Private Duty Nursing

What is Private Duty Nursing?

Private Duty Nursing is a Medicaid State Plan service that provides in-home skilled nursing care to Medicaid clients of any age who require continuous nursing services beyond the Medicaid State Plan Home Health benefit.

The purpose of Private Duty Nursing is to provide continuous skilled nursing care for consumers with complex medical needs if the skilled care can be provided safely in the consumer’s residence.

Medicaid State Plan also provides home health services for consumers who have a medical need for part-time intermittent skilled nursing or aide care and therapies.

A consumer enrolled in the Medicaid State Plan Hospice benefit cannot access State Plan Home Health or PDN services. When a consumer elects to receive hospice care he or she agrees to waive Medicaid services that are equivalent to hospice care. Hospice election by a consumer younger than age 21 does not constitute a waiver of any rights of the child to be provided curative services related to the treatment of the child’s terminal condition.

Who is eligible to participate in Private Duty Nursing?

In order to be eligible for Private Duty Nursing services, the consumer must:

Be Medicaid eligible
Require continuous skilled nursing services, and
Have a comparable institutional level of care.

What are Home Health Services and how are they different from Private Duty Nursing Services?

Home Health Services are Medicaid State Plan services that are provided on a part-time and intermittent basis to Medicaid clients of any age. Home Health services include home health nursing, home health aide, and skilled therapies (physical therapy, occupational therapy, and speech-language pathology).

Private Duty Nursing Services are Medicaid State Plan skilled nursing services that are provided on a continuous basis to Medicaid clients of any age in their home.

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