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.
Update: April 2023
The administrative approval process has ended effective April 2, 2023 for all except a small number of members.
Review Informational Memos IM 23-009 and IM 23-010
PAR Approval and Denial Rates - December 2023
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
PDN Rule Review
- 8.540 PDN Rule Revision - Draft - February 2024
PDN Stakeholder Engagement Meetings
Listening Log - Updated February 16, 2024 - Tracks stakeholder engagement, feedback, and Department responses
January 11, 2024
- PDN Rule Review Agenda
- 8.540 Rule - Full Draft - December 2023
- 8.540 Rule - Clean Copy - December 2023
- Presentation
- Webinar Recording
October 26, 2023
- PDN Rule Review Agenda
- 8.540 Rule Draft - October 26, 2023
- Presentation
- Webinar Recording
October 3, 2023
August 31, 2023
- PDN Rule Review Agenda
- 8.540.2-5 Benefits and Eligibility Rule Draft - August 31, 2023
- Presentation
- Webinar Recording
June 29, 2023
- PDN Rule Review Agenda
- 8.540.6 Provider Requirements Draft - June 29, 2023
- Presentation
- Webinar Recording
April 27, 2023
- PDN Rule Review Agenda
- 8.540.7-8 PDN Rule Revision - Draft - April 27, 2023
- Presentation
- Webinar Recording
February 23, 2023
- PDN Rule Review Agenda
- 8.540.7.A-C PDN Rule Revision-Draft - February 2023
- 8.540 PDN Rule - Current
- Presentation
- Webinar Recording
November 10, 2022
- Webinar Recording
- Description: This information session is for members and families, it will include the content covered in the first session with additional updates from the question and answer session.
- Description: This information session is for members and families, it will include the content covered in the first session with additional updates from the question and answer session.
November 1, 2022
- Webinar Recording
- Description: This information session is geared towards families and includes an overview of recent updates to Private Duty Nursing, addressed frequent questions about the Temporary Administrative Approval process, and provides time for a question and answer period.
- Description: This information session is geared towards families and includes an overview of recent updates to Private Duty Nursing, addressed frequent questions about the Temporary Administrative Approval process, and provides time for a question and answer period.
More Information
- Private Duty Nursing FAQ page
- PAR Approval and Denial Rates - December 2023
- Medical Services Board (MSB) Questions From Stakeholders and Department Responses - Updated May 3, 2023
- 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