Nursing question...

drct1245 · #1 10-02-2007, 10:50 PM

I know this question will vary by state, insurance, etc... but just wondering for those of you who have had kids on vents and have been able to ween them, when did they "take away" your day nursing. With Ayden off the vent 8 1/2-9 hrs a day, I am afraid of taking him off all day long because someone will say that he doesn't require skilled nursing the 18 hrs/day we have been given from my insurance and Medicaid. Mind you we only receive 10 hrs w/ 1 night nurse every other week or so. He is still on CPAP/vent at night, so that would qualify him for the night, but with the winter coming up, there is NO way that we would even consider putting him in a medical daycare and we would be taking out a 2nd mortgage to afford day nursing for the winter.

I don't think this would happen, BUT... got think about it.
What is your guy's experience??? Should I be worried??
thanks in advance

Ariana'sMom · #2 10-02-2007, 10:55 PM

with me i have always been able to chose when in the day i want my nursing. so if i dont want days and i want nights they try to get that for me. but as far as when the nursins hours went down it has only happened once so far when she lowered her amount of hors on the vent and then they only did that when they did her recert. with medicaid. right now we are at 84 hours a week untill Jan. 1 because they did a 6 month recert and they dont need to put in any paper wark until then so even with her off the vent completely she is still going to recieve 84 hours. i think it is up your nursing company and medicaid or what you go through. hope i helped

alizesmom · #3 10-03-2007, 12:13 AM

We live in PA and adopted Alize from fostering. He has a trach and multiple other problems but is not on a vent. We have been getting 18hrs a day. Just today our weekend hours were cut back a very small amount (from 18 to 12). I can't explain why we've been lucky, whether it is the fact that he came already in the system or whether it's because of his other problems. Karen

LeslieML · #4 10-03-2007, 07:29 AM

While Chase was vented 24/7 we only received 10 hours a day of nursing. we used it while we worked and dealt with the nights ourselves. We had hours on Saturday and Sunday but chose not to use them all the time. we enjoyed family hours.
When he was weaned off the vent until just at night same same. 10 hours while we worked.
3 days after the trache came out our nursing was stopped.
I feel it's not a vented issue but a trached issue.

Whitney · #5 10-03-2007, 09:31 AM

We live in Colorado and have insurance/medicaid. Aetna provided 16 hours per day of nursing when Alex was on CPAP (same for vents). When he weaned entirely off CPAP, they cut him to 12 hours per day. Medicaid approved him for 12 hours of nursing likewise (CPAP free). During his CPAP weaning, we maintained the 16 hours of nursing. Aetna tried to eliminate the nursing during the wean, but our doc got them to approve the nursing. We could divide the hours however we wanted (we had late-night and day nursing once we went to 12 hours a day).

elijah'smom · #6 10-03-2007, 10:22 AM

Here in Ohio we have the wavier program for skilled nursing care. Our private insurance paid for nursing 84 hours a week for the first month until the waiver took effect. With the waiver we get 96 hours a week nursing. That number has not changed since Elijah has been vent free. Hope all goes well insurance companies can be a battle.

Louise D · #7 10-03-2007, 10:54 AM

We live in calif. We get 40 hrs of skilled care (LVN or RN) a week. We only have a trach, no vent. Its through medical, our problem was finding an agency to take medical AND children.

Louise

drct1245 · #8 10-03-2007, 10:41 PM

OK, it gives me a little relief that there are people w/ trachs and no vents w/ nursing... The person who knew the most had left the agency just after we started and I always felt that they weren't quite w/ it. I thought that there was a recert done every 6 months, but that's how much they don't tell me exactly what's going on!
Thanks again!!!!

Mom2TwinsPlus1 · #9 10-04-2007, 09:53 AM

We were told once our weaning was done (if we ever get to wean) we would lose all nursing. We are recert. every 6 months and once weaning starts they told me that may go to every 3 months. Before the vent, when it was just the trach we qualifed for no nursing, so its not a big shock to me that once its gone so is my nurse

drct1245 · #10 10-04-2007, 04:04 PM

Our agency just called me and I just found out our recert is done every 60 days!!! ??? WOW hu? Right now I said we HAVE to have a consistent night nurse at least once a week for when we are weening Ayden at night. Medicaid rep asked her why and how much nursing are we getting right now. We are approved for 112 hrs a week and we only have 50-60, max of 70. That will be a fun one to explain.

I also express our concern for Ayden & the winter. How I don't want to lose night nursing, etc. They can't give me an answer, but from the sounds of it, when he is weened, we won't have acess to paid nursing.