​A wheelchair-bound resident was riding the shuttle to a doctor’s appointment when the van got in a fender-bender at an intersection. The wheelchair’s locking mechanism failed, the chair tipped over, and the resident sustained injuries—despite it being a relatively minor collision.

As this unfortunate incident and others along the spectrum of severity illustrates, transportation is an evolving risk for senior living facility operators, staff, and residents.

Senior living organizations typically have small fleets that travel short distances. Yet owners and operators underestimate transportation risks when staff take quick trips with vehicles they’re often unaccustomed to driving. In reality, 75 percent of accidents involving trauma center transport occur within 10 miles of a patient’s place of residence. Senior drivers and passengers are at increased risk for injury during an automobile accident compared to other demographics. It takes just one collision to have a serious problem.

Senior living communities face a trifecta of challenges that can impact their ability to safely transport residents to and from appointments, recreational events, and errands.

• Large passenger vehicles are awkward to operate.

Most senior living vehicles are large vans or small buses designed to transport several residents, which means there is multiple injury potential in the event of an accident. These types of vehicles lack the same level of drivability and visibility as cars and leave more room for operational error. For example, they have longer stopping distances and respond differently when a driver swerves.

• Aging residents have limited mobility.

Seniors don’t move as quickly or nimbly as they once did, and their wheelchairs, walkers, and other equipment can malfunction or contribute to damage or injury during transport. Additionally, residents with impaired mobility or disabilities may stumble, lose their balance, or trip when entering or exiting the vehicle.

• Staff shortages put less-qualified drivers on the road.  

Staffing shortages leave service providers shorthanded and stretched thin, and high turnover means less-experienced teams. Drivers may be seniors themselves, working as volunteers or for a retirement job. Or drivers may primarily be on the janitorial or kitchen staff with additional roles that include driving residents to appointments. When staff wear multiple hats in an organization, they’re likely to be undertrained on the unique transportation risks for senior residents and the importance of safe driving habits.

6 Safe Driving Habits for Senior Living Facilities 

Follow these best practices to manage resident transportation risk.

1.    Establish a driver safety program.

Address speeding, tailgating, distracted, and other poor driving behaviors in your program. Define policies, procedures, and accountability measures for those responsible for transporting patients.

Keep in mind: Organizations face greater litigation risk if they have a safety program and don’t hold all employees accountable. Conduct regular reviews to ensure the program is consistently enforced across the organization.

2.    Hire drivers with safe records.

Include a thorough review of each driver’s motor vehicle record (MVR) in driver hiring practices. Decide which qualifications all drivers are required to meet and identify disqualification criteria for DUIs, speeding, accidents, and other moving violations. Review MVRs for any employee you’re asking to drive.

3.    Engage in distracted driving prevention.

Distracted driving the past five years has caused an average of 9 deaths a day in the U.S., and distractions can be particularly high for senior living community drivers. Residents like to talk with drivers during their ride, or the driver may not know exactly where they’re going—common scenarios that detract from a driver’s focus on the road.

Coach drivers on how to maintain focus when transporting residents. Have them plan their route before driving and reduce and eliminate other distractions by requiring employees to keep devices out of reach while driving and use hands-free technology responsibly.

4.    Utilize telematics to guide corrective action.

Telematics like dashcams or vehicle tracking systems are a great start, but the device itself is just the beginning of the solution. Successful telematics implementation lies in knowing how to leverage the data it provides. Engage a risk management team to assist with the proper use and interpretation of telematics data to inform corrective interventions and coaching techniques tailored for each driver.

If affordability is a concern, there are several cost-effective smartphone applications that utilize a phone’s GPS and other sensors to track driver behavior.

5.    Conduct ride-alongs and patient-transportation safety training.

Have an independent safety professional conduct ride-alongs to assess driver proficiency during onboarding and at least once per year after that. Provide quarterly driver safety training through e-learnings on topics like defensive driving.

6.    Perform regular vehicle maintenance.
Require staff to conduct pre- and post-trip inspections on items such as mirrors, tires, and seats. Regularly inspect company vehicles to ensure tires, brakes, and lights are in optimal condition, and conduct quarterly reviews of any personally owned staff vehicles used for work purposes. 

Risk Prevention Reduces Costs and Increases Safety

Senior living owners and operators have a lot on their plate, which can result in a lack of attention paid to transportation risk prevention. In a recent survey of business leaders, just 41 percent said they require employees to attend mandatory safety training before using a company vehicle. But, commercial auto premiums rose nearly 7 percent in the first quarter of 2025 due to factors like heightened repair costs, nuclear verdicts, inflation, and distracted driving—all of which are expected to drive further rate increases. This makes risk prevention even more critical.

Work with your commercial auto insurance company to engage transportation risk management services. Senior living organizations go the extra mile to serve the unique health and care needs of their communities, and those that channel this protective spirit to address transportation challenges as well will go far in helping keep residents and employees safe while also reducing claims and liabilities—both factors in maintaining long-term financial stability.

Jeff Cole is assistant vice president of national accounts for Sentry Insurance. Sentry insures more than 28,000 businesses throughout the U.S., including those in the health care sector.