42 C.F.R. § 440.80
Private duty nursing services
Private duty nursing services means nursing services for beneficiaries who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing staff of the hospital or skilled nursing facility. These services are provided—
(a) By a registered nurse or a licensed practical nurse;
(b) Under the direction of the beneficiary's physician; and
(c) To a beneficiary in one or more of the following locations at the option of the State—
(1) His or her own home;
(2) A hospital; or
(3) A skilled nursing facility.
Notes of Decisions
Cited in 15
cases (4 in the last 5 years), 1989–2024 · leading case: Moore Ex Rel. Moore v. Reese, 637 F.3d 1220 (11th Cir. 2011).
Moore Ex Rel. Moore v. Reese, 637 F.3d 1220 (11th Cir. 2011). “” 42 C.F.R. § 440.80 . Since 2002, DCH has employed the Georgia Pediatric Program (“GAPP”) as its service-delivery model for providing nursing care in the home to medically fragile children with multiple systems diagnoses, such as Moore.”
Donna Radaszewski, Guardian, on Behalf of Eric Radaszewski v. Barry S. Maram, Dir., Illinois Dep't of Pub. Aid, 383 F.3d 599 (7th Cir. 2004). ““Private-duty nursing,” defined as nursing services provided to a person who requires more individualized and continuous care than would routinely be provided by a visiting nurse or by the nursing staff of a hospital or skilled nursing facility, 42 C.F.R. § 440.80 , is one of…”
Raleigh Spizman v. BCBSM, Inc., 855 F.3d 924 (8th Cir. 2017). “” 42 C.F.R. § 440.80 . Providing Raleigh round-the-clock in-home nursing care is nursing “for a single patient .”
Skubel v. Sullivan, 925 F. Supp. 930 (D. Conn. 1996). “42 C.F.R. § 440.80 . II. Undisputed Material Facts The following material facts are acknowledged as true by all parties.”
Detsel v. Sullivan, 895 F.2d 58 (2d Cir. 1990). “22 The regulations at 42 CFR 440.80(c) limit the provision of private duty nursing services "to a recipient in his own home or in a hospital or skilled nursing facility".”
Moore Ex Rel. Moore v. Medows, 563 F. Supp. 2d 1354 (N.D. Ga. 2008). “” 42 C.F.R. § 440.80 . These services are provided by a registered nurse or nurse practitioner under the direction of the recipient's physician at either the recipient’s home, a hospital, or a skilled nursing facility.”
Moore v. Medows, 674 F. Supp. 2d 1366 (N.D. Ga. 2009). “" 42 C.F.R. § 440.80 . These services are provided by a registered nurse or nurse practitioner under the direction of the recipient’s physician at either the recipient’s home, a hospital, or a skilled nursing facility.”
Detsel ex rel. Detsel v. Sullivan, 895 F.2d 58 (2d Cir. 1990). “According to the Secretary of Health and Human Services, denial is compelled by 42 C.F.R. § 440.80 , the Medicaid regulation that defines “private duty nursing services”.”
In the Matter of Sulerzyski (Md. Ct. Spec. App. 2023). “” 42 C.F.R. § 440.80 . FACTUAL AND PROCEDURAL BACKGROUND The underlying facts are essentially undisputed.”
Moore v. Reese (11th Cir. 2011). “” 42 C.F.R. § 440.80 . Since 2002, DCH has employed the Georgia Pediatric Program (“GAPP”) as its service-delivery model for providing nursing care in the home to medically fragile children with multiple systems diagnoses, such as Moore.”
M.H. v. Comm'r, Georgia Dept. of Cmty. Health, 111 F.4th 1301 (11th Cir. 2024). “” 42 C.F.R. § 440.80 . The pa- tients argue that the Department’s policy unlawfully denies them the private nursing services to which they are entitled under the Act and substitutes those services with skilled tasks performed by their caregivers.”
Waclawski v. Axelrod, 151 A.D.2d 977 (N.Y. App. Div. 1989). “) require that private-duty nursing services are limited to such services provided "[t]o a recipient in one or more of the following locations at the option of the State— "(1) His or her own home; "(2) A hospital; or "(3) A skilled nursing facility” (42 CFR 440.80 [c]). The…”
— 42 C.F.R. § 440.80(c) — 2 cases
Detsel v. Sullivan, 895 F.2d 58 (2d Cir. 1990). “22 The regulations at 42 CFR 440.80(c) limit the provision of private duty nursing services "to a recipient in his own home or in a hospital or skilled nursing facility".”
Detsel ex rel. Detsel v. Sullivan, 895 F.2d 58 (2d Cir. 1990). “According to the Secretary of Health and Human Services, denial is compelled by 42 C.F.R. § 440.80 , the Medicaid regulation that defines “private duty nursing services”.”
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