Top Insurance Claims Assisted Living Facilities Face

Assisted living facilities provide sensitive services, which subjects them to scrutiny from many directions, residents and their families, employees, and regulators. Because so many daily activities carry real risk to residents and staff, facilities need strategic insurance planning matched to their specific operations.

This guide covers the top types of claims operators face and the insurance strategies to prepare for them, giving owners and managers a roadmap to prevent risks where possible and respond effectively when incidents occur.

1. Injuries caused by facility operations

National studies indicate that 22 percent of residential care community members experienced a fall in the previous year, and 19 percent of those who fell were hospitalized for their injuries.

Common evidence of neglect, including bedsores, unexplained bruises, and infections, can fuel an injury or neglect lawsuit that exposes a facility's hiring, staffing, and safety practices to scrutiny. Related claims of medication errors or mismanagement are also common.

How to prepare: frequent safety updates with employees support accountability and transparency, including an up-to-date electronic database of safety and medication records, safe dispensing practices, and performance audits of employee safety. General liability covers damages and legal fees from injury lawsuits, and professional liability responds to care-related claims. Limits should be personalized to projected needs based on claims history, staff experience, and resident health trends.

2. Claims of resident abuse

Beyond accidental injury and malpractice claims, allegations of abuse, up to and including wrongful death lawsuits, are all too common. Abuse claims are not limited to physical or emotional harm; they can also include financial abuse, such as the misuse of a resident's credit cards, failure to address abuse by another resident, or neglect rising to the level of malicious intent. These can produce legal and settlement costs that overwhelm a facility without the right protection.

How to prepare: residents and families must trust that the facility acts in their best interest, and even an unfounded claim can cause reputational damage and legal expense. A combination of general liability, professional liability, and dedicated abuse and molestation coverage protects against the cost of abuse settlements. Abuse and molestation is usually excluded or sublimited on standard policies, so it warrants a dedicated limit. See our deeper guide to abuse and molestation coverage.

3. Workers compensation claims

Assisted living facilities handle far more workers compensation cases than the average industry. According to the Bureau of Labor Statistics, the 2023 rate of nonfatal work injuries was 2.4 per 100 workers across all industries, but 6.4 per 100 workers for care facilities.

That gap is driven by the physical demands of lifting residents, exposure to illness, and burnout from staffing shortages. Workers compensation claims commonly include medical expenses, lost wages, and settlement costs that can overwhelm an uninsured facility.

How to prepare: workers compensation is required in most states, but the minimum limit may not fully protect a facility from the cost of employee injuries and burnout. Operators can also reduce claims with updated safety and ergonomics training, lift-assist equipment, and clear incident-reporting pipelines, then review the data at least annually to spot and close safety gaps.

Best practices for assisted living facilities

From this claims data, operators should recognize the need for customized, robust coverage. These practices form a foundation for proper oversight and help prevent incidents before they occur:

• Perform frequent safety audits
• Maintain ergonomics training protocols
• Survey and monitor abuse-awareness protocols
• Manage medication awareness and training processes
• Communicate clearly with employees
• Avoid understaffing
• Enforce safe-lifting and fall-prevention programs
• Keep residents and their families in the communication loop
• Assess cybersecurity infrastructure
• Maintain relevant documentation

For a full line-by-line review, see our coverage checklist and current pricing in the cost guide.

Frequently asked questions