Skilled Nursing Facility Insurance
Skilled nursing is one of the most demanding classes in healthcare insurance. Liability claims can be large, the market is selective, and regulatory and billing exposures sit alongside the clinical ones. Stonebrook places skilled nursing and post-acute facilities with specialist carriers and advocates for you at every renewal.
Reviewed by Nate Feuerman, High Net Worth Insurance Producer at Stonebrook
Last updated
Quick answers
What insurance does a skilled nursing facility need?
Professional and general liability, excess liability, abuse coverage, workers’ compensation, property, cyber, regulatory and billing coverage, EPL and D&O.
Why is nursing home insurance so hard to place?
Liability claims can be severe and fewer carriers write the class, so underwriting is selective and much of the market is in surplus lines.
What is regulatory and billing coverage?
It helps pay legal costs and certain fines from Medicare and Medicaid billing audits and regulatory investigations, which liability policies don’t cover.
What helps a facility get better terms?
Survey history, staffing, quality measures, documented risk management and clean loss runs.
What a skilled nursing program covers.
Professional and general liability
Resident care and premises claims, usually written together, often with defense costs inside the limit.
Abuse and molestation
Allegations of abuse or neglect involving staff or residents. Check for exclusions and sublimits.
Regulatory and billing
Legal costs and some fines and penalties from Medicare and Medicaid billing audits and government investigations.
Workers’ compensation
Required in nearly every state. Resident handling makes nursing one of the highest-risk occupations for back and shoulder injuries.
Property, cyber, EPL and D&O
Buildings and generators, health information and ransomware, employee claims, and board and officer protection.
How we build a skilled nursing program.
- Start with the submission.Census, beds, services, staffing, survey results, quality measures and five years of loss runs, presented the way underwriters want to see them.
- Tell the risk management story.Fall, pressure injury and infection control programs, incident reporting and claims handling.
- Structure the limits.Primary and excess layers, retentions and how defense costs affect your limits.
- Close the gaps.Abuse coverage, communicable disease exclusions, regulatory and billing, and cyber.
- Prepare for renewal early.Specialist markets need time. We start well before the expiration date.
Read the policy before you need it.
Since 2020, many healthcare liability and property policies have added communicable disease exclusions. Know whether yours has one and how it is worded.
Abuse and molestation is often excluded or sublimited. Defense costs are often inside the limit, which means legal fees reduce the amount left to pay a settlement.
We review every exclusion, sublimit and retention with you before you bind, not after a claim.
A broker who knows your business.
Stonebrook is an independent agency. We work with standard, specialty and excess and surplus lines carriers, so we can shop your facility with specialist healthcare carriers, including surplus lines markets instead of fitting you into one company’s program.
Since 1982 we have placed commercial programs for businesses and property owners across the country. We read the fine print, flag the exclusions that matter for your operation, and advocate for you at underwriting, at renewal and at claim time.
Coverage that works together.
Most families need more than one policy. Here is how the pieces fit.
Skilled nursing insurance questions, answered.
What insurance does a skilled nursing facility need?
Most need combined professional and general liability, excess liability, abuse coverage, workers’ compensation, property with business income, cyber, regulatory and billing coverage, employment practices and D&O, plus commercial auto if the facility transports residents.
Why is nursing home liability insurance so expensive?
Claims involving resident injury or neglect can be large, litigation costs are high, and fewer carriers write the class. Survey history, staffing, quality measures and loss history drive price.
What is regulatory and billing coverage?
It covers legal defense, and in some policies certain fines and penalties, arising from Medicare and Medicaid billing audits and regulatory investigations. General and professional liability policies typically don’t cover these.
What does “defense inside the limit” mean?
It means legal defense costs are paid out of your liability limit, so every dollar spent on attorneys reduces the amount left to pay a settlement or judgment. It is common in healthcare liability, and it affects how high your limits should be.
Does our policy cover COVID-19 or other infectious disease claims?
Many policies written since 2020 include communicable disease exclusions. Read the exclusion carefully, and ask us what alternatives exist for your facility.
What is an excess and surplus lines carrier?
A carrier that insures risks the standard market won’t, often with more flexible terms. Much of the skilled nursing liability market is in surplus lines, and we have access to it.
When should we start our renewal?
Earlier than you think, usually 90 to 120 days before expiration. Specialist carriers need complete submissions and time to underwrite.
Let’s build a program that stands up to a claim.
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Tell us what you need and we’ll take it from there.