RN/NP – Question of Insurance

Kasie Cousino News

The subject of liability insurance for nurse practitioners (NPs) was discussed in a recent article published in Medscape. This article brought up two key points in insurance considerations for NPs working as an RN that the NP and the facility should consider.

First, is the NP an employee or an independent contractor?  In senior living, most nurses are hired as employees (full-time, part-time, or contingent).  For NPs, most are independent contractors either individually or through a physician practice.  If an NP is being hired into an RN role: DON, charge nurse, or covering a shift; most likely it will be in an employed position.  Independent contractors are not covered by the facility’s insurance regardless of level of licensure.  That person (or practice) needs to secure their own insurance.

Second, it is important to check the facility insurance policy to see if NPs are excluded.  Even if the individual is working in an RN role, by virtue of holding the NP license, an exclusion for NPs would most likely be triggered.  Talk to your agent and ask for a carve out.  Be prepared to show proof that the NP is hired in an RN role.

If the NP is seeking an individual insurance policy, either as an independent contractor or simply as personal protection; make sure to submit the job description or posting in addition to the license.  It will be up to the insurance carrier whether they issue a NP insurance policy or an RN insurance policy.  Make sure the policy matches what you’ll be asked to do in the job.

As part of all of these important insurance considerations, don’t forget to have clearly stated boundaries about what an NP can and cannot do when working as an RN.  It’s hard for each of us to forget what we’ve learned and trained for; but it can be very disruptive and possibly destabilize systems of checks and balances if lines of responsibility are not clear.