Worker Comp Claims at Gracedale Under Scrutiny

On her first day at Gracedale, one 28-year old employee filed a claim for worker's compensation. So did another, age 22. Both claims were paid, too. In a presentation to Northampton County Council's Personnel Committee on February 15, PMA Management's Scott Bogdan reports an excessive number of claims by new hires at the County's nursing home.

Between 8/1/10 (when PMA started as the County's claims administrator) and 12/1/11, nineteen claims were filed by Gracedale workers, mostly nurses' aides, who had only been employed there for only 90 days or less. Cost to the County? $28,177.

Countywide, only one other new hire reported an injury during the same time period.

"It just seems ridiculous," complained Personnel Committee Chair Ken Kraft. "It just seems like there's a trend, and we should get to the bottom of it."

PMA's Chris Rothwell, a risk control consultant, answered that this is a "low hanging fruit." There will be a "thorough investigation," starting next week, to make sure "these claims are legitimate." PMA will also initiate preventative programs and "change the culture" there.

In addition to an abnormally high number of workers comp claims being filed by new hires, Gracedale also has the highest total - 480 between 8/1/10 and 12/1/11. Countywide, this dwarfs the rest of the County, where only 170 claims were filed, including 94 at the jail.

This high number of claims overall is consistent with PMA's experience at other nursing homes, Manager Bogdan told Council. But still, the amount of money being spent for worker's comp at Gracedale, is disproportionately high. On a cost to payroll basis, it's 35 per cent higher than other nursing homes in PMA's entire portfolio.

Kraft suggested incentives for employees who can keep the workplace injury free, mentioning that the workers he represents are sometimes rewarded with a truck for worker safety at construction sites.

"But I'm not saying we should give a truck away," Kraft cautioned.

"We have a few old deputy sheriff cars," joked Executive John Stoffa.

Gracedale also accounts for $2 million of the $3.1 million spent on worker's comp claims between 8/1/10 and 12/1/11.

Aside from the disappointing news from Gracedale, Bogdan told Council that PMA has saved the County $1.78 million since 8/1/10, when it became the County's claim administrator. Open claims have also gone down from 102 to 58. Assistant Solicitor Curtis Creveling, who handles the worker's comp claims for the County, stated this is primarily a result of settling clear claims instead of engaging in expensive and lengthy litigation.

The top reasons for a workers comp claim from a County worker, in descending order, are: lower back, knee, shoulder(s), multiple body parts, and hands. Treating shoulders costs the County the most money, an average of $6,781 per claim.

Norco Workers Comp Claims Rise $1.1 Million

If you work in the mines or on a firetruck or setting up firing ranges, you'll see lots of workers comp claims. That's to be expected. But in a county workforce? A whopping thirty per cent of Northampton County's staffers have filed claims within the last year. That's three times the 10-12% average among county workers. It certainly explains why workers compensation costs have skyrocketed from $1.8 to $2.9 million over the last two years. Because the County has been self-insured since 1986, that's money out of your pocket.

This is unacceptable, according to PMA's Scott Bogdan. Yesterday, the Finance Committee recommended replacing Alliant, the current third party administrator of the County's self-insured workers compensation program, with PMA.

Under Alliant, the County was continuing to pay benefits after cases were over or abandoned, leading to high costs. PMA is the low bidder of four administrators requested to submit proposals.

County Council will decide whether to approve PMA tonight.