In senior living and healthcare, most leaders don’t set out to “have a communication problem.” They set out to deliver safe, high-quality care often under real constraints: staffing pressure, rising acuity, regulatory scrutiny, and families who (understandably) want clear information and reassurance.
And yet, when we look closely at how claims form and why they escalate, the story frequently isn’t “a single clinical mistake.” The story is “information didn’t move,” “expectations weren’t aligned,” “concerns weren’t heard early,” “the handoff didn’t land,” or “the documentation couldn’t tell the story.”
Clinical care matters, of course. But communication is the force multiplier. It shapes trust, teamwork, documentation, and defensibility especially when something goes wrong.
Communication is a claims driver hiding in plain sight.
Large-scale malpractice data has consistently shown that communication breakdowns are a major contributor to claims and claim severity. In an analysis often cited by CRICO/Candello and the Risk Management Foundation, communication problems were implicated in roughly 30% of malpractice claims reviewed over a multi-year period, with meaningful human and financial impact. (Harvard RMF)
RMF’s more recent coverage continues to reinforce the same theme: communication failures remain a high-cost, high-consequence risk driver across care settings. (Harvard RMF)
That’s the “macro” view. Now here’s what matters for senior living operators, insurers, and risk leaders:
Even when a clinical event is unavoidable or appropriately managed, communication determines whether that event becomes a grievance, an allegation, or a claim and how hard it is to defend.
Why senior living feels this risk more intensely:
Senior living lives at the intersection of healthcare, hospitality, and increasingly, technology. That’s why communication failures land differently here. Residents are living in community. Families are partners (and advocates). Teams are multidisciplinary and often stretched. And care involves continuous micro-handoffs: shift to shift, agency staff to core staff, nursing to leadership, leadership to families, and community to outside providers.
Claims studies in the senior care space increasingly reflect this reality.
MedPro Group’s senior care claims data analysis identifies communication as a recurring contributing factor in cases with indemnity paid specifically including suboptimal communication among providers/staff around changes in resident condition, and noting that suboptimal communication with residents/families appears at a similar share of case volume.
CNA’s Aging Services Professional Liability Claim Report similarly points out that “improper care” allegations can include failures to notify a provider of a change in condition, communication failures between care providers, and delays in treatment, exactly the kinds of breakdowns that start as “process gaps” and end as “legal allegations.”
And when you layer on the larger litigation environment where claims severity and pressure continue to rise, communication becomes one of the most practical, controllable levers an organization can improve. For example, Liberty Mutual/Ironshore’s Senior Care Claims Study reports increasing severity trends and highlights the volume and high-exposure nature of senior care claims.
The communication failures that most often turn events into claims:
When we say “communication failure,” we’re not talking about one thing. In our work with healthcare and senior living organizations, the communication patterns that most often create downstream exposure tend to cluster in a few predictable places.
When information doesn’t move with the resident:
Transitions of care are a known high-risk zone not only clinically, but operationally and legally. Research looking specifically at hospital-to-skilled nursing facility transitions describes poor quality discharge communication as a major barrier, creating delays, inefficiencies, dissatisfaction, and increased risk of adverse outcomes. (PMC)
In the senior living context, “transitions” also include internal transitions: moving units, changes in level of care, new providers, new diagnoses, new medications, and changes in cognition or function. If your systems don’t reliably move information, risk gets created quietly then shows up loudly later.
When families are surprised:
Families don’t usually escalate because they learned “hard news.” They escalate because they learned it late, inconsistently, or from the wrong person and it didn’t match what they believed was happening.
This is where expectations management becomes a true risk strategy. When families understand the resident’s baseline, foreseeable risks, and the community’s plan for communication, they’re far more likely to experience the organization as transparent and responsive even in difficult moments.
When documentation can’t tell the story:
In both healthcare and senior living claims, documentation is communication. It’s also the record that decision-makers, surveyors, and (when it comes to it) juries rely on to understand what happened, when, and why.
MedPro’s analysis also highlights documentation issues as a recurring factor and notes how insufficient documentation can make later malpractice defense more difficult and can contribute to breakdowns in the chain of communication among team members.
When escalation isn’t easy for the frontline:
Many organizations believe they have an “escalation process.” What they often have is a policy.
A usable escalation process is different: it’s practiced, reinforced, psychologically safe, and designed for real-world conditions (weekends, nights, short staffing, and mixed-experience teams). CNA’s report even points toward structured tools like SBAR as a practical way to create shared expectations for urgent communication.
What proactive leaders are doing in 2026:
If communication is truly a risk driver, the goal isn’t to “tell people to communicate better.” The goal is to build a communication infrastructure that makes the right communication easier, earlier, and more consistent.
Here are the shifts we see working (and sustaining) over time.
They operationalize expectations management at the front end.
The strongest organizations treat move-in and onboarding as the beginning of risk mitigation. They define how updates will work, who communicates what, how concerns are raised, and how decisions will be documented. They don’t wait for conflict to “teach” families the system.
They standardize change-in-condition communication and handoffs.
In a claim file, “we assumed someone else knew” is almost always expensive.
Organizations that reduce exposure build reliable routines: structured shift report, consistent documentation habits, a clear call chain, and a shared language for what “urgent” means across nursing, operations, leadership, and outside providers.
They build early response and CRP readiness.
When something goes wrong, speed matters—but so does tone, consistency, and follow-through.
Communication-and-resolution programs (CRPs) and similar early response frameworks have been studied in hospital settings and have shown positive or neutral liability effects (including trends in claims and costs) when implemented thoughtfully. (PSNet)
While senior living is a distinct environment, the underlying lesson carries: early investigation, timely communication, and a coordinated resolution pathway reduce escalation, protect trust, and support better organizational learning.
How Adelman Firm helps:
At Adelman Firm, we work with healthcare and senior living leaders to strengthen communication where it actually happens: across teams, across shifts, across levels of care, and across the resident–family–staff ecosystem.
That includes evaluating real-world communication workflows (not just policies), strengthening documentation as a defensibility tool, and providing practical education and training that supports enterprise risk management, early response readiness, and communication-and-resolution strategy.
Through the use of expectations management programs and documentation, negotiated risk agreements, and the CRP Senior Living Blueprint, we can create actionable plans to improve communications, empower staff, engage families and reduce risk.
If your organization is looking at 2026 and thinking, “We need to reduce escalation, strengthen trust, and move down the risk spectrum,” we’d welcome the conversation.