closeup of nurse in a corridor

Malpractice claims involving nurses working in aging services, including senior living communities, have decreased over the past decade, according to a report issued by the two major insurers.

The findings covering 2015 to 2019 in the CNA and NSO Nurse Professional Liability Exposure Claim Report show that gerontology nurses working in aging services facilities, which the report defines as assisted living and independent living communities as well as nursing homes, accounted for 10.5% of claims. The decrease in claims can be attributed to the growing home care field and the increase in older adults preferring to “age in place,” according to the report. 

Approximately 11% of all closed claims were connected to aging services settings, down from 16.9% in the 2015 report and down 18.4% in the 2011 report.

The top three paid claims were tied to communication, monitoring and scope of practice complaints, with an average cost of $210,513, up more than 4% from 2015 data.

Treatment and care allegations accounted for 56% of closed claims in the 2020 analysis, including failure to fulfill core nursing responsibilities, duties and expectations. 

The report noted that claims related to medication administration decreased significantly in 2015 compared with 2011, but they increased in the 2020 report. Many of those claims were “difficult to defend” because a nurse used “work-arounds” to bypass a facility’s established safety procedures, did not follow established facility policies and procedures, or diverted medications.

Approximately 41% of all injuries in nursing-related malpractice claims were fatal, with cardiopulmonary injury / arrest accounting for 47.3% of all fatal injuries. Many of these closed claims involved a pattern of multiple adverse patient events and injuries leading to arrest, and they took place in a variety of locations, including aging services settings.

The average total cost of a paid claim connected to aging services was $141,185.

The majority of professional liability closed claims involved nurses providing direct patient care, but nurses in leadership roles also were subject to claims, with the majority occurring in aging services (38.7%) or in a patient’s home (32.3%). The average cost of a claim against nurses in leadership roles in aging services was $181,335. These claims are based on the assumption that the nurse leader was personally responsible for the actions of the members of the nursing care staff and the care of each patient or resident. 

The average cost of defending allegations against a nurse’s license in 2020 ($5,330) increased 33.7% compared with 2015 data and 58.9% compared with 2011 figures. Professional conduct, scope of practice and documentation allegations had the highest distribution of license protection board matters, and approximately 55% of those matters lead to action against a nurse’s license.

CNA, the leading professional liability insurer of nurses, and the Nurses Service Organization jointly published the report. For information related to home health workers, see the article below.

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