Or Maybe...your current Home Health company is unable to provide 100% coverage for your Private Duty Nursing...NOW WHAT?
Medicaid does not have preferred providers for PDN (Private Duty Nursing). Any agency who is willing to accept the small amount medicaid is willing to pay, is fine with medicaid.
Here is what I am currently doing to find better coverage (I was previously only getting about 3 nights per week covered). I googled home health agencies in Ogden. I wrote down their phone number and address. A few months ago I tried calling each of them. It was a lengthy process. And did not yield any success.
Medicaid told me that you just have to call each of the agencies each month and see if anyone has openings because nursing staffing can change month to month.
This time around I decided to take a different approach...I wrote a letter listing out all of the information I knew they would want to know and asked them to contact me if they were interested in providing services. I mailed it out to all of the local agencies.
As a side note...my particular Medicaid (Healthy U) is willing to do a split authorization due to the nursing shortage. This means that 2 agencies would provide services. So for example...one agency could provide night nurses Mon-Wed and another agency could provide nurses Thurs-Sun. Or whatever configuration works out. Agencies do not love doing this and some are not willing to do it at all...but some will.
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Here are the agencies in my local Ogden UT Area (at least that came up on Google)
Ivy Lane Pediatrics
115 Historic 25th St #2
Ogden UT 84401
801-774-9698
Canyon Home Care and Hospice
450 S. 900 E. #100
SLC UT 84102
801-485-6166
5478 Adams Ave Pkwy
Ogden, UT 84405
801-392-8880
72 W. Gentile
Layton UT 84041
801-294-8600
Harmony
5650 S. Green St.
Murray UT 84123
801-264-8000
Bright Star
5320 S. 900 E. #280
SLC UT 84117
801-559-3999
Salus
7001 900 E. # 300
Midvale UT 84047
801-352-7358
1496 E. 5600 S. Unit 6
South Ogden UT 84403
801-479-7026
Here is the letter I sent to each company, we will see how it works...
3/27/18
Dear Home Health Company,
I am looking for new Night-time Private Duty Nursing for my
16 YO daughter. Do you meet the
following criteria?
Offer pediatric PDN services?
Offer services in Ogden?
Have nurses available to meet night-time shifts/or can hire
new nurses?
Willing to take payment from Medicaid Healthy U for PDN
services?
If you answered yes to those 4 questions, keep reading to
see if we will be a good match.
Hours
We qualify for 8 hours of night-time private duty nursing
per night on the acquity grid paid for by Medicaid Healthy U
These hours can be an LPN or an RN
Sun, Mon, Tues, Fri, Sat would be 8 PM-4 AM
Wed would be 8:45 PM-4:45 AM
Thur would be 8:30 PM-4:30 AM
Hours could be tweaked slightly if nurses have different
needs
Location
We live in Ogden
My daughter _________ is almost _______ years old.
She weighs 60 lbs.
Medical Needs
We do not have a lift in the home…we will within a few
years…when we remodel our bathroom.
So nurses need to be capable of lifting 60 lbs. Such as from her elevated “sleep safe” bed to
her wheelchair or from the bed into the elevated bath chair.
She has a G-tube and is on continuous feeds with a feeding
pump.
She gets meds by G-tube.
She would be cathed twice on the night shift.
She wears braces on arms and legs at night.
She gets multiple breathing treatments and suctioning before
bed.
She uses bi-pap and oxygen during the night
Her temperature needs to be monitored due to dysautonomia.
She needs to be bathed in the shower several times per week.
She requires diapering
She gets enemas
She needs range of motion stretching done
She needs position changes to avoid pressure sores.
She is non-verbal and non-ambulatory
She cannot talk verbally, cannot sit up, cannot hold up
head, cannot roll over
Preferences
I only want female nurses
Your company needs to have pediatric clients or be currently
branching out into pediatric…they are completely different that geriatric.
We also have 1 small dog (Schnauzer mix)…in case nurses have
allergies.
Insurance
We have_________ Insurance as Primary (they will not pay anything
towards PDN)
Medicaid Healthy U is our secondary insurance. So you need to be willing to accept the
payment that Medicaid is willing to offer.
Her Medicaid number is _________________
Our PDN backstory
We have been approved for PDN since about late summer
2017. We were using _____________Home Health (since they
also provide the school nurses for my daughter). I only ever got 3 nights per week covered
with them. They were never able to hire
enough nurses to provide us with better coverage. Ivy Lane was audited by the state and were
told they needed to provide better coverage than 3 nights a week for their
clients. So Ivy Lane will be discharging
us as of Apr 14, 2018 in order to give their remaining clients better
coverage.
Please contact me if you are interested in serving us. We are also willing to do a split
authorization if necessary.
Sincerely
My Name
Me cell number (text or
voice call OK…but no messages)
My email
