Home care nurses account for most malpractice claims over five-year period

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Home care nurses were more vulnerable to professional liability claims than any other nursing specialty from 2015 to 2019, according to a new report.

The findings, recently released by professional liability insurance providers Nurses Service Organization and CNA, signal the first time nurses in home care made up the most malpractice suits than other nurse specialty since the reports began in 2008.

In the most recent report, which looks at 455 closed professional liability claims from Jan. 1 2015 to Dec. 31, 2019, home care nurses accounted for 20.7% of the claims, representing a 12.4% increase from the previous report in 2015. In past reports, adult medical/surgical nurses accounted for the most closed professional liability claims. Home care nurses are defined as those providing home care as well as palliative and hospice care.

The shift represents the growing popularity of home care services, said Georgia Reiner, a risk specialist for the Nurses Service Organization, but she added home care nurses are also more susceptible to lawsuits for reasons unique to the setting. Acuity of patients in home care is rising while the home doesn’t have 24-hour oversight of patients and the same level of equipment as hospitals to identify patients at high-risk for negative outcomes.

“Nurses who are working in home care lack the institutional support that their peers would get in a healthcare organization or hospital,” Reiner said. “It really falls to them to identify patients who are at higher risk and need to be escalated to a higher level of care.”

The average total costs incurred for a home care nurse as a result of closed claims, including legal fees as well as the amount awarded to the patient or family, was $216,051 over the five-year period, which is slightly higher than the overall average, according to the report.

There are things home care nurses, as well as nurses in any other specialty, can do to protect themselves from professional liability suits, Reiner said. She recommends nurses stay up to date on education and training; document patient care assessments in a timely and objective manner; use the chain of command when concerned about a patient; and maintain files that demonstrate their character such as letters of recommendation, notes from patients and performance evaluations.

Overall, the average total costs incurred from a closed liability suit was $210,513 over the five-year period, representing a 4% rise since the last report in 2015. Reiner said that’s because legal and expert counsel is more expensive. The rising cost of healthcare plays a role too, she added, as the payment to a patient includes costs of their medical treatment that led to the malpractice suit.

Nurses Service Organization and CNA together insure more than 500,000 nurses, and the claims in the report represent those that were closed and led to a payment to the patient of $10,000 or higher.



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