Assisted Living Facilities

Your responsibility doesn’t stop at shift change. Most ALF policies aren’t built for 24/7 reality.

Wandering residents. Overnight staffing gaps. Medication handled by non-licensed staff. Falls in common areas. These exposures don’t happen during business hours—and most policies are written like they do.

Why ALF Operators Come to Us

You’re running a licensed Assisted Living Facility in Texas—responsible for your residents around the clock.

Your residents need help with activities of daily living: bathing, dressing, medication reminders. Some have dementia. Some are fall risks. Your staff works around the clock. Your liability does too.

Most ALF programs we review have at least one premises liability gap and at least one professional liability gap tied to medication administration or overnight supervision. Residents wander off property. Aides handle medication without a license. Falls happen in hallways at 3am.

One incident—and you’re defending a six-figure claim your policy may not be structured to cover. The exposure doesn’t care what time it is.


Coverage Reality

Where ALF Claims Actually Come From

These are the claim patterns we’ve seen across Texas ALF programs for 46 years. Elopement and fall claims are the most frequent. A&M claims are the most expensive. Each exposure has a policy response—or a gap where one should be.

The Exposure Coverage That Responds What It Protects Financial Exposure
Elopement Liability. A resident with dementia exits the facility overnight while staff is attending to another resident. Found hours later with severe injuries from exposure. Family sues for inadequate supervision, failure to secure exits, and breach of duty of care. General Liability (GL) + Professional Liability (PL) Premises liability for elopement incidents, combined with professional liability for supervision standards—both are required; GL alone won’t cover the supervision claim $400K–$800K
Unlicensed Medication Handling. An aide assists with medication administration and gives the wrong dosage. The resident experiences serious complications requiring hospitalization. Family alleges negligent medication handling by unqualified staff. Professional Liability (PL) for Medication Management Coverage for medication administration by unlicensed staff under facility supervision protocols—must be explicitly stated in the policy, not assumed $150K–$350K
Common Area Slip-and-Fall. A resident slips in a common area shortly after cleaning. No warning signage was posted. The resident falls, fractures a hip, and requires surgery. Family alleges inadequate maintenance and failure to warn. General Liability (GL) + Premises Liability Bodily injury from slips, trips, and falls in dining rooms, hallways, and resident common areas—the environments your residents navigate daily $200K–$400K
Workers’ Comp Payroll Exposure. A caregiver slips in the resident dining hall. The resulting claim triggers a payroll audit. Auditor discovers caregiving staff were coded as office workers (8810) instead of residential care (8835). Retroactive reclassification and back-premium bill follow. Workers’ Compensation — Class Code 8835 vs. 8810 Caregiving staff correctly coded as 8835 (nursing homes, assisted living) from day one—not discovered during a claim-triggered audit $35K–$60K
Memory Care A&M Exposure. Family discovers unexplained bruising on a memory care resident and alleges inappropriate physical contact by a night-shift aide. The resident cannot speak for themselves. Your General Liability caps abuse claims at $100K. Jury awards significantly more. Abuse & Molestation (A&M) with Dedicated Limits Dedicated $1M limit for abuse allegations, kept entirely separate from your general liability aggregate—critical when residents cannot report incidents themselves $500K–$1M+

Critical ALF Coverage Details

  • Note on Claim Costs: The financial exposures above aren’t just settlements. They factor in legal defense costs. Even if you prevail, defending an elopement or abuse claim routinely costs $100K–$200K in attorney fees before any judgment is entered. Defense Outside Limits (DOL) is critical—without it, defense costs consume the limit meant to pay a settlement.
  • Elopement requires both GL and PL: Wandering resident incidents trigger premises liability AND professional liability. Policies carrying only GL leave you exposed on the supervision standard claim—which is typically where the largest damages are awarded.
  • Medication administration by unlicensed staff is a major exposure: Texas allows this under certain protocols, but your PL policy must explicitly cover it. Most general PL policies do not. This is consistently the gap that surfaces at claim time.
  • A&M with dedicated limits is non-negotiable for ALFs: Memory care and cognitively impaired residents cannot report incidents. Allegations are harder to disprove. A shared GL aggregate is structurally inadequate for this exposure.
  • Workers’ Comp class code 8835 is required: Assisted living caregivers are not office workers. Wrong code means a year-end audit, retroactive reclassification, and a back-premium bill due in 30 days.

Your residents live in your building. Your liability lives there too.

No clocking out. No weekends off. A fall at 2am costs the same as a fall at 2pm. An elopement at 3am is a six-figure claim regardless of what shift it happened on. The exposure is continuous—and most policies aren’t written that way.

Elopement and fall-related claims are the most frequent. Memory care A&M claims are the most expensive. Workers’ Comp misclassification is the most predictable. All three consistently appear in the ALF programs we audit.

We don’t quote you first. We read your current policy first. We look for the gaps between 24/7 residential care operations and what your policy actually covers. Then you decide what to fix.


What We’ve Seen

Across Texas ALF Programs

Hundreds
Healthcare and residential care programs reviewed across Texas over 46 years
Majority
Contain at least one gap tied to supervision, staffing conditions, or medication protocols
$400K+
Typical starting point for elopement claims—the most common ALF exposure

Elopement and fall-related claims are the most frequent triggers in assisted living. A&M allegations in memory care units carry the highest dollar exposure. Most operators learn their policy has structural gaps during a claim—not before. That’s the window we’re trying to close.


Get Started

Let’s audit your Assisted Living program.

30-minute call. You walk us through your staffing model and overnight protocols. We’ll tell you exactly where your current policy breaks—and what a claim would actually cost.

Office 6750 West Loop South, Suite 767
Bellaire, TX 77401