VNS Health MLTC: Private Duty Nursing (PDN)

Skilled nursing care provided in the home by licensed RNs and/or LPNs/LVNs. This differs from the professional home health care benefit.

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Cost
$0
Prior Authorization Required
Yes
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Documentation required to review a request for PDN:

    • Network provider order and plan of care, including all skilled nursing tasks necessary for care.

    • In-person home evaluation (for those on a ventilator, this must be completed by a respiratory therapist).

    • Training statement signed and dated by all backup family caregivers.

    • For members 18 and over and living alone, the provider must submit an annual signed and dated statement that they are aware the member resides alone, a backup caregiver does not live in the residence, and feels this is a safe plan of care.

  2. The VNS Health MLTC Care Team coordinates these services. For questions or concerns, contact the VNS Health MLTC Care Team at (888) 867-6555 (TTY 711), 9 am - 5 pm, Monday - Friday, or use the Send Us a Message form.

Availability
Ongoing, as ordered and authorized
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Private duty nurses (PDNs) provide long-term, comprehensive hourly nursing care in a patient's home or other non-traditional health care settings (for example, when traveling). They are either registered nurses (RNs) or licensed practical nurses (LPNs) who practice under the supervision of an RN clinical supervisor.

Private duty nursing is often paid for by the person receiving care, though many state Medicaid plans also pay for continuous skilled nursing services in the home.

Private duty nurses provide long-term, comprehensive hourly nursing care and are skilled in managing medical tasks, equipment, and technology. They will be in the home anywhere from 4 to 24 hours per day. Private duty nursing is also sometimes referred to as continuous skilled nursing or block shift nursing.

Private duty nursing differs from professional home health care. Professional home health care is:

Private duty nursing services are nursing services for those who require more individual and continuous skilled nursing care than is available from a home health agency. The intention of PDN services is to support – not replace – the skilled care provided to a member by family and other responsible caregivers.  Private duty nursing services are not for non-skilled tasks such as, but not limited to, turning and positioning, ambulation, transferring, bathing, toileting, oral feeding, dressing, and household chores.

Private duty nursing is continuous and customizable to meet changing and ongoing needs and is not necessarily beholden to specified goals or time limits (though care needs do have to be apparent).

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