NC Medicaid realizes the North Carolina nursing shortage continues to impact beneficiaries receiving Private Duty Nursing (PDN) services. The following guidance applies to NC Medicaid Direct.
Please see the following policy guidance on how to best serve beneficiaries who have not received nursing services for 30 consecutive days:
- Per NC Medicaid Clinical Coverage Policies 3G-1 and 3G-2; Section 5.2.4.1 “if no PDN services are provided during 30 consecutive days for any reason including hospitalization, then the prior approval process shall be initiated again as outlined in Subsection 5.1 and 5.2”
- PDN beneficiaries are not terminated or discharged from PDN services because of the inability to obtain nursing staff. The process indicated in the policy is for providers to submit a new prior approval once staffing is secured.
Best practices for providers to support families impacted by the nursing shortage:
- Explore other state plan services that may be available to support beneficiaries to bridge the gap until a nurse can be secured.
- Provide outreach to other agencies for care coordination.
- Provide education to staff regarding PDN policy.