Risk Management Services for Retirement Communities
After the passage of the Americans with Disabilities Act (ADA), several retirement organizations were concerned about legal risk in accepting or not accepting applicants.
In 1997, Green Oak was asked by retirement community leaders to develop a third-part review process because they were concerned about both their compliance and liability in accepting applicants.
Unknowingly accepting a poor risk applicant has significant long-term financial ramifications. However, declining an applicant without clearly stated criteria and a defined evaluation process, could lead to more immediate problems.
To resolve this, Green Oak’s risk management team conducts an independent, third party evaluation of each applicant’s potential risk for using long-term care services. It does this using a national database of retirement community residents developed over many years.
The basis for the risk assessment is whether or not the applicant would be approved for coverage under an individual LTC insurance policy. In most cases, there will be a clear “Yes” or “No” response. In borderline situations, there will be additional back-up information for the Community to investigate further.
Liability under ADA and Fair Housing may be reduced due to the use of national norms that establish a realistic actuarial evaluation. Further, the evaluation structure is targeted to indicate potential dementia issues that might not otherwise be identified.
The Community is not bound by this information. The process is simply an independent evaluation of an applicant’s risk for using LTC services. The Community can incorporate the results as it chooses.
Green Oak staff work in coordination with the Community to evaluate outcomes and identify general trends that may be significant indicators of marketing and operational issues.
Since 1998, several multi-site systems and stand-alone communities have implemented and utilized the program. Results have been effective for evaluating individual applicants and many communities use the risk assessment as the basis for their acceptance of applicants for life care.