NNHC Skilled Home Nursing
Private Duty Nursing at Home
Extended one-on-one RN or LPN support for individuals with complex health needs who require more continuous skilled nursing than intermittent visits can provide.
What Private Duty Nursing Means
PDN is designed for clients whose care requires substantial, ongoing skilled nursing in the home.
North Carolina Medicaid describes PDN as special, ongoing skilled nursing at home for people with complex health needs who require more individual and continuous care than a visiting nurse can provide. South Carolina Medicaid also maintains home-based private duty nursing services. NNHC reviews each referral against the current orders, payer requirements, nursing competencies, staffing needs, and service area before accepting the case.
Examples of Complex Care Needs
The actual interventions are based on the individual’s current orders and plan of care.
Tracheostomy & Ventilator Support
Airway care, ventilator support, suctioning, monitoring, and emergency-plan implementation by appropriately trained nurses.
Enteral Feeding & Hydration
Tube feeding, water flushes, medication administration through enteral access, and aspiration precautions under current orders.
Seizure Management
Observation, documentation, ordered rescue protocols, and device-related care such as VNS instructions when included in the plan.
Medication Administration
Scheduled and PRN medication administration under valid orders and within nursing scope of practice.
Clinical Monitoring
Ongoing assessment, documentation, change-of-condition recognition, and communication with the authorized care team.
Other Skilled Interventions
Additional nursing interventions may be considered when ordered, clinically appropriate, and within NNHC’s capabilities and staff competencies.
Family Caregivers Remain Part of the Plan
Private duty nursing supplements—not replaces—the overall care system around the client.
Consistency Matters
Medication schedules, feeding plans, seizure action plans, respiratory instructions, positioning, equipment settings, and emergency procedures should remain consistent across family caregivers and nursing shifts.
Backup Planning Matters
Families should maintain current emergency contacts, DME information, medication lists, backup-power plans when relevant, and clear instructions for what to do if scheduled nursing coverage changes unexpectedly.
Payer & Authorization Considerations
PDN is a high-acuity service and usually requires more documentation and review than routine home care.
NC Medicaid
NC Medicaid PDN requires program eligibility and prior approval under the applicable PDN policy and authorization process.
SC Medicaid
South Carolina maintains state-plan and waiver-related home-based nursing pathways; the applicable program and authorization depend on the member’s circumstances.
VA / Other Payers
NNHC reviews VA-authorized and other referrals according to the specific authorization, clinical needs, payer rules, and staffing requirements.
Before NNHC Accepts a PDN Case
We review the full picture before promising nursing coverage.
Clinical Orders
Current orders, plan-of-care information, diagnoses, medication profile, equipment, emergency protocols, and skilled-care requirements.
Nursing Competencies
Whether appropriately trained RN/LPN staff are available for the required clinical interventions and schedule.
Authorization & Coverage
Approved hours, payer requirements, service location, start-of-care conditions, and any other referral requirements.
Related Family Resources
Families managing complex home nursing often need more than one type of support.
Request a PDN Review
Tell us the general care needs, location, payer or authorization source, and schedule being requested. Please avoid sending detailed protected health information through a general website message unless the form is specifically designated as secure.
Service notice: PDN acceptance, authorized hours, staffing, nurse skill mix, and start dates vary by client, payer, clinical requirements, location, and available qualified nurses. NNHC does not guarantee immediate coverage before referral review and acceptance.