How Accreditation Supports Mergers and Acquisitions

Since 2018, there has been significant merger and acquisition activity in the behavioral healthcare field, but why? Individuals are becoming more aware of healthcare issues; there is less stigma about seeking help for mental health struggles; and more effective treatments are now available. This has created increased demand for and use of mental health and addiction treatment services, as well as channeling more funding towards meeting the demand and growing need. Not only this, but as individuals, including professionals, gain understanding of the link between mental and physical wellbeing, more integration of physical and behavioral health care is occurring. So, where does accreditation come in?

There are a number of accrediting bodies that work to ensure providers of substance use disorder treatment and mental health services meet specific, nationally accepted standards, including The Joint Commission, CARF International, Council on Accreditation (a service of Social Current) and others.

Accreditation requirements (standards of safety and quality of care) center around three main areas: documentation, facilities, and people. Documentation standards focus on written plans; polices and procedures; clinical records; and personnel files. For people, standards address not only the care of the persons served, but also those that provide it. Facility standards ensure that the physical environment where care is being provided is safe, healthy, and therapeutic for everyone within. All these standards create stability within an organization, which is a favorable factor in M&A activity.

Achieving accreditation also gives a behavioral health organization a framework for growth and management of their internal resources. It helps to standardize clinical processes and documentation and provides an external validation of the quality of services provided. Accredited organizations will often see increased efficiencies from improved practice consistency, tightened administrative practices, and an increased emphasis on risk management. Because of accreditation requirements, organizations will inevitably have a broader view and a more detailed approach to risk mitigation and risk management than they’re doing on their own.

For an investor looking to acquire a service provider, seeing that a facility is accredited can provide peace of mind. Accreditation indicates that an organization has gone through the work to create a strategic plan, comply with legal and regulatory requirements, and has implemented quality monitoring practices. All of which assist with due diligence, both on the administrative and clinical sides. Investors can also be assured that the facility’s finances are well managed, as accreditation speaks to sound financial management practices. There are even a number of reports that say accreditation reduces staff turnover, which can save an organization money and maintain a high-quality workforce.

Another part of due diligence is examination of litigation and claims history of an organization. Have there been any lawsuits filed or any pending? What is the frequency and severity of claims? Are there identifiable patterns and trends? What steps were taken to reduce the chance of reoccurrence? Accreditation supports this type of investigation by helping to maintain a positive history by proactive identification of risk and finding ways to mitigate or eliminate it where possible. Secondly, it encourages a performance improvement process that requires collection and analysis of key data and then taking action for improvement. Additionally, accreditation promotes a safe and healthy physical environment with requirements for emergency and disaster planning.

If your organization is going through a merger or considering accreditation, you are not alone! Accreditation Guru operates nationwide and provides a number of services to guide you through the process, such as:

  • Individual accreditation consultation
  • Mock surveys
  • Development of accreditation-compliant plans and policies
  • Risk assessment
  • Strategic planning facilitation
  • And more…

If you would like to have a conversation, please feel free to contact us via our website or schedule a free Zoom consultation with one of our experts.

For more information or questions about the contents of this article, please write Peggy Lavin @ peggy@accreditationguru.com.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Accreditation – A Bedrock of Risk Management

When insurance companies are considering coverage for an organization, they are generally looking for those that can demonstrate high performance in risk prevention, safety, quality, outcomes, and qualified and competent staff. Accreditation standards often drive good practices in these same areas, particularly with risk management and performance improvement. Thus, the accreditation status of an organization can be indicative of the frequency and severity of costly claims.

Dan Rains, CSP, ARM, Risk Control Manager for Berkley Human Services, offers insight, “Accreditation speaks volumes about the quality of an organization. It demonstrates commitment to a continuous improvement culture with data-driven quality assurance processes and visionary leadership. These are all things that are important from an underwriting perspective which can have long term impact on losses and total cost of risk.”

Sean Conaboy, MSW, MPA, Insurance advisor with NSM Insurance Brokers, Behavioral Healthcare/Human Services Practice provides additional insight. “Insurance companies are interested in how an organization mitigates its risks, and one sound mitigation strategy is national accreditation. That’s why the first questions on an insurance application are regarding both licensure and type of accreditation.”

Accreditation as a Risk Reduction Strategy

By shifting an organization from a reactive stance after an adverse event to an ongoing proactive risk management approach, accreditation can become the bedrock for effective risk control and mitigation. The standards and survey process of accreditation guides an organization in a process of identifying and assessing actual and potential risks as well as implementing activities to prevent occurrence and to reduce severity should there be an occurrence.  Connaboy agrees, “When an applicant for insurance notes that they are accredited by a national accrediting body, the underwriter reviewing the application can assume that the organization has a strong infrastructure based on sound risk control activities and practices. At the end of the day, insurance companies want to know how well-run an organization is – and being accredited provides the framework for a well-run organization.”

Additionally, legal conformance and regulatory compliance are universal, risk-reducing requirements of all accrediting bodies. Accrediting organizations also encourage and assist organizations to go beyond what is regulated and strive for a higher level of quality and safety through a continuous improvement process that incorporates monitoring the effectiveness of risk reduction activities as well as outcomes achieved.

Risk Exposures and Controls

Risk exposures and controls are addressed in a variety of ways during the accreditation process, notably in standards and in areas addressed during the onsite survey. Below are some examples of the high-risk exposure areas and controls that may be used to mitigate the exposure.

Risk: Transporting Clients/Persons Served

Control Examples:

  • Criteria for authorizing drivers
  • Use of vehicle telematics
  • Appropriate safety restraints and adequate passenger supervision

Risk: Abuse/Molestation

Control Examples:

  • Zero-tolerance policies/Culture of safety
  • Criminal background and reference checks
  • Mandated reporting policy/procedures

Risk: Cyber Attack

Control Examples:

  • Initial and periodic staff training on cybersecurity
  • Policies and procedures addressing staff use of computers and passwords (remote access)
  • Software protection of information
  • Updating computers and backup/recovery procedures

Risk: Lack of Qualified/Competent Staff

Control Examples:

  • Policies and procedures for verification of credentials
  • Oversight and supervision of staff
  • Staff training
  • Written job descriptions linking duties/responsibilities to qualifications/competencies

Effective risk controls also include emergency response preparedness. An accredited agency is usually required to have a written disaster plan including, if applicable, evacuation and relocation of staff and clients, as well as specific plans to meet the needs of individuals with disabilities and other special needs during emergencies. The organization must also address coordination with governmental authorities and emergency responders.

Accreditation and the Risk Management Model

The standard risk management model includes identification, analysis, evaluation, and mitigation of risk. Accreditation can help organizations to identify risks they perhaps have not thought about, such as requiring a possible potential disaster be used in an emergency management plan. Requirements to conduct a risk assessment help organizations analyze and evaluate risks to determine how severe or costly they might be and can help identify risk controls to mitigate the risk. Additionally, accreditation helps organizations to reduce or mitigate risk through standard compliance in key areas, such as safety standards, fire code compliance, IT data management, human resources policies, emergency planning, and more.

How Can Accreditation Guru Help?

Although reducing risks is common with accreditation, there are differences in the risk management/risk reduction requirements between the accrediting bodies. Please feel free to contact us to learn more about the differences in risk management standards across the national accrediting bodies.

In addition to helping organizations achieve their accreditation goals, Accreditation Guru’s consulting team is also available to assess your organization’s risk management/risk reduction processes. Our service includes a holistic, systemic assessment of your risk management process or an assessment of one or more specific critical risk exposures.

 

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

The Alliance’s New “Operations Support Services”

As a partner of the Alliance for Strong Families and Communities, Accreditation Guru is excited to share with you their new and game-changing “Operations Support Services” offering for the nonprofit sector. This offering is intended to help leaders address provision of operations support services related to human resources, finance, administrative operations, and more. This is available to ALL nonprofits in the United States, not just Alliance member organizations.

Across the country, daily tasks, ranging from detailed budget reports to regular donor stewardship, siphon limited energy and resources that could be better directed toward program implementation. Because dollars available for overhead functions are particularly scarce, nonprofits should look for smart ways to maximize these resources. For organizations that cannot cost-effectively sustain internal capacity and expertise in administrative functions, the gap will continually widen and plague their abilities to focus and execute on their missions.

The Alliance is dedicated to helping community-based organizations (CBOs) bolster their approach to risk management, improve the effectiveness of fund usage, and understand the benefit of shared services—all of which allow for an increased focus on mission and people served. The “Operations Support Services” offering was created to help fulfill the five identified “North Star” initiatives in the landmark report, “A National Imperative: Joining Forces to Strengthen Human Services in America,” by the Alliance for Strong Families and Communities and the American Public Human Services Association.

By partnering with the Alliance, CBOs can outsource various financial and administrative duties for which internal capacity and resources may be limited. As part of this new venture, the Alliance also is offering competitive and robust benefits packages, enhanced retirement planning services, and comprehensive EAP and work-life services to their employees at a reasonable cost, regardless of their size. In addition, the Alliance’s unemployment tax program combats hidden expenses, avoids claims volatility, and enables better management of cash flow and claim tracking.

The Alliance has established many strategic partnerships to facilitate provision of operations support services that can be customized for any size nonprofit:

  • Flexible accounting and bookkeeping assistance delivered directly by Alliance staff
  • Comprehensive, competitively priced group health insurance packages offered via industry
    leaders that cover thousands of companies and hundreds of thousands of lives
  • Employee assistance and work-life services from FEI Behavioral Health, the Alliance’s
    social enterprise
  • The ability to provide a wide range of retirement plans and planning services to employees,
    with the added value of no administrative fees
  • A cost-effective alternative to the state unemployment tax system
  • Access to group purchasing savings programs

“Along with our expertise in human resources, finance, and administrative operations, it is our intent to enhance and expand our support services to help leaders address needs related to fundraising and development; marketing, public relations, and communications; and information technology,” explains Lenore Schell, Alliance senior vice president of strategic business innovation.
For more information, visit the Alliance’s website.

Why Your Organization Needs Hired & Non-Owned Auto Insurance

Hired & non-owned auto insurance is a highly misunderstood coverage and as a result, often gets put at the bottom of the insurance coverage priority list. Hired and non-owned auto insurance provides coverage for bodily injury and property damage losses caused by vehicles you don’t own, vehicles you lease, hire, rent, and/or borrow, but are used for business operations.
For this discussion, we are going to focus on coverage for vehicles not owned by your organization but used for your operations. Typically, these vehicles are personally owned by employees and volunteers—in other words, non-owned auto.

Organizations that don’t own company vehicles, may automatically think they don’t need auto insurance. Nothing could be further from the truth! If you have employees or volunteers that drive their own vehicles on behalf of your organization, for any reason, then you can become responsible for auto claims. Situations, where your organization may be responsible for damages, can include (but is not limited to):

• Using their own vehicle to go to meetings
• Using their own vehicle to go to the bank, the post office, or other errands
• Using their own vehicle to provide the services offered by your organization

If there’s an accident in any of these circumstances, then your organization can be held responsible and sued for damages. Auto liability claims can have a significant impact on your bottom line. Hired and non-owned auto liability coverage can help absorb potential financial losses and protect your business.

What is Hired & Non-Owned Auto Insurance?

Hired & Non-Owned Auto Liability Coverage is for vehicles owned by employees or volunteers and covers injuries to other people and damage to other people’s property. This is coverage in addition to the coverage an employee or volunteer may already have on their vehicle. It does not cover damage to the vehicles owned by your employees or volunteers, only liability.

In the event your organization is in any way responsible for an accident, a driver’s own auto insurance will be responsible for any claims. However, if the claims are more than the liability coverage limits that the individual has on their personal auto policy, then your non-owned auto insurance could kick in to pay the remainder of the claim. In other words, the employee or volunteer auto insurance triggers first.

Example

The Executive Director of an organization was driving to the bank in their own vehicle to drop off some paperwork for a business loan. She was in a hurry and sped through a yellow light. A car turned in front of her and she hit the driver’s side of the oncoming vehicle. This collision resulted in considerable damage to both vehicles and severe injuries to the other driver.

The injured driver sued the Executive Director and the organization for the damage to his vehicle and his injuries. Because the Executive Director was driving for business, the organization would be responsible for the damages caused by the accident. The total claim was $450,000 including the associated legal fees.

The payments were as follows:

• The Executive Director’s personal auto policy paid up to her limit of $300,000
• The organizations non-owned auto policy paid the remaining $150,000
• The annual premium cost of the non-owned auto Insurance was $350

Auto claims are by far the most frequent type of claim we see, and auto claims involving injury can be quite large. All organizations have some type of driving associated with their mission and general operations. If an organization is deemed in any way responsible for an auto accident, even a small claim can quickly eat up the organization’s reserves and as we’ve seen, a small expenditure for the coverage more than compensates for the potential risks.

Make sure that you include non-owned auto insurance as part of your organization’s risk management arsenal.

~TJ Armstrong, Business Development Manager, Hawley & Associates, LLC