Question Re Medicaid Pediatric Private Duty

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Specializes in Tele, Cardiac Stepdown, (New) Peds PD.

The home where I currently work has 5 adults living there. There are always at lease 2 adults in the home and 2 work outside the home. I care for a 10 year old. I am wondering if it is common for there to be capable caregivers in the home? My patient has 24/7 nursing care. I am wondering if any of you work in similar circumstances and if it frustrates you at times? Thanks for any input.

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Specializes in Complex pedi to LTC/SA & now a manager.

Are you feeling that 24hr/day PDN is not necessary as there are what you feel competent adult caregivers present in the home?

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Specializes in Tele, Cardiac Stepdown, (New) Peds PD.

That is a concern. He does need SOMEONE with him at all times. With all of the cut backs in healthcare in general, I worry that nursing hours could be decreased. This has not been implied in any way.

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The only problem I would have with this is if any one or more of those competent adults thought it was their duty to micromanage my job duties and ride my back. If I thought that medicaid might catch on to the situation and cut back the hours, (which is quite possible, it has happened on cases I have been on in the past), I would find another case. It never hurts to be proactive when considering one's own interests.

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Specializes in Complex pedi to LTC/SA & now a manager.

There is always a risk that Medicaid could reduce hours without notice if the case is audited but this is true for any case. Is it trach-vent or basic care? Is CPS involved in any way? Are any of the adults related to the child? Are you certain they are competent care givers? Plenty of adults can barely care for themselves never mind a complex kiddo.

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Specializes in Tele, Cardiac Stepdown, (New) Peds PD.

He doesn't have a vent. Mom and grandma are there the most. They have an in home day care that grandma mostly does. They don't micro manage as much now that they are comfortable with me. Meds and suctioning are pretty frequent. CPS is not involved. Maybe I used "competent" a little loosely. :-)

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

One of my cases involves a teenaged boy who is on a vent and must be cathed Q4H. He has three adult siblings living in the home in addition to the two parents who are authorized as "able to report off to / leave in the care of".

However, for the sake of the patient's dignity (he is completely A&O and age appropriate), the parents chose to have the siblings only involved in his care on portions of his body outside of areas covered by a bathing suit. This requires some creative scheduling from time to time, making sure that a parent or a nurse will be in the home at the scheduled cathing times.

So while there are competent caregivers in the home as far as trach/vent/suctioning/transfers are concerned, there is still a need to have a nurse (or one of the two parents) in the home Q4H.

Granted, it doesn't sound like the case in the OP's situation, but another example of how "competent caregivers" can mean different things to different people.

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