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Private Duty Nursing (PDN) Services

Date: 12/07/23

Fort Lauderdale, Florida

Private Duty Nursing (PDN) is a covered benefit that provides skilled nursing services from home health providers for Sunshine Health Medicaid (MMA), Child Welfare Specialty Plan (CWSP), Serious Mental Illness (SMI), Children’s Medical Services (CMS) Health Plan, Long Term Care (LTC), Wellcare Medicare, and Ambetter Marketplace members under the age of 21 with complex medical needs. These services are covered up to 24 hours per day.

We rely on our diverse network of providers, who offer different levels of nursing care within all regions, to ensure members with complex needs have services available around the clock. We value all providers in our network and work hard to identify needed services for our members to ensure there are no gaps in care and members have access to timely and appropriate care. We want patients and their caregivers to feel empowered to determine what provider is authorized to service their child’s in-home care needs.

We encourage all discharge planners to conduct widespread exploration of available providers to obtain needed PDN. Should a participating provider not have available staffing to meet a member’s needs, Sunshine Health will seek to secure a single-case agreement (SCA) arrangement with a provider outside of the network who is able to offer immediate access to services to ensure timely discharge. 

In addition to statewide agencies, such as Maxim and Aveanna, we partner with many qualified home health providers of all sizes across the state for PDN services and to ensure members have access to care. 

We encourage discharge planners to access our public Find A Provider tool to search for all available and participating PDN providers in our network. Please ensure to bookmark this page.

Submitting Authorization Requests:

If you need assistance in identifying appropriate PDN providers for a member’s individual healthcare needs within any geographic area:

  • For after-hours support, contact our 24/7 Nurse Advice Line at 1-866-796-0530 (TTY 1-800-955-8770). It’s available to members and their caregivers to report critical incidents, report a missed visit, or seek after hours assistance. It’s also a very resourceful tool and beneficial for you as our providers. If you’re experiencing any staffing challenges, please do not hesitate to notify the 24/7 Nurse Advice Line. 
  • PDN member escalations can be sent to PDN_Escalation@SunshineHealth.com. Include the patient’s name, Medicaid ID number, name of home health provider, the date and time of the shift missed, and the parents’ contact information.

Thank you for being a Sunshine Health provider. We appreciate your assistance in ensuring our members receive the best care.

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