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The Private Duty Nursing (PDN) program provides skilled nursing services on a continuous basis to Health First Colorado members in their place of residence. A plan of care as ordered by the attending physician is developed by the Home Health agency. The plan of care is reviewed periodically by the physician.
Announcement - PDN Feedback Request
HCPF is seeking stakeholder feedback on suggested clarification of the definition of Private Duty Nursing (PDN). This regulatory clarification is intended to provide guidance about the frequency of nursing tasks for interventions that would be provided during the provision of PDN services. Once approved, this policy clarification will be posted on the PDN website and will also be included in a memo that will outline this updated information.
Clarification of the PDN definition is as follows:
- “Private Duty Nursing (PDN) is a direct skilled nursing service that is more continuous and individualized than care that can be safely managed within the timeframe of intermittent home health nursing visits and is beyond the scope of a certified nursing assistant. These nursing services include assessment, judgment to determine if a nursing intervention is needed and requires the specialized knowledge and skills of a Registered Nurse (RN) or Licensed Practical Nurse (LPN) more than intermittent nursing which can occur every 2.5 hours. These services are routinely provided by the equivalent nursing staff of a hospital or skilled nursing facility, and allows a member to maintain their current health status or prevents and/or delays the deterioration of a member’s condition.”
Submit your feedback on this provided clarification by email to homehealth@state.co.us by May 1, 2025.
Who Qualifies?
Health First Colorado Members who*:
- Require continuous skilled nursing services and meet medical necessity and criteria
- Are not residing in a nursing facility or hospital at the time PDN services are delivered
- Are technology dependent
- Have a care plan developed by their physician
- Are able to be safely served in their home by a home health agency under the agency requirements and limitations of the PDN benefit and with the staff services available
* = Not an exhaustive list for eligibility
Benefits and Services
- Skilled Nursing Services (provided by a Registered Nurse or Licensed Practical Nurse)
- All Private Duty Nursing services must be prior authorized
Stakeholder Engagement Opportunities
Policy Team Office Hours
Office Hours Question and Answer Log
- Office Hours occur on the second Tuesday of each month from 1 to 2 p.m.
Join via Google Meet
Join via Phone: 1-321-430-0021 PIN: 928 613 877#- These meetings will be held for training and technical assistance and will be hosted by HCPF policy staff.
- These meetings will be an open forum for questions and information sharing.
- Stakeholders can submit questions or topics for discussion before the meeting via email to homehealth@state.co.us or submit them through the live queue.
- View the meeting calendar on the Office of Community Living Stakeholder Engagement Page
- Submit questions/topics of discussion via the Stakeholder Engagement Interest Form
Quarterly Home Health and PDN Newsletter
- View newsletters on Home Health Page
- Sign up to receive newsletters via the Stakeholder Engagement Interest Form
- Topics will include an overview of meetings held during the previous quarter, a summary of progress from workgroups, education and training topics, collaborative topics with CDPHE, program reminders, and notices of upcoming events.
PDN Rule Revision Meetings
March 18, 2025 - PDN Rule Update for Nurse Assessor
This meeting reviewed updates to the Private Duty Nursing (PDN) rule language to include the Nurse Assessor program and Skilled Care Acuity Assessment.
July 2, 2024 - PDN Rule Revision Training
- Presentation
- PDN Rule Revision Crosswalk
- PDN Utilization Management Process Flow
- Webinar Recording
- 8.540 PDN Rule Revision - June 30, 2024
- Listening Log - Updated February 16, 2024
January 11, 2024
For meeting documents prior to 2024, contact HomeHealth@state.co.us
Resources
- Private Duty Nursing FAQ page
- PDN PAR Approval and Denial Rates - January 2025
- Community Providers in a School Setting Letter - May 3, 2024
- PAR Step Down Process - April 2023
- Informational Memo - IM 23-009 - PDN PAR Update for Members, Families, and Advocates - March 17, 2023
- Informational Memo - IM 23-010 - PDN PAR Update for Providers - March 17, 2023
- Private Duty Nursing Regulations 10 CCR 2505-10 8.540
- Private Duty Nursing Billing Manual
- Colorado PAR Program
- PDN Acuity Tool
Contacts
Email: HomeHealth@state.co.us