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MASSACHUSETTS NURSE NEWSLETTER ::
January 2008
Why personal liability insurance is more important than ever
Nurses are soon going to feel even more on-the-job pressure due to
all of the reimbursement changes underway (see Page 4.) The commonwealth
wants hospitals to lower costs as a way of driving down
insurance companies’ premiums. The Massachusetts health reform
project that is underway (the “Connector,” or mandatory health insurance
for all) is at stake.
The cost of Connector premiums has to be kept down for people to be
able to afford coverage or the whole deck of cards will come tumbling
down. In addition there is a sea change coming in Medicare reimbursement.
Plans are underway for Medicare to stop paying as of Oct. 1, 2008
for eight conditions or events deemed to be preventable. Sen. Richard
Moore has filed a bill that would go further and prevent Massachusetts’
hospitals for billing for any of the 28 “never events” defined by the
National Quality Forum.
Why is this my problem?
Many RNs are concerned that hospitals will be more likely than ever
to look for somewhere to place the blame for these occurrences for which
they will shortly no longer be getting reimbursed.
These eight conditions include: falls; mediastinitis (an infection that
can develop after heart surgery); urinary tract infections that result from
improper use of catheters; pressure ulcers; vascular infections resulting
from improper use of catheters; objects left in the body during surgery;
air emboli; and blood incompatibility.
MNA is already hearing of pressure on nurses to document skin condition
extensively, even in ED situations where the presence or absence
of erythema may not be the nurses’ logical primary focus. However,
the financial incentive is to have early documentation of “pre-existing
conditions” so that the hospital doesn’t get blamed for the pressure
ulcer and subsequently lose reimbursement dollars.
We’re not just being paranoid here!
The National Patient Safety Foundation electronic mailing list has
been buzzing in recent weeks over the issue of how to get hospital staff
to increase their reporting of “mistakes.” A Milwaukee hospital is offering
baseball tickets to encourage staff to report med errors and near
misses—contests, anonymous reporting being encouraged, etc. This
is real and it’s happening now, near you!
Here’s a quote from a quality improvement specialist at a Virginia
hospital about how she has managed to increase her staff ’s reporting
of errors:
“We have tried a couple of different methods that have worked—of
course money speaks the loudest.
- $1 coupon for near misses that are redeemable in the gift shop (did
this for three months and doubled our reporting).
- Instituted a unit competition—for each near miss reported, the
staff reporting were entered into a $25 monthly drawing.”
But wait … there’s more!
“Perhaps reporting could also be in the criteria for salary reviews and/or
bonus considerations.”
It goes to show—money talks!
Many nurses feel that as long as they are practicing appropriately they
have nothing to worry about. Although they certainly are on top of the
game, there is no assurance that they are home free.
MNA staff and board members attend the monthly meetings of the
Massachusetts Board of Registration in Nursing and witness month
after month instances where a nurse has been reported to the BORN
by a disgruntled supervisor, administrator, colleague, family member,
team member—or even a nurse who has been caught in an investigation
of conditions at a hospital by a DPH investigator who places blame on an individual since system error doesn’t have a face and name. The
reporting cited above appears to be done to churn out numbers of
reports—it’s a quantitative game. Any discussion about the impact of
the reporting in terms of improving care is completely lacking.
More problems ahead
Is this not enough to convince you of the importance of protecting
your license and protecting your assets by obtaining liability coverage?
Add to all of this another move by Sen. Richard Moore to make Massachusetts
a “Compact” (interstate licensure) state. Along with this would
come new authority for the BORN to levy financial penalties and fines
on nurses, something they have not done to date but which does happen in other, primarily southern, Compact states.
And there’s more bad news: Compact will
permit boards of registration to discipline
nurses across state lines and a nurse may find
herself needing legal representation in more
than one state.
Many nurses are under the impression that
liability coverage from their employer is sufficient.
This is not true at all. Your employer’s
policy is not likely to offer coverage for off-duty
incidents. Your employer’s policy is not likely
to cover you following a layoff or job change—
even though you may still be held liable for a
medical incident that occurred while you were
employed. Worse yet, your employer's insurance
company could actually turn around and
sue you to recover damages if they feel you are
even remotely responsible - armed with all the
information you provided in good faith!
The MNA strongly encourages every single
nurse—practicing, teaching, consulting, retired
(you never know when you might be tempted to
volunteer)—to spend what is, for most nurses,
less than $100 a year for coverage. MNA’s suggested
and preferred provider of professional
liability insurance is NSO. For details on the
services NSO offers, see above story.
NSO offers members liability insurance at a discounted rate
The MNA strongly encourages every single
nurse—practicing, teaching, consulting,
retired (you never know when you might be
tempted to volunteer)—to spend what is, for
most nurses, less than $100 a year for coverage.
MNA’s suggested and preferred provider of
professional liability insurance is NSO.
NSO benefits at a glance
- Up to $1 million each claim, up to $6
million aggregate professional liability
limits
- License protection coverage
- Defendant expense benefit
- Assault coverage
NSO also offers these additional coverages,
at no extra cost:
- Personal liability protection. You’re
covered, up to $1 million aggregate
(depending on the limits you choose),
for liability damages for covered
claims resulting from incidents at
your residence that are unrelated to
your work.
- Defendant expense benefit. Reimburses
you up to $10,000 aggregate
for lost wages and covered expenses
incurred when you attend a required
trial, hearing or proceeding as a
defendant in a covered claim.
- License protection. Reimburses you
up to $25,000 aggregate, up to $10,000
per proceeding for your defense of
license or disciplinary action and
other covered expenses arising out
of a covered incident.
- Personal injury protection. Protects
you, up to the applicable limits of
liability, against covered claims arising
from charges of privacy violation,
slander, libel, assault and battery,
and other alleged personal injuries
committed in the conduct of your
professional services.
- Medical payments. Pays up to
$100,000 aggregate, up to $2,000
per person for reimbursement of
medical expenses to others injured
at your residence or business premises.
- Assault coverage. Covers your medical
expenses or reimburses you for
damage to your property up to
$25,000 aggregate, up to $10,000 per
incident if you are assaulted at work
or while commuting to and from
your workplace. (Assault coverage
is not available in Texas.)
- Damage to property of others. Pays
up to $10,000 aggregate, up to $500
per incident for damage caused
accidentally by you to the property
of others at your residence or workplace.
- First aid benefit. Reimburses you
up to $2,500 aggregate for expenses
you incur in rendering first aid to
others.
- Deposition representation. Reimburses
you up to $5,000 aggregate,
up to $2,500 per deposition for attorney’s
fees as a result of your required
appearance at a deposition that arises
out of professional services.
And these additional benefits.
- 24/7 protection. During the policy
period, coverage is in force 24/7.
You’re covered for incidents that
occur on the job and after hours as
well. Your protection remains in force
even if you change jobs or during a
period of unemployment.
- Occurrence-based coverage. Protects
you regardless of when a claim is filed,
provided the policy was in force at
the time the covered medical incident
occurred.
- Legal representation. An attorney
will be provided to represent you
personally when we find it necessary.
Legal fees will be paid for covered
claims, in addition to your liability
limits – win or lose.
- Worldwide protection. Coverage is
available worldwide, provided claim
is brought against you in the United
States, its territories and possessions,
Puerto Rico, or Canada.
- Outstanding service. More than
650,000 nursing professionals are
already covered by the Professional
Liability Insurance Program offered
through NSO. Our insurance representatives
have the knowledge and
experience to help you.
- Outstanding individual protection
at affordable group rates. NSO Professional
Liability Insurance coverage
provides you with the very best benefits
available that we know of—at
a truly affordable group rate. It’s a
straightforward approach to professional
liability coverage. And, it’s
protection that works!
Discounts
Continuing education. You can qualify
for a 10 percent discount on your first three
years of professional liability insurance coverage
by completing our continuing education
modules.
Students. Just $29 a year for students.
First-year graduate discount. If you’ve
graduated within the previous 12 months,
you are entitled to a 50 percent discount as
a first-year graduate. Be sure to indicate your
graduation date on the application.
Retired discount. If you are retired but
maintain an active license, you may qualify
for a 50 percent discount with reduced coverages.
Risk management discount. A 10 percent
non-cumulative credit will be applied to your
annual premium for up to three years for
attending an eligible risk management course.
(The course must be 6 contact hours in a subject
related to an insured’s area of specialization.
Must provide a certificate of attendance showing
course name, number of hours and course date.
Course must have been completed within the last
12 months in order for discount to be applied.)
For more information, contact NSO at: 800.247.1500 or by e-mail: service@nso.com or
visit the Web site at www.nso.com.
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