I know risk, I know the industry. I actually didn't really know insurance so decided to be a commercial underwriter for four years again, specializing in healthcare and senior living, because I wanted to understand how insurance was priced different coverages. I thought that would make me a much better insurance broker. And now I've been a commercial insurance broker and risk manager for a little over two years.

Speaker 4:

Well, you're new to the insurance side of the business but not in senior living side, and so to find the problem with employee injuries in senior living, this is huge. I mean it's you know we're talking about sometimes and lifting individuals that may be even heavier than yourself, or trying to get someone out of bed or into bed. Tell us a little bit about what that problem is.

Speaker 1:

Sure, let's start with this. I would encourage your listeners and you too, john, to do a little bit of a mental exercise. Think about four industries in the country. I'll split up assisted living and skilled nursing. Think construction, manufacturing, assisted living and skilled nursing. Now, in your mind, rank those from highest rate of lost time injuries to lowest. So here's the answer the highest is skilled nursing, the second highest is assisted living, then manufacturing, then construction. Wow, so when you're driving past construction sites, these employees are getting injured on a lost time rate at 25% the rate of assisted living and about 12% the rate of skilled nursing. I mean so for every injury on a job site, a construction job site, at a manufacturing plant, we're seeing four to five in assisted living and eight, nine, 10 in skilled nursing. It's just staggering.

Speaker 4:

So tell me some of those injuries that happen. What are you seeing most? So you're saying that skilled nursing and assisted living are the highest of that five group Correct? Tell us what the highest injuries that are happening within skilled nursing and assisted living.

Speaker 1:

Yeah, and I like to start with lost time injuries, because that's really that's the data that you know. It impacts resident care, it impacts the life of the employee, it impacts the business's bottom line. Those are also tend to be the most costly. And so when it comes to lost time injuries, by far the number one cause is transfer and mobility assistance. You know, skilled nursing operators are probably providing some type of repositioning assistance in bed as well. But you know, when we get into any kind of ADLs, you know your toileting, your dressing, getting out of bed. You know ambulation assistance walking down the hall. A big one is fall assist.

Speaker 1:

Some of the most tragic and sad injuries I've seen for staff have been getting somebody off the floor and then usually number two cause is slip strips and falls or falls at an elevation, like somebody in a facilities role working on a ladder. And speaking of sad, I've actually had a client in my career that had a fatality and it was somebody falling off a roof doing HVAC work. So if I were an operator and I was looking at this, I would obviously start with my data and my hunch is the data is going to lead you to those two places. We might have cuts and lacerations, needle sticks those are frequent, they don't tend to lead to lost time. And then another category that we can see is moving of furniture, dietary services if they're handling large boxes of maybe fruits and vegetables, meat, things like that. And then, depending on the community, some communities have transportation services. Sometimes we see just like any industry where there are drivers we can see motor vehicle injuries.

Speaker 4:

That's sad when that happens yeah.

Speaker 1:

But part of the problem. John and I want to be really candid about what I think is a challenge, and I'm guilty of this as well, and I've had to learn the hard way way. I believe a lot of industry partners in supporting senior living need to do a better job of helping owners and operators understanding the broad impact of this, how it impacts things like culture, staffing, occupancy, quality of care. Because here's another mental exercise that I like to have people do when I talk about the topic of employee injuries, I'll talk to like an executive, a CFO, a president or CEO, and I'll say when I talk about employee injuries, what is the first thing that comes to mind? And they'll think about it and usually the response is my workers' compensation rates. That's usually the number one thing that they think of and that's natural.

Speaker 1:

So if I'm an owner or an operator, then I would go to my P&L mentally and I would think, okay, here's what I'm spending on insurance. Then I'd think about my last insurance renewal and you might think well, property insurance is a lot more expensive. General and professional liability is a lot more expensive. So workers' comp is it's, by the way, one of the only types of insurance in the country right now. That is a soft market for buyers, so I believe that it's incumbent upon people like myself to speak about this. Beyond the workers' compensation benefit, there are tremendous benefits with key business drivers, because if we're just thinking about workers' compensation, I don't think we're serving the industry well, because it doesn't really grab the attention of senior leadership.

Speaker 4:

So share some of the positive examples of each of those five areas.

Speaker 1:

Sure, why don't we start with culture? When I was in a leadership role, I learned very quickly that if I cared about my employees for leadership role, I learned very quickly that if I cared about my employees for eight hours, I wasn't going to be successful. Strong leaders care about their employees for 24 hours a day, when they're at work and when they're not at work, and work-related injuries go home with you. They impact you for 24 hours a day. Also, think about the potential disruption to operations. My cousin's a CNA and she's the type of CNA that I'm telling you every one of your listeners would hire her today if they could. She's been on the floor for over 20 years. She refers to her residents as family. She truly loves what she does, family. She truly loves what she does, and she was in a mentoring and training role before they ever actually elevated her to that official position. So the value that she brought to that organization was just profound. And I imagine your listeners, if they took a moment to think about it, they could list multiple care providers. Maybe they're in leadership roles, maybe they're not. Maybe they're in kind of semi-leadership roles so they make a little bit more money for added responsibilities. But here's the thing when I've met people like this and when I worked alongside them on the floor, I noticed that they tended to almost talk about work-related injuries and the soreness on their body almost like a battle wound, about work-related injuries and the soreness on their body almost like a battle wound Like this is just what comes with the territory of providing care for people we love. And it kind of breaks my heart, because I've visited enough communities, assisted living communities and skilled nursing facilities to know that it doesn't have to be that way. So we can do both. We can care for residents and we can care for caregivers. So we can do both. We can care for residents and we can care for caregivers. We can do both Because think about the devastated impact of a work-related injury on the life of an employee In our industry, john, there are a lot of young mothers with small children at home and let's say you're in human resources and you have a work-related injury for one of your caregivers and you get the doctor's notice back saying they can't lift more than 10 pounds for maybe six weeks, maybe eight weeks, whatever.

Speaker 1:

That is Okay. Now, as a business, we need to think about what our next steps are. But let's look at it through an empathetic lens and say, well, what's next for that individual If they have a young child at home? That means six weeks, eight weeks, that they can't pick up their young child. So, first of all, just the responsibilities of life outside of work just got a whole lot more difficult. Second, you know, talk to a mother. They will tell you you don't get certain moments in life back if you lose the ability to provide certain level of care for your own children.

Speaker 1:

Or let's say you have a person in a facilities role or transportation role, or maybe dietary, and they just have an upcoming golf trip. They're going hunting and then boom, something happens. They slip and fall, they fracture an ankle, something happens. Those personal plans are canceled, they can't do it. And then the last thing I would say is and I've had a couple of serious injuries in my life, but non-work related skiing, playing, basketball, things like this I learned instantly that the topic of ADLs, these are folks who provide support for the activities of daily living for others.

Speaker 1:

The second you have a work-related injury. You need someone else to support you with those things. You know, when I had my basketball injury, I was 24. This is 16, 17 years ago, you know, I needed a friend to carry my groceries up to my second-story apartment. You don't think about this pre-injury, you just don't, until life becomes real.

Speaker 1:

So I would just kind of step back and think about the impact that all of that has on the culture of an organization, because our employees talk, they know each other, they care about each other and they're having to pick up the slack from one another, and it's a challenge and it can be a burden. So it definitely impacts culture. So when you know and, by the way way, I don't know if I mentioned the data, I mentioned the comparison between different industries, but the Bureau of Labor Statistics publishes injury data every year. They publish it in November and it always lags behind about a year and a half. So the most lost time injury rate is 4.6 incidents cases or 100 FTS, and for skilled nursing it's 9.4. Wow. So when I share these personal anecdotes, think about the numbers. That's every year, john. That's every year. So if you're an operator, this is okay. On average, 4.6 this year, 4.6 next year. So it's a problem and I think we need to talk about it.

Speaker 4:

Let's talk about that. What do you recommend to operators as it relates to their current safety programs or non-programs, or whatever it may be? Let our audience know what you do when you come in and you talk about safety with an operator.

Speaker 1:

Yeah, step one is basically a baseline assessment of where are we today, where are we currently? I would start with a little bit more of a qualitative assessment of my executive leadership team. I would ask questions about do like a one to five scale, how much do we focus on this? Do we know our frequency and severity of injuries? Do we know it on a community level? Do we know it on a regional level? What about shifts? We talked about cause of injury and then asking questions like well, how do we compare to the industry? How do we stack up against our industry peers? All of this data is available publicly. How often do we do a benchmark analysis and see where we are compared to the industry and compared to ourselves? What kind of goals do we have? So that's step one is to just kind of get a finger on the pulse of where are we? How much have we prioritized this? Because the benefits I touched on. If you wouldn't mind, I'd like to jump back to a couple other benefits and then talk a little bit more solutions. Okay, yeah, if you don't mind, I'd like to also touch on staffing, quality of care and occupancy, and I wanted to share a story when it comes to staffing.

Speaker 1:

I've done a lot of work in my career working with communities in small towns and this one time I had both of the assisted living communities in the same town and they were in a constant fight over labor and I imagine people can relate to that. And when it comes to risk management again I'm in a risk management role and that's the lens I'm looking at it these two communities were truly a one-star and a five-star and since I would always visit them they were about an hour and a half drive from my house I'd always visit them the same day. I had this incredible perspective of seeing the two differences. I was meeting one day with what I would call five-star and these folks were. These people were incredible. The lady who handled all of their ambulation and transfer training. She came up to me and she said Steve, I'm really concerned. I said what? What's happening? She said you know one star the people who had some work to do on the other side of town. They were raising their CNA pay and they were not in a position at that time to match. She said we're worried about losing a lot of people. And they did.

Speaker 1:

The next time I was there, which is about three months later, I believe, I was working with the executive director on a project and she saw me that I was there and she came running up and she said oh, I'm so excited you're here. I wanted to tell you something. I said what she said remember, I told you we were going to lose a lot of our people. She said we did. And she said and we never raised our pay and they almost all came back. I said really. She said human resources did an interview of everyone, said we're happy you're back. Help us understand what made you decide to return. She said person after person said over there, they don't care about my safety here I know you do. They don't care about my safety here I know you do. That was just so powerful. Just so powerful. And then I wanted to share a personal story when it comes to quality of care, and now this is a kind of an adjacent care industry.

Speaker 1:

Again, I've done a lot of work in home health and hospice. John, I'm 40 years old. The moment my job became a career. It's about 10 years ago. It's when my grandmother was on hospice care, because you know a guy in my 20s and around 30, my job was a job. I wanted to pay the rent, I wanted to have fun with friends, but it was a job. I didn't really see the connection to what I was doing to other people's lives.

Speaker 1:

When my grandmother was on hospice care, I was able to visit her about three, three times and she was a couple hour drive. So I drove and I opened her door. I walked in. The first words out of her mouth were not hi, steve. First thing she said is you have to meet Julie. Julie was her hospice nurse and just you know, my grandmother somebody not easy to gain her trust, but once you had it it was a really precious thing.

Speaker 1:

And when I, you know, drove home and I had a lot of thinking on my mind, I've obviously had a long drive after seeing my grandmother and one of the things that was just sticking with me is what if something happens to Julie? What? What if Julie is caring for somebody else and, you know, pops her shoulder? What if she's walking into another patient's home and slips and falls and breaks a bone? What if something prevents Julie from being with my grandmother during the remaining days of her life? The moment that I realized how much this mattered. So when you look at, we're going to talk solutions. When you look at your data, consider lost time, injuries, but also consider injuries where maybe we're able to bring somebody back on a modified duty role but they aren't caring for residents, they're doing some other job. So that caregiver resident bond has been broken. So that caregiver resident bond has been broken. We can track that data. So quality of care is I mean it is something profoundly impacted by employee injuries.

Speaker 1:

And then the last one I was going to touch on was occupancy. Again, it's another personal story I wanted to share, no-transcript, you know, and it didn't really resonate with me until 10 years later. And now, in a span of about eight months, my family has helped two loved ones move into assisted living and I had independent conversations with the family members who helped make the decision and they both. You know and I'm very familiar with one of the communities that they moved into. It's a beautiful place and apparently the other place that my other loved ones moving into is also really nice.

Speaker 1:

But my parents who helped with one, and then my two aunts who helped with another, they both said the same thing. They talked about the people. They used words like warm, happy, welcoming nice of everybody, of every department, whether they were in leadership, whether they were an hourly employee. That was such a draw for them. If you have chronic back pain, if you have a nagging knee injury that hasn't yet become a workers' comp claim, how can you do that? You know injuries impact everything. So you know occupancy is a little bit tougher to quantify, but it's real. It's real.

Speaker 1:

Okay now we can get back to solutions.

Speaker 4:

We're at the beginning of the NFL season. You're telling me assisted living has more injuries than the NFL.

Speaker 4:

You know I've never done that analysis, but you should do it. It was. That'd be really big impact. That's my homework assignment, john Guild nursing. Anyway, it's just real excited about the NFL start again and I know a lot of injuries happen there. But these stories are very, very impactful. I remember visiting my grandmother who had Alzheimer's and for 20 years she was in a memory care community and she was just so happy all the time because those around her really loved and cared for her. And so, yes, having an individual get injured and not be able to continue to have that bond with the resident impacts everything in that relationship. So, yeah, keep going. I love these stories.

Speaker 1:

Yeah, yeah. So, from a solution standpoint, I mentioned kind of doing like a little bit of a leadership team gut check. Where are we? I also recommend doing a personal gut check, because the starting point from the leadership team when it comes to employee safety should be data and empathy. What are our numbers and how are we connecting with our staff? How are we connecting with our staff? And you know I shared some personal stories of injuries that I've had.

Speaker 1:

I would encourage everyone in a leadership role, if you're talking about this, to ask yourself how would my life be impacted if I wasn't able to use my dominant arm? What about if I wasn't able to use my right leg, which is, by the way, how we drive? Okay, I just lost some independence there. What if you can't lift over 10 pounds? You know? Think about just living, think about your hobbies, think about your children, your grandchildren, and then think about those who depend on you. How are they going to be impacted? So the ripple effect here is huge and, by the way, I encourage that personal assessment to be included in safety training. Personal assessment to be included in safety training, like, if you're doing training on resident handling and mobility, have the employees before you start training at all. Personalize it and ask them how will your life be impacted if you go three months and can't lift over 10 pounds? And think about it. Have them write it down. Don't have them hand it in and say, okay, that's for you to keep. We want you to really think about this personal about it. Have them write it down, you know. Don't have them hand it in and say, okay, that's for you to keep. We want you to really think about this. Personalize it, because nobody thinks about the impact of an injury before it happens. Well, not nobody, but, trust me, very few people do. I do this for a living and I wasn't thinking about it.

Speaker 1:

But then the last step of the self-assessment I would encourage you to really dig into your data. Self-assessment I would encourage you to really dig into your data. Every community should have an annual OSHA 300 log, which is a great source of data. It's not the only source. We can look at workers' comp trends as well, but I would start with the OSHA 300 log and the pieces of data I would capture are how many cases of lost time did we have and how many days of lost time? Because that's where our staffing and our quality of care has really been interrupted. And then also look at any kind of injuries involving transfer or job restriction, because, again, maybe they're able to go to work but they can't do their full job or maybe they can't provide care. Maybe they're able to go to work but they can't do their full job or maybe they can't provide care. And then, after you've got that data, I would sit down with the executive director, whoever knows the community or the facility inside and out, and I would say how many of these injuries impacted our rock stars you know how many impacted that person who takes the new hire under their wing, how many impacted the person who's they're like a leader on the floor, but they don't carry that title To really understand the true impact on our culture, on our training, on our mentoring, because we can capture all this data and see where we're at as an organization. So that's step one, but then the next thing I would do is I would take a very close look at how we're responding to injuries when they happen.

Speaker 1:

I wanted to share a story from when I was in a leadership role. I had a consultant I was managing health and safety consultants at the time and she had a client who is an operator of, I want to say, 16 assisted living communities across multiple states. Who is an operator of, I want to say, 16 assisted living communities across multiple states. Their executive team talked about this annually. They had an annual strategy meeting to look at their risk management plan and see what's working, see what's not working and then make changes, and they really valued her input. She was like an extension of their team and she invited me to join once and the VP of human resources came. So they had a lot of data they were going over and one piece of information they were going over was any work related injury over $50,000 for workers' comp claim, and I think they had like seven or eight and we just asked her to read basically, what did we learn and what did we do about it? Just those two things.

Speaker 1:

And she went through each one and she was going through these reports and there was kind of some awkward tension in the room when she was done with this because almost every single instance the blame was placed on the employee. My consultant, who again she's able to say things in this room that a lot of people can't they had her trust and respect. She said may I ask a question? They said, of course. She said are you hiring them stupid or are you training them that way? I don't know. And everybody laughed, except for the president and CEO.

Speaker 1:

The president and CEO said point taken. She looked at her team and she said this is unacceptable. She said we've had these are costly injuries, these are impacting care, these are impacting our culture, these are impacting the lives of our team members and we as a leadership team don't have any kind of action item that we have taken to prevent recurrence If we haven't learned from the serious injuries that have happened. Well then, what good is our safety program at all? So you know, it was a leader really taking the reins and showing leadership.

Speaker 1:

So they put in place a very detailed plan to, you know, get all the way down to the community level and make sure that when something happens, large or small, we're doing an effective investigation, we're coming up with the true root cause of the issue Understanding. Is it a training issue? Is it a quality issue? One of the common things that I've seen in my career is safety training used as punishment. Oh, the employee took a shortcut. They didn't do what they were supposed to do. Let's retrain them. Hold on, we need to pause. If they didn't know how to do it safely, then we retrain them. If they did know how to do it, why are we turning training into a management, a performance improvement tool? It's important to understand the root of the issue, but there is almost always something that the leadership team can do to work to prevent it from happening again.

Speaker 1:

So if I were to start anywhere as an organization, it'd be understand your data, understand how we're responding to incidents that have occurred, especially the more severe ones. I just love the Albert Einstein quote. He said if I had an hour to solve a problem, I'd spend 55 minutes thinking about the problem and five minutes thinking about solutions. Because you know, if leaders do an effective job understanding these two things, the solutions kind of fall into place. So a couple other things I wanted to share solutions. And you know, john, one of the really cool things about my career is, since I'm in and out of different locations all the time, I'm just sharing what I've seen that's worked.

Speaker 1:

You know I'm not really inventing anything new here. You know, is safety of employees a priority? Is it part of your company's core values? Is it specifically laid out as something in how you operate. This is what we believe in.

Speaker 1:

You know, I was doing a presentation a few months ago and in preparation I went through a lot of the large assisted living operators in the country and I read their core values. I saw employee safety listed very seldom. It's just not common. So I would take a look at that and say, if we're not talking about this, how are we ever going to move the needle? And then the next thing I would say is you know a lot of organizations put together safety teams, which is a great idea, but you need to assemble the right team.

Speaker 1:

And when it comes to assisted living and skilled nursing, I would encourage you to keep resident handling and mobility separate from facilities, because it's really apples and oranges. You know, if you have a facilities team, you know that's great. They're focusing on burnt out exit lights and trip hazards and life safety. You know these are great things to be focusing on, but it's just completely different from what are we going to do when a resident falls and they're in a tight area. That's just completely different from what are we going to do when a resident falls and they're in a tight area. That's a completely different intervention and the teams are going to have a different makeup. So I would encourage that. And then the last thing I would encourage you to do is really tap into the resources that you already have. A lot of HR and quality systems. You don't need to like reinvent something, but you can say what are we already doing and can we make it a little bit more robust and include training and quality assurance when it comes specifically to our employee safety?

Speaker 1:

And then also, I mean obviously I'm on the commercial insurance broker side. I was on the insurance company side for 16 years. Both tend to have a lot of resources available. The one thing to keep in mind and I can say this from experience anybody who works for an insurance company they know who signs their check. Your insurance broker works for you. I am extremely fortunate I have a nurse on my team. My clients can be 100% candid with her. They don't have to worry about it because she works for them. So there are a lot of insurance companies that have really part of their job is to communicate to the person who prices it, which used to be me. Hey, here are the good things they're doing, but here's the bad things they're doing. So just understand that. And then also, you know, osha, cdc and the VA actually have some really phenomenal resources. There are a lot of good tools out there. So anyway, john, I can send you some links after this if you're interested.

Speaker 4:

Yes, Steve, a piece of our community or a subset of our community are individuals that are acquiring communities. They want to be in this business. They just sometimes don't have all the answers to the questions. They aren't familiar with the back end side of operations. How can they use you to minimize the risk associated with acquiring a community that is currently in business?

Speaker 1:

Sure, you know, I imagine when folks are doing you know, people who are doing acquisitions are kind of like, in a sense, underwriters. They're evaluating objective information to weigh risk versus benefit. That's really all underwriters are doing. So I would encourage them to almost put on their workers' compensation underwriter hat hat. I would want to look at five years of injury history. I would want to see their experience modification worksheet. So, for those who don't know, every company and I'm in Texas, which is a little bit different you don't need to buy workers' compensation in Texas, but most do, and I encourage companies to they have a multiplier. Basically rule of thumb if you're at a one, you're average. If you're below one, you get a credit and you're above average If you're below one. So if you're at a 0.75, you're going to get a considerable credit, and if you're above a one, then you're going to get a debit on what you're paying in workers' comp.

Speaker 1:

Now, it doesn't tell the full story. One bad claim can potentially drive that up, which is why I would want to sit down and I'd really want to have a comprehensive look. And then the last piece of information which is required for regulatory purposes is the OSHA 300 log. And, by the way, john, one of the things that's great about looking at OSHA 300 logs is, if they don't have them, that tells you where they're at from a compliance standpoint. Because because they need to be. So those are three really good pieces of information and, you know, if you look at all three, any one on its own doesn't really tell the full story. I would look at all three together.

Speaker 4:

So I know that you want this discussion that we're having to be focused on risk and operational impact beyond insurance. Can you share the insurance benefits as well? Yeah, absolutely.

Speaker 1:

First of all, I always start at the basics. What is insurance? It's simply the transfer of risk for premium, and the reason why I'm really passionate about the risk side of things is because it's upstream from your renewals. Pretty much every insurance broker, most insurance brokers, do a really fine job of shopping insurance, but what are we doing to actually improve our organization and strengthen our negotiating position? That's where risk management comes in and that's something that every employer can control. So that's really the starting point that I would, that I would look at. But you know, even when it comes to insurance I mentioned, I think, there are four benefits that come before insurance.

Speaker 1:

When it comes to employee safety and the benefits there, I personally this is just my opinion I believe general and professional liability even comes before workers come, because when you talk to general and professional liability insurance companies, the number one thing they're asking about is staffing. It is just critical to the quality of care and they want to know the organizations that are least likely to have some kind of allegations, some kind of liability claim, which we know can be very expensive. So they focus like a laser on staffing. I've even seen a general and professional liability application that asks about the company's last two years of workers' comp experience mods. Well, why would they ask that? Because they know if somebody has a higher mod it's going to impact lost time, injuries and staffing and it's just an indication into how employees are being cared for and then they in turn care for the resident. So that's the first benefit and we already touched on kind of the workers' comp benefit which is workers' comp is.

Speaker 1:

It's really the only type of insurance that right now employers are in the driver's seat. I mean, I'm sure your listeners when it comes to property insurance and depending on the state and jurisdiction, liability might be out of control. That's all location dependent. But workers' comp is the one type of insurance that's a little bit less painful right now. So I would encourage people if they're experiencing pain with workers' comp. It's not a market issue. The market is actually very favorable right now. It's got to be because of something risk-related. So that means there's a real opportunity there.

Speaker 4:

Excellent. So, steve, tell us about your company InsureCup, and how you benefit the marketplace.

Speaker 1:

Sure InsureCup was started in 1957. We're the 44th largest agency in the country, privately held. It's a fantastic place to work. In fact, in 2022, we were named best agency to work for by the insurance journal. When I say I was an underwriter, that meant that my clients were insurance agents. That was my client base and so I was able to you know, really across three states in the middle part of the country get to know agencies.

Speaker 1:

You know dozens of agencies and I chose to work at Insurica, the reason being we are a large enough company to have all the bells and whistles and resources and industry expertise of the worldwide insurance brokers. But, yeah, we're small enough to have that personal touch. My clients know me, we have a great relationship and so it was a really good balance. Like I mentioned, I'm really fortunate. I've got a nurse on my team, I've got independent claims people that work on my team, because we don't just want to be an insurance agency. We want to be a risk management partner. We want our clients to view the insurance program as one pillar of their risk management program. You know, we want our clients to think about how can we improve so we can become best in class. You know, that opens the door to different, creative self-funding options, different risk financing options where you can, as an employer, can, take more of your own risk, and so we're a company that we love bringing forward those resources. We have clients as well that they just want us to take care of their insurance and they don't want a lot of hands-on assistance. We understand that. But those who really want to need help or they think they're best in class and they want to get even better that's where we get really excited. So that's a little bit about our team.

Speaker 1:

Yeah, I'm part of our healthcare and senior living practice. We basically break our company into 14 industry practice groups. Healthcare and senior living is one of them. Healthcare and senior living is one of them, and one of the reasons why they brought me on board was to really spearhead senior living because we've got some folks who are really strong in home healthcare. The head of that practice group is a former hospital administrator, so he's really strong working with health systems and hospitals. But I got to develop a relationship with Insurica and they understood my background consulting in senior living and they said we think you'd be a good fit to join the team.

Speaker 4:

Steve, your stories, your passion, your enthusiasm for the senior living space is evident in this discussion, and so it's always a pleasure to have an individual like yourself on the Senior Housing Investor Podcast, because you bring great value to those that are listening. And so how do individuals find you and connect with you so that they can get questions answered or even new insurance or replacing insurance, whatever that may be?

Speaker 1:

Yeah, I would say the easiest way. I mean I'm not too active on LinkedIn. I actually have a newsletter as I build relationships with people. It's a semi-monthly newsletter. I call it an underwriter's take.

Speaker 1:

I'm trying to get people to see things through the lens of the person who prices their insurance. So I'd say if somebody just wants to get on my you know, I'll mail it to them paper copy, if they want it. If they're old fashioned, if they want me to put them on an email list, I'll do that and my, my phone number is 214-422-6098. Am I supposed to give that out? I don't know. Yeah, email's the best way to reach me. Stevegrowth, that's G-R-O-T-H at insuricacom.

Speaker 1:

So I would say, if you know there's a lot of people who are really happy with their insurance broker, but if they want to get on my newsletter list and just you know, know me as a resource would ever want to grab coffee, just have like a quick virtual conversation. You know I love supporting the industry and I know if somebody is in really good hands with their broker but they value a conversation, well then it's valuable to me as well and I know that always rewards me in the long run. So just supporting the industry seems like the best way to also grow the size of my business. So that's the best way people can get in touch with me. But I would encourage the newsletter because a lot of these personal stories I share and it just helps businesses be better insurance buyers and better risk managers just helps businesses be better insurance buyers and better risk managers.

Speaker 4:

Well, thank you for your time, Steve. You're a valuable resource for the space and I encourage our audience to get in touch with you and see if you can help them. Sounds great. Thanks so much, Jeff. You're welcome. Have a great day, Steve. Thanks.

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