Step by Step
At Professional Pediatric Home Care, we know that every child is unique and we specialize in providing individualized care to meet your specific needs. However, we understand how difficult it is sometimes to determine if your child needs additional support from professionals. We have provided a quick check list to help you begin the process. Feel free to contact us with any questions or to help you in navigating the initial process. We are here to help!
Starting nursing care in the home
Many of our referrals for private duty nursing care come from hospitals or doctor’s offices. However, we can also start care in the home with the child already at home.
Your child may qualify for private duty nursing services at home or to go to school if:
- The child has a tracheostomy and/or is ventilator dependent
- The child receives continuous nutritional feeds through a G-tube or NG tube.
- The child receives intravenous nutrition.
- The child is oxygen dependent and has documented needs for oxygen therapy.
- The child has complex medical needs such as frequent seizures.
The Director of Nursing will review the case, speak to the medical team involved, and meet the family to ensure that the case is appropriate for home care. She will take all applicable information such as a detailed history, insurance information, medications, and learn about the child’s needs. We like to get to know your family so we can match you with nurses that will be a “fit” for your home care needs.
Our agency will investigate insurance benefits for nursing and let you know if there are any family responsibilities. Most of our nursing cases receive majority funding from Medicaid, and we will complete the Medicaid Private Duty Nursing Application and request the appropriate number of nursing hours based on the child’s medical needs, the family’s needs, and the physician’s orders. We regularly check eligibility and will alert you to any issues related to insurance coverage.
Starting therapy care in the home
Remember that you are your child’s best advocate and know your child best. Discuss any concerns you might have about your child’s development with your pediatrician.
If your physician presents a formal diagnosis for your child, ask if your child could benefit from help through a physical, occupational, or speech therapist.
Ask your pediatrician for a referral to Professional Pediatric Home Care for an evaluation.
Remember that a “diagnosis” does not mean a life-long disability or problem. Many children with delays in development can easily catch up with the right treatment.
If your child is facing more permanent disabilities, we will work with you and your child to achieve full potential. Early identification and treatment are very important.
If you already know your child has a diagnosis, you can self-refer by completing the patient referral information on our website. We will contact you and make contact with your pediatrician on your behalf.
- One of our Nurse Case Supervisors will be assigned to your case and assist with starting nursing services in the home. This nurse will complete an initial comprehensive assessment and assist with developing a plan of treatment for nursing care with your input and your physician’s authorization. We customize each plan of treatment specific to each child. Consent forms are usually reviewed with you and signed at this point.
- We match nurses with your case based on availability, location, required skills, and family needs and requests.
- Each nurse receives a supervised orientation to your child’s care with your input. The Nurse Case Supervisors assist with ensuring everything starts and continues smoothly.
Nursing at Home
- Whether going from hospital to home or starting care already at home, the nursing staff helps you ensure the home environment is safe and all necessary equipment and supplies are available before starting care.
- A plan of care document (called a “485”) is designed upon admission and then revised every 60 days during a home care episode. This plan of care is sent to your child’s doctor for signature and includes all appropriate medications, treatments, procedures, and care that the nurse will provide for your child. Input and frequencies from therapists, if applicable, is also included in this plan of treatment. The current plan of treatment must always be available in the child’s home chart.
- Nurses complete a daily note and document all cares provided each time they work a shift with your child. The documents will be kept in your home and sent to the office every two weeks for quality review and billing purposes
- Your primary nurse will arrange for a case conference at least every 6 months. This is an interdisciplinary meeting in the home where all nurses, therapists, and the family are invited to discuss the child’s progress and goals.
- PPHC is here to support your needs and ensure optimal home care for your child. Please feel free to contact the Director of Nursing or your assigned Nurse Case Supervisor if you need to identify ways we can provide better service, have concerns about any of the staff, or have any questions at all. Our doors and ears are always open!
Discharge from Nursing Services
- Discharge usually takes place when the goals for the patient are met. This could mean that the child no longer needs oxygen therapy, has their tracheostomy removed, or progresses to oral feeds.
- We will communicate with you throughout the process and let you know well in advance what the plans for discharge are. Your child’s physician, your family, and the entire nursing staff are included in this process. Our agency understands that sometimes discharge from nursing is a big transition and we are here to support you through the process and feel prepared.
- We are happy to research your insurance benefit prior to setting up services and let you know of any patient financial responsibilities. Our agency works with Colorado Medicaid and most major private insurance companies.
- Staffing your case depends on your time availability for scheduling visits and your location. Flexibility on your behalf usually expedites the process. Our staff works hard to match highly qualified therapists with families, and we will let you know if there are any delays in starting services related to therapist availability.
- Once a therapist is assigned to your case, that therapist will contact you directly to schedule an evaluation and subsequent visits as indicated. Please honor all appointments and provide a minimum of 24-48 hours if you need to cancel or reschedule.
- Our agency will maintain communication with your child’s doctor regarding plan of treatment, progress of the child, and obtaining all appropriate authorizations for services.
Starting and Receiving Therapy at Home
- The patient consent packet will be reviewed and you will be asked to sign a few forms.
- The therapist will spend time reviewing medical information given and assessing your child. They will work with you to develop a plan of care including specific goal setting and treatment development. This is a highly interactive process with extensive family involvement.
- The therapist will complete updated assessments every 60 days and develop a progress summary, evaluation, and new goals. The therapist will set up visits with you throughout the 60-day period based upon the recommended frequency of therapy visits.
- All initial and interim evaluations are shared with your child’s doctor.
- The therapist will give the family a home exercise program to work on between visits. This is very important to your child’s progress.
- Sometimes children make great strides in progress and at times they demonstrate smaller, incremental progress. Your therapist can help with explaining your child’s current progress.
Keep in mind that circumstances such as illness or surgery can cause temporary setbacks.
Discharging from home-based therapy
- A patient is typically discharged once long term goals have been reached or when therapy can no longer result in progress.
- If a therapist does not see a child for a period of 30 days or more, they may be required to perform a discharge and re-admit the child if and when that becomes appropriate. This is often the case for prolonged hospitalizations or extended family trips.
- We will communicate any discharge information with your child’s doctor. The therapist will discuss discharge plans with you ahead of time when that seems like an appropriate course of action.