Insurance for nursing care facilities

Nursing care facilities log 6.3 recordable injuries and illnesses per 100 full-time workers, 174 percent above the private-industry figure of 2.3 and number 3 of the 37 trades on this site. That record is what an underwriter sees first, and it is why the checklist below leans on workers' compensation and liability limits.

Tailor the checklist

1Nursing care facilitie 6.3 per 100
2Private industry 2.3 per 100
3Rank of 37 #3

Total recordable cases per 100 full-time workers, 2024: this trade against private industry and the 37 trades on this site. Bars to scale. Source: BLS SOII Table 1.

Recordable cases

6.3

per 100 FTE, 2024

Serious cases (DART)

4.5

71% of all cases

Fatal injuries, 2024

≈0.8 per 100,000 FTE

Workforce

1,131,434

full-time equivalents

What goes wrong in this trade

Among the highest injury rates on this site, almost entirely from lifting and moving residents; abuse and professional liability are required by licensing and by the facilities' own exposure.

The checklist for nursing care facilities

GL
General liability
Injury to clients and visitors.
Not required by federal law. Required in practice by most contracts, landlords and many state contractor licences.
E&O
Professional liability (E&O)
Care decisions are an advice exposure GL excludes.
Not required by federal law; some state licences and client contracts require it.
Abuse
Abuse and molestation liability
Required by many state licences and clients.
Not required by law; often required by state licensing or clients for care providers.
WC
Workers' compensation
Required once you have employees; lifting injuries drive the loss record.
Required by state law in nearly every state once you have employees; the employee-count threshold and exemptions are set state by state and are not reproduced here.
HNOA
Hired and non-owned auto
Staff driving to clients or transporting them.
Not required by law; commonly added to GL or auto.
Cyber
Cyber liability
Health and personal records.
Not required by law; required by some health-care and corporate contracts.

Red tags mark policy types that a law or licence usually requires; green tags are what contracts, landlords and clients ask for. Tailor the list for your situation (no employees, no vehicles, alcohol) with the checklist tool.

What the injury record means for the premium

Nursing care facilities: total recordable cases, cases with days away/restriction/transfer (DART) and cases with days away from work, per 100 FTE, 2024, columns to scale.

Workers' compensation is rated on payroll and class, then adjusted by your own loss history, so a trade with 6.3 cases per 100 workers starts from a high base rate before an underwriter has looked at you. Worse, 71 percent of those cases involved days away from work, restriction or transfer — the expensive kind. The practical consequence: a documented safety programme and a clean experience modifier are worth more here than shopping carriers.

The nearest trades by injury rate are carpet and upholstery cleaning services (5.6), warehousing and storage (4.8), waste collection (4.7); the same payroll insured in those classes would start from a similar workers' comp base.

Legal, licence or contract?

Fixed by law

Workers' compensation once you have employees, in nearly every state (threshold and exemptions set by the state; not reproduced here).
State minimum auto liability on any vehicle the business operates.

Asked for by contracts and licences

Getting quotes. Take this checklist to a broker who writes nursing care facilities — ask them to quote each line separately so you can see what the 6.3-per-100 class rate is doing to the workers' comp figure versus the liability lines. This site does not sell or quote insurance.

Sources: BLS Survey of Occupational Injuries and Illnesses, Table 1 (2024), incidence rates per 100 full-time workers; BLS SOII Table 3 (2024), hours worked by detailed industry; BLS Census of Fatal Occupational Injuries, Table A-1 (2024). Fatal rate per 100,000 FTE is derived (count ÷ hours × 200,000,000) and approximate. Checked 2026-10-23.