Ep. 581 Four RCFE Operational Breakdowns That Turn into Claims

Rancho Mesa's Alyssa Burley sits down with Associate Account Executive Jack Marrs discuss operational breakdowns within residential care facilities for the elderly (RCFE) and how they can turn into claims.

Show Notes: ⁠⁠⁠⁠⁠Subscribe to Rancho Mesa's Newsletter⁠⁠⁠⁠⁠. ⁠⁠⁠⁠⁠⁠⁠⁠⁠

Director/Host: ⁠⁠⁠⁠⁠Alyssa Burley⁠⁠⁠⁠⁠

Guest: ⁠⁠⁠⁠⁠Jack Marrs⁠⁠⁠⁠⁠

Producer/Editor: Megan Lockhart

Music: "Home" by JHS Pedals, “Breaking News Intro” by nem0production

© Copyright 2025. Rancho Mesa Insurance Services, Inc. All rights reserved.

Transcript

Alyssa Burley: You're listening to Rancho Mesa’s StudioOne podcast, where each week we break down complex insurance and safety topics to help your business thrive. I'm your host, Alyssa Burley, and I'm joined by Jack Marrs, Account Executive and the Human Services Group with Rancha Mesa. And we're going to discuss operational breakdowns within residential care facilities for the elderly, or RCFEs, and how they can turn into claims. Jack, welcome to the show.

Jack Marrs: Thanks for having me, Alyssa. It's good to be back in StudioOne.

AB: Of course. Now, you recently wrote an article that outlines operational breakdowns within these types of facilities that end up leading to claims. Will you explain why claims often start with small, repeated breakdowns rather than one major incident?

JM: Yeah, no problem. So in most cases for RCFEs, like I said, it's not just one huge dramatic mistake that happens out of nowhere. It's usually the little things that are going to continuously to add up. People are going to be taking shortcuts, gaps that even happen over and over because everyone's busy. Like maybe the hazard walk doesn't happen every day or transferring clients gets rushed when you're short-staffed or charting gets pushed to later. One time nothing happens, 10 times still maybe nothing happens. But eventually you'll get the one fall or the one wandering incident or the one med mix-up. And now everyone's asking, “Was this preventable?”

And that's where facilities get in trouble. When the routine wasn't consistent, the documentation is thin and the story doesn't line up. The claim isn't just about the incident. It's about what the pattern looks like leading up to it.

AB: Yeah. So you described medication assistance drift in your article as a major contributor to medication-related claims. So what causes this drift and what specific steps can facilities take to prevent it?

JM: Great question, Alyssa. So the drift is when a process starts out clean and slowly turns into the quick way, usually from distractions, turnover, you name it. I mean, if you can picture a residential care facility, you know, there's a lot going on. There's nurses on staff. There's caretakers. There's multiple clients. So say there's a new employee and they're not as familiar with the timing or they're nervous. They're being rushed. Clients are grumpy in the morning. They're getting their morning medication. They haven't had their coffee yet. You know, mistakes happen. and that's where the biggest claims can hit. To prevent it, keep one simple MAR process. Do meds with no interruption rule, tie in controls for higher risk meds, and do quick refreshers so the process doesn't slide over time.

AB: Yeah, and I think that's something that all industries can relate to. So in your article, you also emphasized consistency as a key factor across falls, wandering medication issues and staffing. Will you explain how the routines and practices you outlined like daily hazard walks, post-fall procedures, and shift change head counts help reduce claims and strengthen a facility's position?

JM: Yeah, so consistency is huge because it's going to take decision-making out of the moment. When something happens, you don't want staff guessing what to do or doing five different ways depending on who's working. So routines like a daily hazard walk reduces falls because you're catching problems before they hurt someone. A consistent post-fall procedure matters because it keeps their response clean, assesses, monitor, notify the family, and document in a steady way. That's what prevents the “Wait, what happened?” confusion later.

And shift change head counts help with wandering risk because shift change is when things slip. People assume someone else is watching, doors are opening, staff are transitioning, a simple headcount or visual confirmation make sure nobody gets missed. And at the end of the day, these routines protect residents first, but they also protect the facility because if there's ever a complaint or an investigation, you can show here's what we do every single day, here's the process, here's the documentation and that consistency is what keeps an incident from turning into a mess.

AB: Absolutely. I think all of your clients that are dealing with these types of things can agree with those. So Jack, if listeners have questions about their facilities, what's the best way to get in contact with you?

JM: You can get hold of me either by email, which is going to be jmarrs@ranchomesa.com or call me directly at 619-486-6569.

AB: All right. Well, Jack, thanks for joining me in StudioOne.

JM: Thanks for having me, Alyssa.

AB: Thanks for tuning in to our latest episode produced by StudioOne. If you enjoyed what you heard, please share this episode and subscribe. For more insights like this, visit us at RanchoMesa.com and subscribe to our weekly newsletter.