Who We Serve
Private duty nurses care for medically fragile clients one-on-one, for hours at a time, often managing ventilators, IVs, and complex medications. The acuity is high and so is the exposure, which is why this coverage centers on strong professional liability.
Private duty nursing is skilled nursing care delivered in the home, usually one-on-one and over extended-hour shifts. An RN or LPN is assigned to a single client for a block of hours, sometimes around the clock, rather than dropping in for a short visit. The care is hands-on and continuous: ventilator and tracheostomy management, IV therapy, complex medication regimens, wound and ostomy care, and close monitoring of a fragile patient.
This is what separates private duty from intermittent home health agency care. Home health delivers physician-ordered visits, often under Medicare, on an intermittent schedule. Private duty nursing is continuous, one-on-one, and usually paid for privately or through long-term care insurance rather than Medicare. The nurse is present for the long stretches when a high-acuity client cannot be left alone.
The clients tell you why this work is its own category. Private duty serves ventilator-dependent adults, people with ALS or spinal cord injuries, patients recovering from major surgery, and medically fragile children who depend on technology to breathe and feed. These are the most vulnerable people cared for in the home, and the nursing that keeps them safe is correspondingly skilled and high-stakes.
Private duty nursing sits in a more varied regulatory space than Medicare-certified home health. Because much of it is private-pay or funded by long-term care insurance rather than Medicare, the federal Conditions of Participation may not apply the same way. What does apply, firmly, is state licensure of the nurses themselves and, in most states, licensure of the agency or provider delivering the care.
Nurse practice acts are central here. Every RN and LPN works within the scope defined by their state board of nursing, and private duty care lives at the skilled end of that scope. Staying inside it, and documenting that you did, is both a clinical obligation and a liability shield. Care delivered outside a nurse legal scope is a claim waiting to happen.
State licensing for the provider varies. Some states regulate private duty nursing agencies tightly, with their own insurance, staffing, and supervision requirements. Others fold it into broader home care or home health licensing. If you serve pediatric clients or bill Medicaid waiver programs, additional rules apply on top.
HIPAA runs through it all. Private duty providers keep detailed clinical records and coordinate with physicians and payers, which makes you a covered entity with privacy, security, and breach notification obligations under 45 CFR. The continuous, documentation-heavy nature of the care means you hold a lot of protected health information, and protecting it is part of the job.
The defining feature of private duty risk is severity. The clients are fragile, the care is technical, and when something goes wrong the harm can be catastrophic and the claim can reach into the millions. This is not about claim frequency so much as the size of what a single error can cause.
Equipment and technology errors lead the high-severity claims. A ventilator setting entered wrong, an alarm not heard or not acted on, a feeding pump or infusion mistake, any of these can be life-threatening for a technology-dependent client. The nursing judgment around that equipment, the monitoring and the response, is exactly what a professional liability claim scrutinizes.
Medication errors carry similar weight. Private duty clients are often on complex regimens with high-risk drugs, and a wrong dose or a missed interaction can be devastating in someone whose body has little reserve. Failure to escalate is closely related: a nurse who does not recognize or report deterioration in a fragile client can face a claim that the delay caused avoidable harm or death.
Pediatric care raises the stakes further. Caring for a vent-dependent or technology-dependent child is among the highest-acuity work done in any home, and the emotional and financial weight of a pediatric claim is immense. Alongside these clinical exposures sit the physical ones every hands-on provider shares, lifting and transfer injuries to nurses on long shifts, needle sticks, and the travel and data exposures common to all home-based care. For private duty, though, the clinical severity is the exposure that shapes the whole program.
Professional liability dominates here, and it is usually carried at higher limits than other provider types because of claim severity. The rest of the program supports it. Each card explains why and links to the detail.
The dominant coverage. It answers equipment errors, medication mistakes, and failure to escalate, the high-severity claims that define private duty. Limits start at $1 million per claim and $3 million aggregate and often go higher.
Professional liability coverageGiven the potential for multimillion-dollar pediatric and vent-related claims, an umbrella is often essential rather than optional. It stacks high limits above your liability coverage at a reasonable cost.
Umbrella liability coverageFor the physical accidents that happen during long shifts in the home, like a fall or property damage. Typically $1 million per occurrence and $2 million aggregate.
General liability coverageRequired once you employ nurses. Long one-on-one shifts mean significant lifting and transfer exposure, plus needle sticks, so your clinical payroll carries real injury risk.
Workers compensationDetailed clinical records and payer coordination mean significant PHI. Cyber covers HIPAA breach notification, ransomware, and regulatory response when that data is exposed.
Cyber liability coverageYour nurses drive their own cars to assignments. When one causes an accident on a work trip, the provider can be sued, and this closes that gap affordably.
Hired and non-owned autoIf the provider owns vehicles for staff or client transport, commercial auto covers accidents and the liability that follows, usually at a $1 million combined single limit.
Commercial auto coverageNurses work alone with highly vulnerable clients, including children. Standard liability excludes abuse allegations, so a dedicated limit defends the provider against founded and false claims.
Abuse and molestation coveragePrivate duty providers run into insurance requirements from several directions. Long-term care insurers and case managers who refer clients often require proof of professional and general liability at $1 million or more, plus workers compensation at statutory limits. Pediatric and technology-dependent cases, frequently coordinated through hospitals or specialty payers, can demand higher total limits given the severity at stake.
Medicaid waiver programs that fund some private duty care impose their own provider requirements, which can include specific insurance minimums and documentation standards. Where you staff nurses into facilities or coordinate with a hospital discharge team, expect additional-insured and certificate requirements as a condition of the placement.
The recurring theme is that the severity of private duty claims pushes limits upward. A contract that would accept $1 million from a companion-care agency may expect $3 million or $5 million total from a provider caring for a ventilator-dependent child. We read those requirements and build the professional liability and umbrella limits to satisfy the most demanding payer you work with.
Private duty is among the more expensive home care types to insure, because acuity drives professional liability and the claim severity is high. Carriers weigh your case mix, your nursing payroll, your revenue, your states, and your claims history. These are typical annual ranges for a core program, not quotes.
$8,000 to $20,000 / year
A small provider with a few nurses, carrying professional liability, general liability, and workers comp, with limits set to acuity.
$20,000 to $50,000 / year
A growing nursing payroll, an umbrella for higher total limits, and cyber coverage for clinical records.
$50,000 to $120,000+ / year
Vent-dependent and pediatric cases carry the highest severity, pushing professional liability and umbrella limits, and premiums, up.
Professional liability and workers comp are usually the two largest lines, and the case mix matters more here than almost anywhere else: a provider caring for stable adults pays differently than one serving fragile pediatric vent patients. Get your private duty nursing quote and we will price to your actual acuity.
Details are changed, but these patterns repeat in private duty nursing, and they show how the coverages respond.
A night-shift nurse caring for a vent-dependent client did not respond quickly enough to a disconnect alarm, and the client suffered serious harm before the issue was corrected. The family brought a high-value claim. Professional liability, backed by the provider umbrella, covered the settlement and the substantial defense. The case reached well into seven figures, the kind of severity that defines why private duty carries high limits.
A nurse managing a complex medication schedule for a fragile adult administered a high-risk drug at the wrong interval, and the client was hospitalized. The family alleged the error reflected inadequate care. Professional liability paid the claim and the defense costs. The provider responded by tightening its medication verification protocol and shift handoff documentation.
A medically fragile child on continuous care suffered a decline that the family alleged a private duty nurse failed to escalate in time. Pediatric claims carry enormous emotional and financial weight, and the defense was long and expensive. The provider professional liability and umbrella coverage carried it. The case underscored how essential high limits are for any provider serving children with complex needs.
Given the severity of private duty claims, prevention is worth even more here than elsewhere. Strong clinical practices protect fragile clients and make a real difference in how carriers underwrite you.
Each practice maps to a specific, high-severity claim type. A provider that documents competence and safety is both protecting clients and earning better terms from carriers.
State nurse practice acts and provider licensing shape private duty more than federal rules do. Scope of practice for RNs and LPNs differs by state, and so do agency licensing, staffing, and insurance requirements. Medical malpractice caps, where they exist, affect how large a clinical claim can grow and the limits a prudent provider carries. A multi-state provider has to meet the strictest standard across its footprint.
We work with private duty providers nationwide and tailor the program to your states, whether that is Texas, California, Florida, New York, Pennsylvania, or Virginia. Each state page lays out the licensing body and any malpractice cap that applies.
Private duty nursing is not a risk to hand to a generalist. The acuity, the high claim severity, and the need for substantial professional liability and umbrella limits call for a broker who understands skilled nursing in the home. Here is what to look for.
For professional standards in nursing, the American Nurses Association publishes scope and standards of practice, the National Council of State Boards of Nursing covers licensure and practice rules, and the National Association for Home Care and Hospice represents home-based nursing care.
The questions private duty providers ask us most.
Because the clinical acuity is higher and the clients are often medically fragile. A nurse managing a ventilator, a central line, or a pediatric patient on continuous care faces claims that can reach into the millions if something goes wrong. A $1 million per-claim and $3 million aggregate limit is a starting point, and many providers carry more through an umbrella. The severity of these claims, not just their frequency, drives the limits.
Yes. Home health typically delivers intermittent, physician-ordered visits under Medicare. Private duty nursing usually means one-on-one, extended-hour shifts, often private-pay or funded by long-term care insurance, caring for a single high-acuity client. The continuous, hands-on nature and the medical complexity raise the professional liability exposure compared with intermittent visits, and the coverage reflects that.
Professional liability responds when a nursing error involving equipment harms a client, such as a ventilator setting mistake or a missed alarm. The medical device itself may also involve the manufacturer, but the nursing judgment and monitoring are squarely a professional liability matter. For providers serving vent-dependent or technology-dependent clients, this is one of the most serious exposures to insure properly.
It runs higher than non-medical care because of the acuity. A small provider often pays $8,000 to $20,000 a year for a core program, and larger operations with pediatric or vent-dependent clients can run well beyond that. Professional liability and workers compensation are the largest lines. We price to your specific case mix, because a provider serving stable adults differs from one serving fragile pediatric patients.
Yes. Your RNs and LPNs are covered for on-the-job injuries the same as any employee, including the lifting and transfer injuries common in extended one-on-one care, plus needle sticks and exposure. Because shifts are long and hands-on, the physical exposure is real. Correct payroll classification for nursing staff matters to both your premium and your compliance.
In most cases yes. Private duty providers keep detailed clinical records, care plans, and often coordinate with physicians and payers electronically. That protected health information triggers HIPAA duties, and a breach is expensive to resolve. Cyber coverage pays for breach notification, ransomware, and regulatory response, scaled to the volume of records you hold.
Pediatric private duty, often for technology-dependent children on ventilators or feeding tubes, is among the highest-acuity care delivered in the home. The clinical stakes and the potential claim severity are significant, and carriers underwrite it carefully. We work with providers serving medically fragile children and structure professional liability limits and umbrella coverage to match that exposure.
Intermittent skilled care, the closest cousin to private duty nursing.
Home health agency insuranceElder care services that sometimes include skilled nursing needs.
Senior care coverageThe dominant coverage for skilled nursing, explained in full.
Explore professional liabilityHow agencies reach the high total limits private duty often requires.
Explore umbrella coverageSend us your case mix and staffing, and a specialist will build a private duty program with professional liability and umbrella limits sized to the severity of the care. It takes a few minutes and there is no obligation.
