Home Care Nursing Information

Pediatric Pulmonology and Sleep Medicine

Home Care Nursing Information

The following information was developed for nurses who want to explore private duty nursing and for American Family Children's Hospital families who are looking to simplify the process of hiring private duty nurses.

If you have additional questions about the process, please contact an American Family Children's Hospital Case Manager.

Terms You May Hear

Term Acronym Definition
Private Duty Nurse PDN A nurse who provides care in your home.
Prior Authorization Liaison POC Completes your child's plan of care and submits to your child's insurance provider for approval.
Plan of Care   Specific and unique directions for care of your child completed by your child’s home care PAL. This plan of care needs to be approved by Forward Health or your private insurance company to provide authorization of nursing hours. This can take up to 21 business days each time a POC is submitted.
Agency   A business where health care staff can be hired.
Agency Nurse   A nurse that is employed with an agency.
Independent Nurse   A nurse who works independently to find work, submits their own billing, etc. (not employed by an agency).
Case Manager   AFCH Case managers are members of your hospital team who will support you and answer questions throughout the process of securing home nursing.

Differences Between a Nursing Agency and Independent Home Nurse

Nursing Agency Independent Home Nurse
An agency will recruit, interview, hire and train care providers. They will also dismiss the provider, if necessary. Your family will need to interview, hire and train the care providers. You are also responsible for dismissal of the provider, if necessary.
All agency staff meet mandatory training criteria. You will be responsible for recruiting nursing staff and reaching out to providers.
Background checks are performed on all applicants. Licensing, certification, background and reference checks are your responsibility.
May be able to provider “back-up” care if the care provider is absent. There may not be a “back-up” if the independent provider is not able to work.
Oversees all care providers. Independent nursing requires one RN be a PAL (Prior Authorization Liaison) who will work on sending paperwork to the state.
Sets shift times: 4, 8, 10 or 12 hours. Care providers may have more flexibility to work partial shifts (if the worker agrees to this).
The agency will do all scheduling on your behalf. The family oversees scheduling coverage for the most part. This is something that can be discussed with the PAL (Prior authorization liaison) that is working on your child’s case.
Liability for care is covered by the agency. Liability for care is not covered by an agency.
Agencies are licensed allowing you to check performance history or any complaints filed. You family will need to complete reference checks on the care providers if desired.

Frequently Used Local Nursing Agencies

Requirements for Independent Nursing

  • Current nursing license
  • Active National Provider Identifier(NPI) number
  • CPR certification current
  • Trach/Vent course, if required. All independent nurses in Wisconsin providing care for a child using a ventilator through their trach need to complete the trach/vent class and submit documentation of attendance. This class consists of completing online learning modules with accompanying quiz and attending an in-person class.

Links for Independent Nurses

Professional Homecare Providers (PHP)
Provides support and guidance for independent homecare nurses who are members.


Forward Health
This is the agency in Wisconsin that manage healthcare providers and recipients.

Badgerland Billing
(Can provide billing assistance for independent nurses who bill for their hours worked)

UW Home Health Trach/Vent Class

  • Nurses working with a child who needs respiratory support need to complete a certification class prior to working with the child. These classes are offered in several places throughout the state.
  • Classes are held throughout the year through the UW Home Health Program.
  • Class information and registration: Melody Miller (608) 203-2273.
  • Process-registration must be completed 3 weeks prior to class date to allow time to complete online modules and quiz submission.

Home Nurse Education Resources

Private Duty Nursing Family Resources

How do I find a nurse? Some of our families have found private duty nurses through:

  • Website
  • Social media
  • Faith based communities
  • Word of mouth/friends/family

Questions for Home Nursing Agencies

Home nursing agencies all work a little differently. Each has their own set of policies and rules. Know what to expect from them. This may help you decide if you prefer using an agency or independent nurses. Some questions you may want to ask include:

  • Are nurses hired specific for my child’s case?
  • How do you recruit nurses?
  • How do you do background checks?
  • Will there be specific nurses assigned to my child’s case?
  • Will the nurses assigned to my child have pediatric nursing experience?
  • What skill level can I expect of the nurses caring for my child? Will they be RN, LPN, tracheostomy or ventilator certified?
  • Will my child be assigned a primary nurse or do the nurses rotate? If they rotate, how often?
  • Will I be able to meet the nurses before they start working with my child?
  • Expectations of nurses: Do they get breaks? Do they need to be awake when they are in our home? Are they allowed to smoke?
  • What do I need to provide for the nurses (chair, desk, TV, refrigerator)?
  • Are the nursing hours scheduled according to the needs of my child and family?
  • How much input do I have to decide what hours are scheduled? Are the shift times flexible?
  • How will I know which nurse is scheduled for the day?
  • Does your agency guarantee shift coverage?
  • What if there is a sick call? How soon will we be notified?
  • How will schedule changes be related to us?
  • What happens if a nurse isn’t a good fit for our family?
  • Will the nurse be able to come with my child to appointments?
  • Will the nurse go to events outside of our home?
  • How do your nurses communicate with each other about my child?
  • Will your company assist me in getting medical supplies and equipment?
  • How do you create a plan of care for my child?
  • How will your agency keep my family’s privacy?
  • How can I reach someone during and after business hours if I have concerns?

Tips for Skilled Home Nursing Interviews

If you decide to use independent nurses, use the interview process to make sure that those who apply have proper training. They may need to be tracheostomy and ventilator certified. Be honest about the full range of your child’s medical condition. This prepares the nurses you hire to be able to do a better job. During the interview you can choose to directly ask questions or work your questions into conversation. Here are some things to check during your interview.

  • Find out the length of commitment: How long do you think you will work here?
  • Personality traits: Can you tell me about a time when you have had a conflict in your workplace? Can you tell me about a time when you had to be creative to make a situation successful?
  • Knowledge about children with tracheostomies and ventilators: Have you ever cared for a child with a tracheostomy or ventilator?
  • Hobbies or special interests: What do you like to do in your spare time?
  • General work history: What home health nursing experience do you have? What nursing experience do you have? Make sure they are qualified:
  • Do you have a tracheostomy and ventilator certification?
  • Do you have any other certifications that will help you in your job? References: • Do you have any references from previous jobs?
  • What is their contact information?


  • See if the nurse applying for the job shows up to the interview on time.
  • Watch the interaction with your child.
  • Is the nurse greeting or talking to your child?
  • Is the nurse making eye contact?
  • Do you have a gut feeling about the nurse applying to take care of your child?
  • Are this person’s values compatible with your families?
  • Is there something about this person that really bothers you, but are not quite sure what it is?

Professional Homecare Providers (PHP)

This organization has a job board for families needing more independent nursing support. View job board 

Family Resources

Frequently Asked Questions

How long does it take for a POC to be approved?

It can take up to 21 days for the POC to be evaluated by forward health after it is submitted. If additional information is requested, the 21-day waiting period can restart each time additional information is submitted.

Why can’t I obtain home nursing until the POC is approved?

Home nurses are not able to receive payment for their services until after the date the POC has been submitted. If nurses would work before the POC is approved there is a possibility they would not receive payment for the hours. For this reason, most nurses will not begin to work until after approval is granted.

How do I complete a background check?

Background checks can be obtained by searching the Wisconsin Circuit Court Access website at https://wcca.wicourts.gov/case.html

How can I check if a nurse is licensed?

Nursing Licenses can be verified by going to the Wisconsin Department of Safety and Professional Services Credential/Licensing Search website at https://app.wi.gov/licensesearch