Update on Malpractice Claims

by Elizabeth E. Hogue, Esq.

Update on Malpractice Claims

New analysis by Claggett, Sykes and Garza Trial Lawyers shows that registered nurses (RNs) and physicians continue to top the list of health professions most likely to be sued for malpractice. A total of 50,555 claims were filed in 2024. Complaints included 12,655 against RNs while 12,299 complaints were filed against physicians. There were 5,851 complaints against licensed practical nurses. There were also 2,889 complaints against nursing paraprofessionals and 1,068 complaints against advanced practice nurses. Registered nurses now have a risk level that is 2.3 times higher than average. The report says that large patient volumes make nurses especially vulnerable.

Claims and Payouts

While the total number of malpractice suits has decreased by almost 20% in ten years, the severity of claims has risen. In 2024, total payouts were $4.93 billion, averaging $433,000 per case, while the cost per claim against home health nurses was previously much lower as described below. 

Home care nurses, including those providing hospice and palliative care, were the most vulnerable to professional liability claims of all nursing specialties for the period from 2015 to 2019, according to “Nurse Professional Liability Exposure Claim Report: 4th Edition,” recently issued by Nurses Service Organization and CNA. This is 

Malpractice

the first time that nurses in home care topped the list since the reports were first compiled in 2008. According to the report, home care nurses accounted for 20.7% of claims, which represents an increase of 12.4% over the previous number reported in 2015. Adult medical/surgical nurses topped the list in past reports.

Cost

The average total costs incurred per claim against home care nurses, including legal fees and amounts awarded to patients and/or families, was $216,051 over the five-year period of the study. This amount is a little higher than the overall average for claims against nurses. 

The average total costs incurred from closed liability lawsuits against all nurses was $210,513, representing a 4% rise since the last report in 2015. This increase is likely based on more expensive legal and expert counsel, and the rising cost of healthcare since payments to patients include costs of medical treatment that led to malpractice suits.

The following may contribute to increases in claims against home health nurses:

  • Lack of institutional support for home care nurses that is routinely received by nurses in hospitals and other facilities
  • Growing popularity of home care
  • Rising acuity of home care patients
  • Lack of 24-hour oversight of patients
  • Absence of equipment in patients’ homes that is readily available in institutional settings to help identify patients at high risk for negative outcomes

Strategies that nurses can use to protect themselves from malpractice claims include:

  • Stay up to date on education and training
  • Document assessments of patients in a timely and objective manner
  • Go up the chain of command when concerned about the well-being of patients
  • Maintain files that demonstrate character; such as letters of recommendation, notes from patients, and performance evaluations

Final Thoughts

And, of course, complete, accurate and contemporaneous documentation may provide the best defense of all. 

It is time to keep risk management close to the top of lists of potential problems that need on-going attention.

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Elizabeth E. Hogue, Esq.
Elizabeth E. Hogue, Esq.

Elizabeth Hogue is an attorney in private practice with extensive experience in health care. She represents clients across the U.S., including professional associations, managed care providers, hospitals, long-term care facilities, home health agencies, durable medical equipment companies, and hospices.

©2025 Elizabeth E. Hogue, Esq. All rights reserved.

No portion of this material may be reproduced in any form without the advance written permission of the author.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. 

Gaslighting Patients and Caregivers

by Elizabeth E. Hogue, Esq.

Gaslighting

Gaslighting, According to:

Nurse Professional Liability Exposure Claim Report: 4th Edition issued by Nurses Service Organization and CNA, for the period from 2016 to 2019 nurses who prvided services to patients in their homes; including those providing home health and hospice, and palliative care; were the most vulnerable of all nursing specialities to professional liability claims.

A Dubious Distinction

This is the first time that nurses in home care topped the list since the reports were first compiled in 2008. Home care nurses accounted for 20.7% of claims, which represents an increase of 12.4% over the previous number reported in 2015. Adult medical/surgical nurses topped the list in past reports.

Tell me Why

These factors may contribute to increases in claims against home care nurses:

  • Lack of institutional support for home care nurses that is routinely received by nurses in hospitals and other facilities
  • Growing popularity of home care
  • Rising acuity of home care patients
  • Lack of 24-hour oversight of patients
  • Absence of equipment in patients’ homes that is readily available in institutional settings to help identify patients at high risk for negative outcomes

According to the Experts

However, the nonprofit organization Emergency Care Research Institute (ECRI) says that eroding trust is a major threat to patient safety in 2025. ECRI ranks “gaslighting,” or dismissing concerns of patients and caregivers, as the top issue. In other words, nurses aren’t listening to patients and their caregivers! There is an old adage that says that if practitioners would just listen to their patients, patients will tell them what is wrong (i.e., the diagnosis). Perhaps, then, the best way to avoid negligence and resulting lawsuits is to listen to patients and caregivers.

Gaslighting Safeguards

Other strategies that nurses can use to protect themselves from malpractice claims include:

  • Stay up to date on education and training
  • Document assessments of patients in a timely and objective manner
  • Go up the chain of command when concerned about the well-being of patients
  • Maintain files that demonstrate character; such as letters of recommendation, notes from patients, and performance evaluations

Of course, complete, accurate and contemporaneous documentation may provide the best defense of all!

Final Thoughts

An increase in malpractice claims against home health and hospice nurses is a significant new industry development. It’s time to move risk management, with a focus on listening to patients and caregivers, higher up the list!

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Elizabeth E. Hogue, Esq.
Elizabeth E. Hogue, Esq.

Elizabeth Hogue is an attorney in private practice with extensive experience in health care. She represents clients across the U.S., including professional associations, managed care providers, hospitals, long-term care facilities, home health agencies, durable medical equipment companies, and hospices.

©2025 Elizabeth E. Hogue, Esq. All rights reserved.

No portion of this material may be reproduced in any form without the advance written permission of the author.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com