Emily Windle

Long-term care facilities face a unique challenge right now. Elderly residents are high risk, yet employees interact with and care for them at all times. In a highly populated community, the risk of an outbreak among employees and residents is great.

The No. 1 one priority is to keep residents safe while simultaneously keeping employees safe. As states start to loosen restrictions and businesses begin to reopen, there is a greater risk that employees will be exposed to COVID-19 outside of the workplace and unknowingly spread the virus to colleagues and the residents they care for.

Putting the right controls and procedures in place to facilitate a safe work environment can significantly reduce the spread of the virus within a long-term care facility and protect the organization when it comes to COVID-19-related workers’ compensation claims. Here are some things to consider.

Wellness checks

To help reduce the risk of an outbreak and protect long-term care residents, conduct routine employee wellness checks. Testing may include taking employees’ temperatures as they come to work each day. Daily checks will require additional work from staff who are already stretched thin, but they can quickly identify those who are exhibiting symptoms, mitigating the potential spread of the virus and reducing the likelihood of a workers’ compensation claim. Some states have mandated periodic testing of onsite employees for long-term care and retirement communities, so be sure to check your local regulations.


Some long-term care communities might consider asking their employees to sign waivers to return or continue working. While waivers may seem safe in theory, you cannot waive an employee’s right to workers’ compensation benefits or a safe workplace. Instead, you may consider creating an acknowledgment or adding language to your employee handbook to create a social contract between you and your employees. This will make it clear that you will follow CDC guidelines and take other necessary precautions to prevent the spread of the virus at your facility. In exchange, your employees will acknowledge that they will do their best to comply with social distancing, wearing masks and staying home if they experience symptoms.


Keeping your employees safe and comfortable while also maintaining proper staffing levels can be a balancing act for a long-term care facility. Mandating quarantine for employees who were in contact with a COVID-19-positive employee or resident can stop a widespread outbreak but can leave you shorthanded. Continuing care communities need to maintain certain staffing levels to comply with state minimum requirements. Hiring temporary staff can help bridge the gap while permanent employees are on quarantine or home sick.

Keep an eye out for potential employee retention issues due to COVID-19. Some employees may be fearful of returning to work after quarantining or recovering from the virus. Other employees may want to take advantage of paid leave or other benefits. Implementing the steps mentioned above will help your employees feel confident they will be safe when returning to work.

Contact tracing

When thinking about claims that may follow positive COVID-19 cases, it’s important to determine whether your employees contracted the virus from work or an outside exposure. Putting a standardized procedure in place to find out if an employee may have contracted the virus at work or elsewhere will ensure you have the proper documentation if it leads to a workers’ compensation claim. The procedure will also help you identify which colleagues and at-risk residents the employee interacted with during the virus incubation period so they can take the proper precautions.

Workers’ compensation legislation and regulations

State workers’ compensation regulations and legislation surrounding COVID-19 have been changing rapidly over the past few months. Communicable diseases like the flu have historically not been covered under workers’ compensation. Coronavirus falls within this category; however, many states have proposed and/or passed legislation that presumes certain categories of workers who test positive for COVID-19 contracted the virus at work. In many states, this can easily be overturned if the employer can provide proof of reasonable doubt. This is where proper documentation comes in handy.

Keep up to date with the status of your state’s legislation impacting the workers’ compensation benefits available to your employees and whether it is appropriate to report a claim to your insurer. You can find up-to-date information by state on the National Council of Compensation Insurance (NCCI) website

Impact on workers’ compensation rates

Long-term care and other industries directly impacted by COVID-19 may see an increase in workers’ compensation rates. Because communicable diseases, like the coronavirus, have historically not been covered by workers’ compensation, insurers did not charge the appropriate premium to pay such losses. But the number of COVID-19-related claims will no doubt rise as legislation continues to expand to allow coverage for the virus.

If you have any concerns about risk management or workers’ compensation claims for your long-term care facility, your broker can walk you through your options when it comes to coverage and give advice on mitigating any potential losses.

Emily Windle is a senior analyst at Altus Corporate Risk in Radnor, Pennsylvania. She manages insurance and risk management programs for national and international clients.