What Is Private Duty Nursing (PDN)?

Private Duty Nursing (PDN) refers to medically necessary, skilled care provided by state-licensed professionals—either a Registered Nurse (RN) or a Licensed Practical Nurse (LPN). In NYC, these professionals bring hospital-level interventions into the home.

A private nurse is required if the patient needs advanced monitoring or complex procedures, such as:

• Ventilator and tracheostomy management.
• IV therapy and central line maintenance.
• Advanced wound care (Stage III or IV pressure sores).
• Feeding tube (G-tube) management and complex medication administration.

What Is a Home Health Aide (HHA)?

While nurses handle medical tasks, Home Health Aides focus on the “Activities of Daily Living” (ADLs). They are the primary support system for seniors managing chronic age-related health issues in NYC who do not require constant medical intervention.

An HHA’s role is focused on comfort and safety: bathing, grooming, meal prep, and light housekeeping. Most importantly, an aide provides the safety supervision necessary for those who meet the 3-ADL requirement for Medicaid.

Key Differences: Tasks and Legal Scope

Understanding the legal boundary between Private Duty Nursing vs. Home Health Aides is critical to avoid safety risks and legal liability.

2026 Cost Comparison in NYC

Labor costs in New York City have shifted due to the NYC Wage Parity Law updates for 2026. Private pay rates for nursing are significantly higher than for aides.

Checklist: How to Decide What You Need

Answer these questions to determine the appropriate care level:

• Medical Devices: Does the patient use a ventilator or feeding tube? (If yes -> Nurse)
• Injections: Does the patient need insulin or IV medication administered? (If yes -> Nurse)
• Daily Living: Is help primarily needed for bathing, dressing, and walking? (If yes -> HHA)
• Safety: Is the goal simply to prevent falls and provide companionship? (If yes -> HHA)

Often, a “hybrid model” works best: 24/7 HHA care for daily safety, with a weekly visit from a professional nurse for medical oversight.

Insurance and Medicaid Coverage

Paying for these services in NYC requires navigating state and federal programs:

• Medicaid: The NYIA process is the main pathway to have Medicaid pay for HHAs. Medicaid also covers Private Duty Nursing for “medically fragile” individuals under specific waivers.
• Medicare: As we explain in our Medicare Truths Guide, it only covers short-term nurse visits, not long-term daily aides.

Official Forms:
• Download Physician’s M11Q Form
• Download Medicaid Application (DOH-4220)

Conclusion

In the choice between Private Duty Nursing vs. Home Health Aides, the priority must always be safety. While an HHA is a perfect solution for daily living and aging in place, a private nurse is an essential lifeline for those with complex medical needs. For many New York families, a combination of both ensures the highest quality of life at home.