What is Pediatric Private Duty Nursing?

Pediatric private duty nursing (PDN) is skilled nursing care provided to children from 0 - 20 years of age. It‘s for children who need individualized, continuous care, on an hourly basis and who meet predefined criteria for medical necessity. Children who need private duty nursing (PDN) at home may be dependent on a ventilator or have a trach, they may be quadriplegics, they may have brain damage, or they may have been born with a chronic disease like Cerebral Palsy. They need continued skillful observations and ongoing medical treatments. They may be on special life-sustaining equipment and need nursing support. Some children with these acute or chronic illnesses can leave the hospital earlier and stay out of the hospital or an institution if private duty nursing is available at home. Teaching may be provided to a parent, the caregiver, or to the child in an effort to teach them to provide the care the child needs to stay at home. Private duty nursing is not meant to replace a parent as the primary caregiver or to provide all the care required for the child. Instead, PDN is meant to support the care of the child living at home. Families and caregivers may choose private duty nursing because it:

- Will help them to take care of their children at home

- Can help them learn and feel comfortable taking care of their children

- Can help children learn to take care of themselves

What is Bilingual Pediatric Nurse and therapist services?

We provide pediatric therapy services by experienced professionals.


Venilator Dependency, Gastruslowly Care, Tnacheotomy Care, Cardiac Disorders, Congenital Abnormalities, Cerebral Palsy, Seizure Disorders, Catastrophic Illness or Accident


Wound Care, Weight Checks, IV Therapy, Asthma Teaching, Gastrostomy Care, Patient & Caregiver Teaching


Therapy that assists patients in improving communications and feeding skills Vital Stim, DPNS, Aspiration, Feeding, Complications, Speech Delay


Therapy that assists children to gain the functional skills they need for Fine Motor Skill Development, Independent Play and Self Care, Self Care deficits, Fine Motor Skill Delay, Lack of Socialization skills


Therapy designed to help children reach full potential in gross motor skills and functional motor skills. Delayed Crawling, Walking & Standing, Cerebral Palsy & Traumatic Injury


Autism, Spina Bifida, Hydrocephalus, Dysphagia, Feeding Disorders, Degetnerative Diseases, Developmental Delays, Traumatic Brain Injury, Neurogenetic Disorders, Broncho Pulmonary Dysplasia and Others.

Under What Program is PDN Authorized?

Private Duty Nursing is covered under the Comprehensive Care Program (CCP) which is Texas' name for the expanded portion of Texas Health Steps. CCP covers the nursing services for children ages from birth through 21 years old. The CCP program is a result of a Congressional mandate that took effect in 1990. Federal changes made in the Omnibus Reconciliation Act of 1989 (OBRA 89) expanded Medicaid services and Texas Health Steps in particular. Under OBRA 89, children 20 years old and younger are eligible for any medically necessary and appropriate health care service that is covered by Medicaid, regardless of the limitations of the state's Medicaid Program. Texas Health Steps-CCP services include benefits which were not available to children before OBRA 89. PDN is not authorized for the purpose of providing childcare, housekeeping, activities of daily living, respite, or comprehensive case management beyond the service coordination required by the Texas Nurse Practice Act.

How is a Private Duty Nursing Provider Chosen?

A consumer is free to choose a home health agency or an independent registered nurse (RN) or licensed vocational nurse (LVN) who is an enrolled Medicaid provider. But it is important to keep in mind the quality of the care the child receives and the abilities of the nurse when selecting a provider. Caring for a child with many medical needs at home is rewarding but challenging. The family, the child, the child’s physician, the nurse provider, and other people involved in the child’s care (therapists, equipment and supplies providers, as well as school nurses) should work as a team to plan for the at-home care the child will receive.

How is the Patient Serviced?

A nurse, either an RN or an LVN is stationed at the patient’s home for a predetermined number of hours each week in daily shifts. The shifts are determined by the physician, the parent, and the case manager. Patients are can be authorized as few as 30 or 40 hours a week or up to 168 (24 hours per day 7 days per week) depending on the needs of the patient.

How is the Numbers of PDN hours a Patient Will Receive Determined?

Many factors are considered in deciding how many PDN hours a child will receive. The child’s physician will provide information about specific treatment and medications the child needs. The nurse provider will help develop a plan of care for providing the nursing care. The number of hours that the child receives will be based on how often treatments need to be done, what medications need to be given, how often a nurse needs to do an assessment of the child, and how much help family members need in learning to manage the medical needs of their child.

How Many Pediatric Hours Does Serve?

Restorative Health Care (RHC) services approximately 250,000 hours of pediatric nursing every year. Restorative Health Care (RHC) is one of the largest providers of this service in South Texas.

What Roll Will Each of the Team Members Play?

The parent or caregiver has to be the decision maker for the patient and will have to provide some of the care the child needs. It is important that the parent/caregiver insure the home meets the health and safety needs of the child. The parent/caregiver should understand and follow thru with the physician’s plan of care. The caregiver should understand that the number of PDN hours may change or stop if the child’s condition changes. Finally, they should always name an alternate person who can take care of the child if the primary caregiver is unable to provide care.

The child’s physician is the primary health care provider for your child. They should work with the family, the child, and the nurse provider in planning the child’s medical care. They will need to provide a prescription for PDN services.

The nurse provider should work with the parent/caregiver and the child’s physician to develop a plan of care for the child. She should help the parent/caregiver learn the skills they will need to take care of the child. She should provide nursing care for the child according to the physician orders and keep you and the child’s physician informed about any changes in the child’s condition. She should send in appropriate paperwork for continuation of PDN services to the State. If the company is no longer able to provide PDN services or if a scheduled shift will be missed, she should notify you as such. Finally, she should support family and client independence by respecting the rules of the parent/caregiver’s household and recognize the parent/caregiver as the primary decision maker for the child.