7 Common Safety Risks People Face in Assisted Living Facilities

When the tough decision is made to place a loved one in an assisted living facility, it’s usually because the family fears for their safety and security. Assisted living facilities are there to provide the individual with a home-like environment, but with all the help and support they need.

Even though an assisted living facility is a far safer environment than the typical home, safety risks need to be managed and addressed. Here are seven common safety risks people face in assisted living facilities and how to deal with them.

1. Slip and Fall Accidents

People can slip or fall anywhere at any time, and an assisted living facility is no exception. According to the Centers for Disease Control and Prevention (CDC), one out of four people over the age of 65 falls every year in the United States.

Unfortunately, as we age and become frailer, sustaining an injury from a fall becomes more likely. The potential for serious injury means it’s one of the top hazards that need to be managed. Even a minor fall can lead to severe consequences like broken bones, lacerations, and, in the most extreme cases, premature death.

Slip and fall accidents are the most common type of incident among assisted living facilities. If one occurs on the premises, the assisted living facility is likely to be found liable.

How to Lower the Risk

You can minimize the risk of slip and fall accidents occurring by:

• Providing all residents with walking aids like canes and frames
• Providing a wheelchair for particularly frail residents
• Having staff members assist residents with walking where possible
• Using hoists and other appropriate equipment for getting residents out of bed
• Installing nonslip floor surfaces
• Ensuring all floor areas are even and that carpeted areas do not have loose or raised edges
• Keeping walkways clear of trip hazards
• Mopping up spills as soon as they occur
• Cordoning off freshly mopped floors until dry
• Providing safety alarms to residents to use when they require assistance

Taking these measures will minimize the risk of slip and fall accidents as much as possible. However, it will not eliminate risk. Train your staff to be vigilant and to look out for potential hazards.

2. Inadequate Safety Alert Systems

Staff can’t watch over residents at all times. Therefore, it’s essential to provide them with safety alarms that they can activate when they need assistance. Even something simple, like getting out of bed to use the restroom, can present a significant challenge. If there’s no one around to help them, the chances of an accident increase. Additionally, if a resident does have an accident with no one nearby, without a safety alarm, it could be a long while before someone finds them.

All too often, assisted living facilities don’t install an adequate alarm system. If a resident has an accident and can’t raise an alert for help, the facility is likely to be blamed for the incident.

How to Lower the Risk

An excellent quality safety alert system should include:

• Emergency pull-chains in bathrooms and restrooms
• Call buttons within reach of beds
• Call buttons in communal areas
• A personal alarm for each resident to carry with them
• Regular maintenance and safety checks to ensure the system is working correctly
• Training for all staff to ensure they respond to the alert immediately and as a priority

3. Negligent Staff

Staff members should be an asset, not a liability for assisted living facilities. They have a duty of care to all residents. It is their responsibility to ensure residents are kept safe and secure. One of the most common assisted living safety risks is inadequately trained or unsuitable staff. A report from the Agency for Healthcare Research and Quality (AHRQ) notes that human factors were the most frequent contributing factor in nursing home incidents, with about 45,000 reports citing this as the cause.

Potential risks from negligent staff are:

• Resident abuse and mistreatment
• Residents left unattended and vulnerable to accidents
• Inadequate or missed meals and hydration
• Improper personal care and bathroom assistance
• Failing to alert medical services when required
• Failing to notice and remove slip and fall hazards

Negligent staff can create some serious problems in your facility. And you can be found liable if something happens on their watch. Keep your team happy and well-trained to minimize this risk.

How to Lower the Risk

To avoid this happening, you need to ensure that:

• Your hiring process is thorough and sufficient to allow you to select the best candidate.
• You only accept staff with previous experience and excellent references.
• You provide full orientation training for all processes, procedures, and how to use equipment properly.
• You provide ongoing training to keep your staff at the highest standard.

It’s also imperative to note that overworked and tired staff become less vigilant and are unable to perform to standard. Having insufficient staff on each shift can lead to serious problems. If there is not enough staff, residents cannot receive appropriate care.

4. Infection Control

Infection can be a serious issue in nursing homes because many residents live together in a single building. They also come into contact with staff. Aging can make people more susceptible to infections, so these events have more serious impacts.

How to Lower the Risk

Nursing home facilities and their staff can take various measures to lower the risks, including:

• Promoting and practicing proper hand hygiene, like regular washing and disinfection
• Cleaning and disinfecting high-touch surfaces like doorknobs, counters, tables, phones, and medical carts
• Requiring proper personal protective equipment for staff, visitors, and residents
• Placing infected residents in individual rooms, if possible, to avoid the chance of germs spreading
• Ensuring staff and visitors stay home when infected with an illness
• Requiring staff and residents to have updated vaccinations
• Practicing safe injection procedures, such as discarding single-use equipment and disinfecting multi-use equipment

5. Medication Errors

Most nursing home residents take medication. While living in a facility, these older individuals rely on medical staff to dispense the proper medications in the right quantities. Medication errors could include giving a resident the wrong medication or dose.

In an AHRQ study regarding incidents at nursing homes, those involving medication were quite common, ranging from 17.2% to 26.9% of reported cases. If a resident suffers harmful effects from medication errors, the nursing home or its staff could be held liable.

How to Lower the Risk

When administering medications, professionals should consider the five rights:

• Right drug
• Right dose
• Right route
• Right time
• Right person

Facilities can take several measures to reduce errors, including properly training and educating staff on the correct procedures. Your nursing home can also institute in-depth documentation using technology and medication management systems. Proper medication storage may also reduce error frequency.

6. Environmental Hazards

These assisted living facility hazards can also contribute to nursing home incidents, especially falls. Environmental factors contributed to 11.2% of falls examined by the AHRQ in 2023.

Obstructed hallways are a big culprit in causing slip and fall accidents. Residents are typically not as agile as they once were, so avoiding objects when trying to navigate the floor becomes tricky. Additionally, those who rely on canes, walkers, or wheelchairs to get around will find any obstacle on the floor a big challenge. As well as posing a fall risk, obstructive hallways may block paths entirely.

Besides minimizing obstructions, facilities also need to maximize safety equipment. Handrails and grab bars are an essential component for assisted living facilities. They enable residents to get up and down from a seated or lying position as well as navigate or maneuver in walkways. Handrails offer an element of independence for individuals. They allow people to carry out activities alone that they wouldn’t otherwise be able to do. Without handrails, something as simple as using the bathroom could become a dangerous activity.

How to Lower the Risk

If an individual can’t get to the restroom in time or reach a chair, this can cause severe discomfort to the individual. Keeping hallways clear is, therefore, of the utmost importance for safety in assisted living. Some tips to achieve this are:

• Arrange furniture so that it does not obstruct a doorway or door from opening fully
• Ensure a wide, clear space around doorways to allow walking aids to maneuver safely
• Keep all areas free from clutter, especially walkways
• Do not allow boxes or other objects to be stacked against the walkway walls
• Provide adequate storage for each resident’s personal belongings
• Teach staff to be vigilant in picking up or removing any fallen objects
• Provide tables in common areas for personal belongings
• Never store or place any object in an elevator
• Provide a specific area for large deliveries that is situated away from resident access

To keep your residents safe yet mobile, you should install:

• Handrails and grab bars in all bathrooms and restrooms, notably in the bathing area and next to the toilet
• Handrails along walkways and hallways
• Grab bars next to beds so residents can sit up or exit the beds easily
• Grab bars next to sloped areas and doorways with potential trip hazards, like steps
• Handrails in all elevators

Also, ensure that:

• All handrails and grab bars are installed at the correct heights
• They are not obstructed by furniture or other objects
• They are inspected regularly to see if they’re secure
• Any broken, loose, or wobbly rails and bars are fixed or replaced

7. Accidents During Transportation

This area of senior living safety is often overlooked in assisted living. Residents often need to leave the facility for various reasons. Appointments, medical needs, family visits, and more mean that residents require a method of transportation to get there. Besides the obvious risks that anyone would face when driving, transporting residents presents a unique set of risks.

How to Lower the Risk

Vehicles must be fitted with the right safety equipment and be easily accessible for individuals to enter and exit the vehicle safely. External conditions, such as the weather, should also be observed closely. Icy or wet conditions present slip and fall hazards, while extremely hot weather can cause a resident to fall ill quickly.

When you need to transport residents, observe that:

• The vehicle is specifically designed for use with the residents and mobility aids
• All seatbelts are working properly and are correctly secured
• Any residents who use wheelchairs are safely secured
• All individuals can safely get in and out of the vehicle
• The driver is experienced and has a clean driving license
• The vehicle has adequate climate control
• The vehicle is well-maintained and roadworthy
• Transportation is not attempted when weather conditions are extreme
• A resident who appears unsteady or ill is not transported

If you hire a third party to take care of your transportation, then it’s still important that you observe all the above. Don’t leave it up to the third party to perform safety checks. If an accident occurs while they’re transporting residents on your behalf, you may still be found liable.

Protect Your Facility With Liability Insurance Solutions

Common safety risks in assisted living facilities can largely be avoided by taking the necessary preventive measures. However, you cannot eliminate the risk. Even the highest-quality facilities can be found liable for an accident or incident on the premises. Assisted living facility insurance solutions may help protect your facility in the event of an incident.

XINSURANCE Insurance Solutions for Assisted Living Facilities

Give yourself the extra peace of mind and avoid the huge cost of potential lawsuits by taking out liability coverage. Our team at XINSURANCE can help you find customized coverage solutions for your assisted care community. Explore some of the coverage solutions we can help you identify at XINSURANCE. Find out more about XINSURANCE and receive a quote for coverage solutions.

Authored by Rick J. Lindsey, President, Chairman, and CEO of XINSURANCE

Rick J. Lindsey hails from Salt Lake City, Utah. He began working in the mailroom of his father’s Salt Lake City insurance firm, getting his introduction to the business that became his lifelong career. Rick J. Lindsey quickly rose through the ranks while working in nearly every imaginable insurance industry job. As an entrepreneur, specialty lines underwriter, claims specialist, risk manager, and a licensed surplus lines broker, Rick J. Lindsey is highly skilled in all levels of leadership and execution. As he progressed on his career path, Rick J. Lindsey discovered an urgent need for insurers willing to write policies for high-risk individuals and businesses. He was frequently frustrated that he could not provide the liability protection these entities desperately needed to safeguard their assets. He also formed the belief that insurance companies acted too quickly to settle frivolous claims. Rick J. Lindsey decided to try a different approach. He started an insurance company and became the newly formed entity’s CEO. This opportunity has enabled Rick J. Lindsey to fill a void in the market and provide a valuable service to businesses, individuals, and insurance agents who write high-risk business. XINSURANCE also specializes in helping individuals and businesses who live a lifestyle or participate in activities that make them difficult for traditional carriers to insure. If you’ve been denied, non-renewed, or canceled coverage, don’t give up quite yet. Chances are XINSURANCE can help.