Does adding a memory care wing change our insurance?

Yes, and the common failure is treating it as an administrative change. The unit gets added to the schedule of locations at renewal, premium adjusts, and nobody revisits the wording.

Two exposures distinguish memory care from assisted living: elopement, and resident on resident altercation. Elopement turns on whether the professional services definition reaches supervision and the provision of a safe environment, and on whether any wandering or premises security exclusion has been attached. Altercation turns on whether the assault and battery endorsement applies to claims arising out of assault regardless of how they are pleaded.

Treat a memory care addition as a re-underwriting event. Re-read both of those terms, and get unit-level staffing ratios into the submission rather than facility-wide ones, because facility-wide understates what the unit actually runs.