Private Duty is a term that has been used for decades and may be unclear to most consumers as it relates to home care. It is, in fact, a label that many home care providers use to describe care that lasts several hours or more.

Background

Historically, it was nurses who were hired to care for someone in a home, or an institution for one-to-one care.  Private duty nurses we often hired by wealthy families to provide constant attention and supervision, sometimes in addition to the care received in the hospital.   The caregivers were registered nurses or licensed practical nurses. 

Over time state Medicaid programs started private duty programs using nurses to care for acutely ill or fragile individuals in the home.  Most frequently these patients were disabled children with very skilled needs.  The program for private duty nursing grew as the model of institutionalizing children in facilities fell out of favor and most of the facilities were closed.  Today private duty nursing is still provided in homes for these children. 

TODAY 

Many home care agencies offer private duty care, though they refer to private duty as any caregiver providing long-hour care.  It could be a registered nurse, a licensed practical nurse, an aide, or an unlicensed individual.  The general rule of thumb is any visit that is four hours or greater is considered private duty to a home care agency.

Some common questions are, “How do I get this type of care, and will Medicare pay for it?“

Medicare does not pay for long-hour or custodial care, which is the type of home care most frequently needed.  Individuals that qualify for Medicaid may be eligible for private duty care under certain circumstances which you would need to discuss with a home health agency.  An increasingly common payer for private duty is long-term care insurance for those lucky enough to have taken out a policy; though the largest payer of private duty care today is the patient.

We see patients with round-the-clock private duty care, individuals with four hours per day, or others with eight hours twice a week.  It varies significantly based on the patient or family’s need for support.  We call it "supportive home care" or "private duty," though either way it is the same care.