Nurse Malpractice Claims Are Rising; Nearly Half Involve LTC Nurses (New Report)

Nurses working in nursing homes account for nearly half of all closed malpractice claims over the last five years, according to the latest Nurse Professional Liability Claim Report. The findings highlight growing legal and clinical risks for nurses in aging services and home health—two of the fastest-growing practice areas in healthcare.

Key Findings for Nursing Home Nurses

The CNA/NSO report analyzed 466 closed professional liability claims between 2020 and 2024:

• Approximately 45% of closed claims over the last five years involved nurses working in nursing homes and long-term care facilities, by far the largest share among nursing specialties.
• The average cost of defending a nurse during a malpractice investigation increased by 18%, rising from $5,330 in 2020 to $6,304 in 2025.
• Treatment and care-related claims made up 56% of allegations, making these the most frequent reasons for legal action against nurses in nursing home settings.
• High-severity claims in aging services often involved adverse events like falls, infections, and medication errors, frequently resulting in fatal injuries or severe complications.
• The average cost of a claim:
  • Home health: $301,031
  • Aging services: $179,428
  • Across all settings: $236,749

Home and LTC nurses often care for medically fragile, high-acuity patients with multiple comorbidities, frequently without direct supervision or immediate backup. These conditions increase the likelihood of adverse events—and when something goes wrong, the nurse may be the only clinician on-site.

What’s Driving the Increase

The report points to several broader forces driving up claim severity:

• “Tort inflation,” meaning jury awards and settlements are rising faster than general inflation.
• Staffing shortages, especially during and after the COVID-19 pandemic, which have pushed less experienced nurses into high-risk, independent roles.
• Expanded home-based care, with many nurses providing complex treatments once limited to hospitals.

The authors warn that “exceptionally high jury awards are on the rise across the United States and are often disproportionate to the facts of the case.”

Tactical Tips for Reducing Malpractice Risk

• Document Thoroughly and Objectively: Complete documentation of assessments, care, and communication is one of the strongest defenses against liability. "Documentation of the nursing assessment, care plan, and response to nursing interventions is integral in demonstrating that the standard of care was met.”
• Know Facility Policies and State Laws: Regularly review your state nurse practice act and your facility’s protocols. Adhering to established procedures helps nurses defend against allegations of negligence.
• Stay Current with Continuing Education: "Maintain basic clinical and specialty competencies by proactively obtaining the professional information, education, and training needed to remain current regarding nursing techniques, clinical practice, biologics, and equipment.”
• Invoke the Chain of Command: If there’s concern about patient safety, consult supervisors, risk management, or legal departments promptly. "Nursing experts opined that the nurse should have invoked the chain of command.”
• Communicate Changes Early: Immediately report adverse events, changes in patient condition, or safety concerns to providers and document each step.
• Know Your Coverage: According to the report, the average license defense cost increased 18%, from $5,330 in 2020 to $6,304 in 2025. Make sure your professional liability policy includes license protection and legal representation before your state board.

The report’s findings underscore a troubling pattern: as care moves outside hospitals, liability follows. Nurses in LTC, home health, and medispas face increasing expectations with less infrastructure and fewer safety nets.

Strengthening documentation, staying within scope, and using organizational support systems can protect both your patients and your license.

 

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