For the Small Home Where Real Care Happens.
Protecting operators, residents, and residential care homes
Running a small assisted living home means providing far more than housing. Whether yours is called a board-and-care home, a residential care home, an adult family home, a personal care home, or an RCFE, the model is the same: a converted house where a handful of residents — often frail, elderly, or living with early dementia — receive hands-on help with daily living, from bathing and dressing to medication management and meals. That care is a business and a healthcare-adjacent operation, not a rental. The building is almost incidental; your responsibility for vulnerable people is the risk, and it belongs on a commercial residential-care program, not a personal or landlord policy.
Done right, coverage protects your residents, your staff, and your own home and personal assets.
Why a Homeowner or Landlord Policy Fails Here
Because the care happens inside a house, many small operators insure it on a homeowner or landlord dwelling policy (DP-3). It is the most dangerous decision in the business. A homeowner policy insures owner-occupancy; a landlord policy insures a passive rental. Neither contemplates a commercial care operation with staff and dependent residents, and both contain business-pursuits exclusions that bar liability arising out of a business.
If a carrier later discovers an undisclosed care business, it can rescind the policy from inception and deny the claim for material misrepresentation of occupancy — and that applies to any claim, even a kitchen fire, because the policy itself was procured on a false statement of use. Beyond that, a personal or landlord form covers only premises liability — someone tripping on your walkway — never professional care liability: a medication error, an improper transfer, a failure to supervise, neglect. That professional exposure is your largest, and it is entirely absent. Abuse and molestation, one of the most severe exposures in caring for cognitively impaired elders, is excluded as well. When a resident falls and the family sues, you tender the claim, the carrier finds an unreported care business, denies and rescinds — and you defend and pay out of pocket, with the home itself exposed.
Key Risks in Residential Assisted Living
Your home faces exposure related to:
- Resident falls — the number-one exposure, from transfers, wandering, or wet floors
- Medication errors — wrong drug, wrong dose, or a missed dose
- Elopement and wandering by residents with dementia
- Abuse or neglect allegations against staff, or between residents
- Failure to provide adequate care — pressure ulcers, dehydration, untreated conditions
- Slips and falls of visitors, and food-borne illness from the kitchen
- Staff injury from lifting and transfers, and from bodily-fluid exposure
- Wrongful death arising from any of the above
Because the residents are vulnerable and sympathetic, these claims tend to be both frequent and severe.
Core Coverages for Assisted Living Homes
A properly built program typically includes:
Commercial General Liability — Covers slips, trips, visitor injuries, and premises hazards, plus legal defense.
Professional / Caregiver Liability — Protects against claims of negligent care, medication errors, failure to supervise, or neglect — the crux of assisted living coverage and the exposure most often missing on the wrong policy.
Abuse & Molestation Liability — Responds to abuse allegations against staff or between residents, including defense of false claims, and should be carried at full limits rather than the low sublimit standard general liability allows.
Commercial Property (Habitational) — Covers the building and fixtures on a commercial care basis against fire, water, theft, and similar losses.
Business Personal Property — Covers contents, furnishings, kitchen equipment, and mobility and medical equipment.
Workers' Compensation — Provides legally required coverage for caregivers and staff, who face frequent lifting and fluid-exposure injuries.
Commercial & Hired / Non-Owned Auto — Covers resident transport in a facility vehicle, and staff using their own cars for the home's errands.
Employment Practices Liability — Protects against staff claims of wrongful termination, harassment, or discrimination.
Umbrella / Excess Liability — Adds limits above the underlying policies for catastrophic falls and wrongful-death severity, and is often required by contracts.
What's Commonly Overlooked
Residential care programs are most often weakened by:
- No professional or caregiver liability — the operation's largest exposure, left uncovered
- Abuse and molestation carried at a low sublimit instead of full limits
- No hired-and-non-owned auto for resident transportation
- Workers' compensation missing or misclassified for caregiving staff
- Umbrella limits below what state law, Medicaid contracts, or landlords require
Some states also mandate specific coverage — California, for example, requires licensed residential care facilities for the elderly to carry at least $1 million per occurrence and $3 million aggregate in liability (AB 1523, effective July 1, 2015), and other states set their own minimums or bonding rules — so the right limits are often a licensing question, not just a coverage choice. The gap that hurts most is a homeowner or landlord policy written without disclosing the care business: the carrier can rescind it from inception after a resident's fall, leaving you with no defense and your own house exposed.
Real-World Claim Examples
- A resident falls during a transfer and fractures a hip, and the landlord policy denies it because no professional or caregiver liability was in place for the care the home actually provides
- A caregiver is accused of abuse, and the claim is paid only at a low sublimit if abuse and molestation was carried below the main liability limit, leaving the operator to fund the balance
- A staff member drives a resident to an appointment and crashes, and once the staff member's personal auto limits run out, the claim against the home is covered only if hired and non-owned auto was added
- A caregiver treated as an independent contractor is hurt lifting a resident and the state deems her an employee, so the claim falls on the operator directly when no workers' comp policy was carried
- A state licensing rule requires $1 million per occurrence and $3 million aggregate, and the operator learns the umbrella was never placed when the license renewal exposes the shortfall
Any one of these, on the wrong policy, can fall entirely on the operator.
Why Proper Placement Matters
Small residential care is a specialty, often excess-and-surplus (E&S) healthcare-habitational risk, and — because the homes are small — one that not every carrier will write. Placement depends on the number of beds, resident acuity, whether residents are ambulatory, staffing ratios and caregiver training, building ownership, the services offered, and loss history. Licensing adds another layer: every state regulates these homes under its own name and rules, several mandate minimum liability limits, and Medicaid waiver contracts impose their own insurance and hold-harmless terms. Getting the classification, the limits, and the market right is what keeps the coverage valid and the license in good standing. (For large, purpose-built operations, see our assisted living facility insurance and nursing home insurance pages.)
Our Approach
At Cory Washington & Co., we insure small assisted living and board-and-care homes as the care operations they are. We classify the occupancy correctly, build professional and caregiver liability and full-limit abuse coverage around the property and general liability, add workers' compensation, auto, and umbrella, and set limits that satisfy your state's licensing and any Medicaid or landlord requirements. We also insure related residences, including independent living homes, memory care facilities, continuing care retirement communities, and group homes.
A home entrusted with someone's parent deserves coverage built for that responsibility — not a policy that was never meant for care.
All insurance descriptions on this website are provided by Cory Washington & Co. LLC strictly for general informational purposes. They are not intended to be, and should not be relied upon as, legal, financial, or insurance advice. The information presented is general in nature and does not guarantee the availability, terms, conditions, or scope of any insurance coverage. Actual coverage is determined solely by the specific policy language issued by the insurer and remains subject to underwriting approval. Nothing on this website creates or implies an agent-client relationship, binds coverage, or alters any existing policy. Cory Washington & Co. LLC expressly disclaims any liability for actions taken, or not taken, based on the content provided here. For advice regarding your particular situation, please consult directly with a licensed insurance professional at Cory Washington & Co. LLC or another qualified insurance professional, and always review your policy documents in full.
See the coverages an assisted living home business may carry — core, prevalent, and situational — plus the gap most often missed, in the Assisted Living Home Coverage Checklist.
Complete the Assisted Living Home Supplemental online in a few guided steps, download the fillable PDF, or browse all applications.
Frequently Asked Questions
What insurance does an assisted living home need?
Commercial General Liability, Professional / Caregiver Liability, and Abuse & Molestation Liability form the core of most assisted living home programs. Depending on the operation, Commercial Property (Habitational), Business Personal Property, and Workers' Compensation round out the program.
What insurance gaps are most often overlooked for an assisted living home?
Two gaps come up again and again: no professional or caregiver liability — the operation's largest exposure, left uncovered; and abuse and molestation carried at a low sublimit instead of full limits. Some states also mandate specific coverage — California, for example, requires licensed residential care facilities for the elderly to carry at least $1 million per occurrence and $3 million aggregate in liability (AB 1523, effective July 1, 2015), and other states set their own minimums or bonding rules — so the right limits are often a licensing question, not just a coverage choice.
What do underwriters look at when insuring an assisted living home?
Underwriters focus on small residential care is a specialty, often excess-and-surplus (E&S) healthcare-habitational risk, and — because the homes are small — one that not every carrier will write. Placement depends on the number of beds, resident acuity, whether residents are ambulatory, staffing ratios and caregiver training, building ownership, the services offered, and loss history.
What are common insurance claims for an assisted living home?
Common examples: A resident falls during a transfer and fractures a hip, and the landlord policy denies it because no professional or caregiver liability was in place for the care the home actually provides. A caregiver is accused of abuse, and the claim is paid only at a low sublimit if abuse and molestation was carried below the main liability limit, leaving the operator to fund the balance. A staff member drives a resident to an appointment and crashes, and once the staff member's personal auto limits run out, the claim against the home is covered only if hired and non-owned auto was added.
What if another agency has already declined or non-renewed my coverage?
Difficult, specialty, and previously declined placements are a core part of our work. We access excess & surplus (E&S) and specialty markets that many generalist agencies cannot, and we explain the trade-offs clearly so you can decide with confidence.
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