Is an elopement claim covered under my memory care policy?

Elopement is a resident leaving a secured area unsupervised. The claim that follows alleges some combination of inadequate assessment of elopement risk, a care plan that did not address the risk, interventions that were specified but not performed, and physical security that did not function.

None of that is a separate insurable peril. It is a professional liability claim about assessment, care planning and supervision, with a premises component attached.

Look at the definition of professional services. A broad definition covering services performed in the treatment, care or custody of residents, including assessment, care planning, supervision and the provision of a safe environment, comfortably reaches an elopement claim.

A narrow definition limited to the rendering of medical or nursing services may not obviously reach a supervision and security failure, which creates an argument between the general liability and professional liability halves of the program at exactly the wrong moment.

Then check the exclusions for anything addressing wandering, elopement, or premises security specifically. These are not universal, but where they appear they are decisive.

Elopement cases are built from the facility own records. There is typically a documented elopement risk assessment, a care plan specifying interventions, and a record of whether those interventions were performed and charted.

If the assessment identified the risk and the chart does not show the interventions being carried out, the case largely makes itself. That is why the operational response matters more than the coverage response here: the assessment, the intervention record, and the door alarm and drill logs are the defense.

For memory care, underwriters look at a specific short list: documented elopement risk assessment on admission and on change of condition, a functioning secured egress system with a testing record, a drill record, staffing ratios on the memory care unit specifically rather than facility-wide, and a written missing resident protocol with evidence it has been practiced.

An operator who brings those to a renewal is a different account than one who brings a floor plan. This is one of the areas where risk management work translates most directly into both price and defensibility.

While in the memory care section of the program, check the assault and battery endorsement, because resident on resident altercation is the other core memory care exposure and it is frequently sublimited in a way that captures negligence claims regardless of how they are pleaded.

Those two, elopement and altercation, are what distinguish a memory care program from an assisted living one. A program that was written for assisted living and had memory care added to the schedule without either being addressed is the common and expensive mistake.