General information, not medical advice
Families in Minnesota run into a vocabulary problem early: the hospital says 'private duty nursing', the county says 'home care nursing', the insurance letter says 'extended hours home care', and a federal regulation says something else again. Here is how the pieces fit together.
Private duty nursing and home care nursing are the same service
Within Minnesota Health Care Programs, the service historically called private duty nursing (PDN) is now called home care nursing (HCN). Materials from Minnesota health plans describe HCN as the service 'formerly known as Private Duty Nursing'. The federal regulation that underpins it, 42 CFR 440.80, still uses the older phrase, which is part of why both terms remain in circulation.
For a family, the practical takeaway is simple: if you are told your child or family member may be eligible for home care nursing, that is the extended-hour skilled nursing described throughout this website.
Two kinds of home care license in Minnesota
The Minnesota Department of Health (MDH) licenses home care providers under Minnesota Statutes, chapter 144A. There are two license types, and which one an agency holds tells you what it is permitted to provide:
- A basic home care license covers non-medical services — assistance with daily living, homemaking and similar support.
- A comprehensive home care license covers skilled services, including nursing provided by licensed nurses.
A provider may also hold a Home and Community-Based Services designation alongside a license. MDH's rules also require comprehensive applicants to have policies providing for an in-person initial assessment by a registered nurse or other appropriate licensed health professional.
Check a provider's license yourself
How nursing hours get authorized
Under Minnesota Health Care Programs, home care nursing requires an order from a physician, advanced practice registered nurse or physician assistant before services begin, and the services require prior authorization. An assessment is completed as part of the request using the state's home care nursing assessment process.
The payer — not the agency — decides how many hours are approved. An agency can describe the process, provide clinical documentation when it is part of the care team, and tell you what it can realistically staff. It cannot approve hours, and it should not predict an approval for you.
If the payer is commercial insurance
Commercial plans run their own utilization review with their own forms, criteria and timelines. Some use the phrase 'extended hours home care'. The underlying sequence is usually similar: a provider order, a clinical review, an authorization with a defined number of hours and an end date, then periodic re-review.
Related Minnesota programs families often encounter
Nursing is one piece of a larger landscape. Depending on the situation, families may also be assessed for personal care assistance or its successor program, home and community-based services waivers, or care coordination through a county or health plan. These are separate from nursing and are assessed separately — a county assessment for one does not approve another.
This is general information
Official sources
Program rules change. Check the current guidance directly:
- Minnesota Department of Health — Home Care Provider Regulation (opens in a new tab)
- MDH — Starting a Home Care Agency (license types) (opens in a new tab)
- Minnesota DHS — Home Care Nursing (HCN) Services, MHCP Provider Manual (opens in a new tab)
- Minnesota Rules 9505.0360 — Home Care Nursing Services (opens in a new tab)
- Minnesota Board of Nursing — Nurse Practice Act (opens in a new tab)