What insurance does an RCFE (residential care facility for the elderly) need in California?

Since July 1, 2015, California has required every RCFE, including six-bed homes, to carry liability insurance of at least one million dollars per occurrence and three million dollars in total annual aggregate (Health and Safety Code section 1569.605). The exemption is narrow: RCFEs that are an integral part of a continuing care retirement community.

The statute sets limits. It does not guarantee that the policy covers the claims an RCFE actually faces. A general liability or business owner policy with a $1M limit meets the number on paper and typically excludes professional services, which is where falls, pressure injuries, medication errors and abuse allegations sit.

California is also a high-severity state for these claims. The Elder and Dependent Adult Civil Protection Act allows enhanced remedies, including attorney fees, where abuse or neglect is proven, which is why the punitive damages and abuse coverage terms on an RCFE policy matter more here than in most states.

Professional and general liability on one policy at or above the statutory minimum, with defense costs outside the limit if you can get it and abuse coverage included at a stated limit. Property or a tenant policy. Workers compensation, which California requires for employers. Auto and hired and non-owned auto if anyone drives residents.

Check three terms first: whether professional liability is included, whether abuse and molestation is excluded or sublimited, and whether defense costs reduce the limit.