Senior living insurance markets for commercial agents.
Assisted living, skilled nursing, memory care, CCRCs and adult day — placed through the specialty markets your standard carriers don’t reach. You keep the client.
Senior living is the hardest-priced segment in healthcare liability, and the one where the gap between a good placement and a poor one is widest. Most standard carriers won’t look at it at all. The specialty carriers that will have withdrawn capacity across large parts of the country, per-bed rates in litigious venues can be triple those a state away, and a facility with documented falls protocols prices differently from one without.
Most of this book prices per occupied bed rather than as a flat premium, so census accuracy matters from the first indication. An account submitted on licensed beds instead of occupied beds is over-priced from day one — and the next broker to look at it will tell your client so.
Westwood works this market every day. You bring the account; we match it to the carriers whose appetite fits this year, get it in front of them before a competing broker locks the market, and the client stays yours.
The cover that actually responds.
Professional liability
Resident care claims — falls, pressure injuries, elopement, medication error, failure to supervise — with defense costs structured inside or outside the limit as your client prefers.
General liability
Premises, visitors, contractors and third-party bodily injury, written alongside or split from professional liability where that prices better.
Sexual abuse and molestation
Effectively mandatory in this sector and often required by state contract. Negotiated as a proper limit rather than a token sublimit.
Memory care and higher acuity
Dementia units, behavioral residents and secured wings, which carry their own rating and their own underwriting scrutiny.
Multi-site and campus programs
CCRCs and operators running mixed IL/AL/SNF campuses, where a single program across the estate usually beats facility-by-facility placement.
What underwriters read in a senior living submission
A thin submission is declined on completeness, not on merit. These are the items a senior living underwriter looks for first — send what you have, and we’ll tell you what’s missing before it goes to market.
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Census by level of care
Occupied beds split across independent living, assisted living, memory care and skilled nursing — not the licensed count. Most of this class rates per occupied bed.
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Five years of loss runs
Currently valued, with detail on open claims. Falls, pressure injuries and elopement are read first.
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Survey history
Recent state inspection surveys and plans of correction — for skilled nursing, the CMS-2567 statements of deficiencies. An F-tag pattern that reads as systemic is a premium driver on its own.
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Staffing
Directly employed versus agency staff, turnover and staffing ratios. Agency-heavy models and high turnover price the account up.
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Memory care and acuity
Secured units, the number of memory care beds, behavioral residents, and the elopement and wander-management protocols that go with them.
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Clinical protocols
Falls, wound-prevention and elopement protocols with audit trails. Documented controls move the number; described ones rarely do.
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Abuse and molestation controls
Background checks, training and reporting procedures. Carriers ask about these before they will offer a real abuse and molestation limit.
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The current program
Limits, retention, defense inside or outside the limit, the claims-made retroactive date and any abuse sublimit — so nothing is lost when the account moves.
What it costs.
Indicative annual premium — by facility type and size
Per-bed figures are combined professional and general liability, per occupied bed per year. Skilled nursing is quoted as an annual facility premium.
| Operation | Indicative annual premium |
|---|---|
| Independent living | $200 – $450 per occupied bed / yr |
| Assisted living — standard | $500 – $1,200 per occupied bed / yr |
| Assisted living — with memory care | $700 – $1,500 per occupied bed / yr |
| Assisted living — high-litigation venue | $1,200 – $1,800 per occupied bed / yr |
| Adult day care | $2,750 – $15,000 |
| CCRC — small campus (IL/AL, limited SNF) | $15,000 – $40,000 |
| CCRC — large multi-building campus | $120,000 – $300,000 |
| Skilled nursing — 60 beds or fewer | $45,000 – $85,000 professional liability |
| Skilled nursing — 61 to 120 beds | $80,000 – $180,000 professional liability |
| Skilled nursing — over 120 beds | $175,000 – $400,000 professional liability |
Indicative market ranges for 2026, shown to help you scope a risk before you submit it — they are not quotes and not an offer of coverage. Actual premium depends on venue, claims history, limits, staffing and documented controls, and can fall outside these ranges in either direction. Every risk is individually underwritten.
What moves the number.
Pushes premium higher
- Litigious venue — the single biggest multiplier in senior living
- Memory care, secured units and behavioral residents
- Poor survey history, or an F-tag pattern that reads as systemic
- High staff turnover and agency-heavy staffing models
- Open claims involving falls, pressure injuries or elopement
Keeps premium lower
- Documented falls and wound-prevention protocols with audit trails
- Stable, directly-employed staffing with low turnover
- Clean survey history and prompt plan-of-correction closure
- Accurate occupied-bed census at submission, not licensed beds
- A single program across a multi-site estate
Bring us the whole segment.
- Assisted living facilities
- Skilled nursing facilities
- Memory care and dementia units
- Continuing care retirement communities
- Independent living
- Adult day care
- Multi-site and regional operators
- Group homes for elderly and disabled residents
Placing it, class by class.
What agents ask us.
Do I need to be appointed with Westwood to place a senior living account?
Yes — Westwood places business through appointed agents. If you aren’t appointed yet, send the risk through the quote form anyway: submitting it takes you straight to the appointment application, so both start at once.
Do I keep the client if I place the account through Westwood?
Yes. Westwood is a wholesale broker: we work the specialty market, and the client relationship stays with your agency.
Why do my standard carriers decline assisted living and nursing home accounts?
Most standard carriers don’t write senior living at all, and the specialty carriers that do are selective about venue, memory care, staffing and survey history. A decline from your usual markets is usually a statement about their appetite, not a verdict on the risk.
Should I submit licensed beds or occupied beds?
Occupied beds, broken out by level of care. Most senior living liability is rated per occupied bed, so a census built on licensed beds over-prices the account from the first indication.
Does my assisted living client need abuse and molestation coverage?
In practice, yes. Sexual abuse and molestation cover is effectively mandatory in senior living and often required by state contract, and general liability forms commonly exclude it or cap it at a small sublimit. Check the current program and ask for a proper limit.
Can a multi-site operator be placed under one program?
Often, yes. For CCRCs and operators running several facilities or mixed independent living, assisted living and skilled nursing campuses, a single program across the estate usually prices better than placing facility by facility.
When should I start working a senior living renewal?
Earlier than a standard account. Carrier appetite in this class changes every year, and the first broker to reach a market locks it — so a renewal needs the same work as a new placement, not a copy of last year’s submission.
Which senior living risks does Westwood place?
Assisted living, skilled nursing, memory care and dementia units, continuing care retirement communities, independent living, adult day care, multi-site and regional operators, and group homes for elderly and disabled residents.
Have a risk in this class?
Send it over and we’ll get it in front of the right underwriters — matched to appetite, and before a competing broker locks the market.