CCAP Loss                  Safety

    Newsletter is
   Compliments of
     Insurance                                                       For Nursing Facilities
                                   VOLUME 4, ISSUE 1                                                                   MARCH 2007

                                                        AVOID SLIPS TRIPS AND FALLS
                           A fall at work can put you out          shoes with a low heel. Keep            •	      Stay	 alert.	 	 Your	
                           of commission. Weeks in pain,           laces tied to prevent tripping.        chances for a tripping accident
                           months in a cast or years in a          •	        Maintain	        adequate	   or any accident are greater
                           wheelchair can be the result of         lighting in the areas where you        if you are tired or distracted.
                           a simple slip, trip or fall. Falls      walk. Hallways, stairways, and
                           are among the leading causes            outside areas should be bright         Falls are a leading cause of
Pennsylvania Liability     of death in the workplace.              enough to see where you are going.     workplace injury and death. They
Insurance for County
                           Even a fall from the same level         •	        Keep	 your	 hands	 free	     also cause a great deal of suffer-
Affiliated Nursing Homes
                           instead of a fall from a height can     when you walk, to help you catch       ing. Take fall hazards seriously,
A Reciprocal Risk          cause a fatal or crippling injury.      your balance if you start              and do not let them trip you up.
Retention Group                                                                       to fall. Do not
providing Liability and                                                          walk with your hands     TEST	YOU	KNOWLEDGE	QUIZ
Professional Liability                                                           in your pockets.
Insurance                                                                        •	 If	 you	 do	 carry	   1.	     Unless	 you	 drop	 from	
                                                                                 something be sure        a height of 10 feet or more,
Sponsored by                                                                     you can see over
Pennsylvania Association
                                                                                                               there is little chance of
of County Affiliated                                                                                            being seriously hurt in a fall.
Homes (PACAH)                                                                                                   	True	 	False

A Program of the                                                                                                 2.	Stumbling	      over	 an	
County Commissioners                                                                                             obstacle is        know as:
Association of                                                                                                   a.	Slipping	 b.	      Tripping
Pennsylvania (CCAP)
                                                                                                               3. When your feet go
                                                                                                               out from under you
  IN THIS ISSUE                                                                                                because of lack of friction
                                                                   it      or                                  between your shoes and
                           One of the major causes                 around it.                                 the walking surface you have:
                           of falls is tripping over an            •	        Do	not	leave	equipment,	 a.	Skipped	            b.	       Slipped
Avoid Slips,Trips and      obstacle. The other major cause is      tools	 or	 materials	 on	 the	 floor.
Falls - 1                  slipping.     Here are some             •	        Do	        not	      allow	 4.	      Style	 is	 the	 best	 reason	
                           suggestions to prevent tripping and     cords, cables or wires to to choose footwear for the job.
Superbugs Endanger         slipping accidents in your facility.    create trip hazards. Tie them 	True	 	                   	False
Workers - 2                                                        up and get them out of the way.
                           •	        Slow	 down.	 	 Many	          •	        Always	               close	 5.	     You	should	make	sure	you	
                           falls occur when an                     drawers, even if they are in can see over or around an object
Seven Ways to use          employee       walks    too     fast    an area where you would not you are carrying to prevent falls.
Posters Effectively - 3    through the facility. Do not run.       expect someone to trip over them. 	True	 	               	False
                           •	        Watch	 where	 you	 are	       •	        Do	        not	       place	
PELICAN Insurance          going.      Do not assume a             items     on      stairs    or     in
                           walkway inside or outside the           stairwells, even for just a moment.
Renewal Update - 3         facility is clear.     Watch for        •	        Watch	 for	 hazards	
                           clutter	 on	 the	 floor	 and	           such	 as	 loose	 floor	 tile,	 loose	
Word Search - 4            also watch for unexpected               carpeting and broken stair
                           changes in the walkway surface          surfaces. Report these defects
                           levels, such as a step up or down.      immediately           so         they
                           •	        Wear	      well	   fitting	          can        be        repaired.
         PELICAN	-A	Reciprocal	Risk	Retention	Group	providing	Liability	and	Professional	Liability	Insurance

                                  SUPERBUGS	ENDANGER	WORKERS

                                      bacteria are left to grow and multiply.           In	some	cases,	transmission-based	
Any workplace has its special                                                           precautions	are	required.		They	come	into	
hazards.		In	healthcare,	superbugs	                                                     effect when disease may be spread by
                                       Antibiotic Overuse
are among the dangers for                                                               droplets, airborne mechanisms or contact
                                       There is growing concern among healthcare
workers.		Superbugs	are	any	of	                                                         with dry skin or contaminated surfaces.
                                       professionals that the overuse of
a number of bacteria that have                                                          Transmission-based precautions are used to
                                       antibiotics is leading to the development of
become resistant to antibiotics.                                                        protect against such diseases as chicken pox,
                                       more superbugs. This situation may be the
                                       result of using antibiotics unnecessarily to     flu	or	herpes	simplex.		Transmission-based	
                                       treat	illnesses	that	may	not	require	them	       precautions are used in addition to, not in
                                       or from the repeated use of a few drugs to       place	of,	Standard	Precautions.
      Superbug	Examples                treat the same bacteria.
                                                                                        More	Information	on	Superbug	Hazards	is	
                                       The bacteria that are not reactive to the        Available	at	These	Links:
                                       antibiotics are then selected for survival and   •	       http://www.osha.gov/SLTC/etools/
                                       for possible transmission to other people.       hospital/hazards/univprec/univ.html#1
                                       Infections	that	were	once	easily	and	cheaply	    •	       http://www.osha.gov/SLTC/etools/
                                       treated may now become untreatable or            hospital/hazards/mro/mro.html
                                       expensive to manage.                             •	       http://www.fda.gov/fdac/fea-
                                                                                        •	       http://www.cdc.gov/ncidod/dhqp/

                                                    Standard	Precautions

Some	of	the	more	commonly	
recognized antibiotic-resistant
bacteria include
Staphylococcus	aureus	(MRSA),	
Vancomycin-resistant enterococci
(VRE),	Penicillin-resistant	
Streptococcus	pneumoniae	
(PRSPs)	and	multi-drug-resistant	
Tuberculosis	(MDR)	TB.

These organisms often are              Healthcare staff needs to take action to
resistant to more than one of          protect themselves from infection with
the antibiotics commonly used          these	superbugs.		The	Centers	for	Disease	
to treat these infections. These       and	Control	and	Prevention	(CDC)	
organisms may infect healthcare        recommends that staff protect themselves
staff that may transmit them from      by	using	Standard	Precautions	in	cases	
one resident to another or to          involving	blood,	body	fluids,	excretions	and	
persons outside of the facility        secretions,	except	for	sweat.		Standard	
such as family and friends.            precautions include the use of hand washing
                                       and	personal	protective	equipment	such	as	
Antibiotic-resistant bacteria          gloves, gowns and masks whenever
may result when an infection is        touching or exposure to residents’ body
treated with an antibiotic that        fluids	is	anticipated.
kills susceptible bacteria but
leaves behind bacteria that do         Transmission	Precautions
  not respond. These resistant

Page	2
                      Sponsored	by	Pennsylvania	Association	of	County	Affiliated	

Posters	can	be	an	important	part	of	any	                3.         Display one at a time           PELICAN	INSURANCE	PROGRAM	2007	RENEWAL	
safety program. They serve as advertisements,                                                      UPDATE	AND	NOTICE	OF	PELICAN	FOURTH	
                                                  Display one poster per location at one time.     ANNUAL	SUBSCRIBER’S	MEETING
reminders, warnings and sometimes even as         There are exceptions depending on the
laugh getters because a little humor never        location and the particular display. Do not      PELICAN	Insurance	is	a	CCAP	insurance	program	
hurts and often helps one remember.               mass your posters because the attention is       sponsored	by	PACAH	which	began	writing	business	
                                                                                                   effective	March	1,	2003.		The	PELICAN	Insurance	
                                                  higher and readability is better if the number   program	runs	from	March	1	to	March	1.			
                                                  of posters in one display is kept small.
                                                                                                   As	of	renewal,	March	1,	2007,	PELICAN	has	31	
                                                                                                   members.		Total	PELICAN	premium	as	of	March	1,	
                                                                                                   2007	is	approximately	$3.6M	(excluding	MCare;	$4.2M	
                                                                                                   including	the	MCare	Assessment).		

                                                                                                   This year there are two pieces of good news regarding
                                                                                                   PELICAN’s	liability	insurance	program.	First,	
                                                                                                   PELICAN’s	rates	for	2007-2008	are	remaining	the	
                                                                                                   same	per	occupied	bed	as	in	2006-2007!		We	are	
                                                                                                   pleased that claims experience has allowed us to keep
                                                                                                   rates	flat.		Second,	MCare	has	announced	the	
                                                                                                   extension	to	2007	of	their	MCARE	assessment	
                                                                                                   abatement program which could save nursing homes
                                                                                                   up	to	50%	on	their	2007	MCare	assessment.			
                                                                                                   PELICAN	members	need	to	go	to	MCARE’s	website	
                                                                                                   to	make	application	for	the	refund	(http://www.mcare.

                                                                                                   Also,	PELICAN	will	hold	its	fourth	annual	PELICAN	
                                                                                                   Insurance	Subscriber’s	Meeting,	Wednesday,	May	2,	
                                                                                                   2007,	at	the	Ramada	in	State	College,	PA.		The	meeting	
Posters	cover	many	safety	subjects	and	many	                                                       is	open	to	PELICAN	Insurance	subscribers,	and	their	
hazards, and they utilize many art and                                                             producers,	and	will	take	place	during	the	PACAH	
                                                                                                   Spring	Conference.		The	meeting	will	begin	with	a	
printing	techniques.		Selected	carefully	and	                                                      buffet luncheon followed by a short business meeting.
used discriminately, posters can help staff                                                        On	the	meeting	agenda	this	year	is	the	election	to	fill	
avoid hazards and unsafe acts and can help              4.	         Setting	and	lighting           three	positions	on	the	PELICAN	Subscriber’s	Advisory	
you have a more effective safety program.         Light	your	poster	display	well.		Frame	your	     Committee	(SAC)	whose	terms	expire	in	2007.		The	
                                                  posters. Do not use posters that are             SAC	is	the	Board	of	Directors	responsible	for	the	
                                                                                                   operation	of	PELICAN	Insurance	program.		There	is	
Here are some suggestions to help you get         dog-eared or dirty.                              no charge to attend this meeting, but pre-registration
the most out of safety posters:                                                                    is	requested	for	planning	purposes.		Please	look	for	
                                                       5.            Appropriateness               the	meeting	notice	mailing	in	March.

     1.	           Change	them	often              Use	posters	that	pertain	to	the	location	at	     The	PELICAN	liability	insurance	program	provides	
You	do	not	have	to	discard	posters	when	you	      which they are displayed.                        primary nursing home professional liability and general
change	a	display.		Simply	use	the	posters	at	                                                      liability	insurance	on	a	claims-made	basis.		PELICAN	
                                                                                                   Insurance	is	a	Vermont	domiciled	Reciprocal	Risk	
another appropriate location.                            6.	              Permanence               Retention	Group	(RRG)	formed	under	federal	law	and	
                                                  Some	objects	and	some	posters	are	so	basic	      is owned by the participating nursing facilities.
      2.	            Locate	with	care             that you should construct a permanent
                                                  display around them. For example, certain        Administration, claims and loss control services are
Put	your	poster	up	in	either	poster	frames	or	                                                     provided	by	CCAP.		Producer	and	consulting	services	
on bulletin boards at strategic places such as:   fire	protection,	first	aid	and	rescue	posters	   are	provided	by	Willis	Pooling	and	Willis	Management	
•	        Where	staff	pass                        are important enough to warrant permanent        (Vermont)	Ltd.		The	individual	facilities	must	choose	
•	        Where	staff	lingers                     display in some locations. These posters can     their own insurance producer.
•	        Where	staff	stop	and	read               be mounted, laminated or placed in a glass
                                                                                                   PELICAN	membership	is	open	to	current	PACAH	
•	        Near	vending	machines                   front poster box.                                Full	Voting	Member	and	Associate	Member	non-profit	
•	        Smoking	stations                                                                         nursing	homes.		This	program	is	not	open	to	for-profit	
•	        Staff	lounges                                 7.	 	         Special	notices	and          facilities.
•	        Cafeteria                                                   “homemade” posters           If	you	would	like	any	additional	information	regarding	
•	        Conference	or	meeting	rooms             Also use you poster locations for news           the	PELICAN	Insurance	program,	or	the	PELICAN	
•	        Near	time	clocks                        bulletins, press clippings, safety alerts,       Annual	Subscriber’s	Meeting,	please	contact	Steve	
•	        Outside	supervisors’	offices            homemade	posters	and	signs.		Side	from	the	      McDermott,	Captive	Programs	Director,	CCAP	
                                                                                                   Insurance	Programs,	telephone	800-895-9039,	email	
                                                  value such communications may have               smcdermott@pacounties.org.
                                                  themselves;	they	also	draw	staff	to	your	
                                                  poster	locations.		Condition	your	staff	to	
                                                  check these spots for interesting, timely and
                                                  entertaining material.
                                                                                         The words listed here are found in the articles in
   T   R    U       S   W   M   I   B   R    E   W   Y   S   H   U   S   Q   B   O   E   this	issue	of	Safety	Essentials.		Look	for	them	in	the	
   R   F    E       G   L   Q   U   E   G    S   P   N   O   A   T   O   Q   E   Y   V   word search puzzle.
   I   F    G       S   R   I   C   I   R    V   O   W   R   Z   H   W   Y   X   K   I
   P   A    V       J   I   U   P   E   M    I   X   Q   G   A   Q   R   W   G   Y   T        BACTERIA                      ORGANISMS
   P   T    M       B   D   S   T   P   T    E   C   N   A   R   U   S   N   I   L   P        BALANCE                       POSTERS
   I   S    G       O   A   S   T   C   I    F   R   L   N   D   H   I   V   G   P   A        CAPTIVE                       PREMIUM
   N   D    R       F   O   L   E   A   H    N   I   P   I   S   X   J   I   S   I   C        CLUTTER                       PRODUCER
   G   P    P       P   Z   F   A   W   N    G   G   M   S   M   R   O   B   A   T   R        DISPLAY                       RENEWAL
   A   M    L       L   N   X   P   N   H    T   X   W   M   P   E   P   Q   W   L   O        HAZARDS                       RESISTANT
   B   E    F       I   Q   A   R   T   C    W   A   Z   S   N   S   I   L   S   U   R        INFECTIONS                    SAFETY
   V   L    O       C   A   T   I   O   N    E   P   A   O   V   B   I   U   D   M   V        INSURANCE                     SLIPPING
   V   F    Y       L   D   N   G   R   C    D   I   S   P   L   A   Y   L   I   S   A        LIABILITY                     STAFF
   R   I    W       K   G   F   Y   L   E    V   E   D   G   B   J   Y   X   K   Q   W        LIGHTING                      SUPERBUGS
   F   I    R       H   M   B   U   T   L    T   Q   V   I   L   A   W   E   N   E   R        LOCATION                      TRIPPING
   F   O    O       L   J   T   K   O   E    G   C   L   E   F   A   S   N   U   U   V        MULTIPLY                      UNSAFE
   O   U    Y       G   T   W   J   A   W    F   I   A   L   J   W   F   J   A   U   V
                                                                                         Answers	to	Test	Your	Knowledge	Quiz	from	Page	1
   S   U    P       E   R   B   U   G   S    T   A   L   B   G   F   L   D   T   B   B
   Z   L    R       Q   P   U   C   S   Y    P   N   S   F   V   F   C   E   V   P   U   1.     False
   R   W    I       N   G   G   C   O   G    Z   X   P   B   D   E   W   G   V   J   P   2.     b.
   M   H    R       R   G   D   D   U   Z    Y   R   J   Q   D   Z   E   D   Z   Y   D   3.     b.
                                                                                         4.     False
                                                                                         5.     True

CCAP Loss Control Services
P.O. Box 60769
Harrisburg, PA 17106-0769

Newsletter Contact - Gary Nicholson, CHSP
Phone: (800) 895-9039
Fax: (717) 526-1020
Email: gnicholson@pacounties.org

Fax: 717-526-1020
Email: gnicholson@pacounties.org

                                            Pennsylvania	Liability	Insurance	for	County	Affiliated	Nursing	Homes

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