Can a nurse come to the house under the Georgia waiver?
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Yes. Intermittent skilled nursing is a service in Georgia's EDWP waiver. A licensed nurse visits the home to carry out tasks that need clinical training, such as wound care, injections or monitoring a condition. It is visit-based rather than continuous, and it goes into the care plan after an assessment.
What it is
A licensed nurse comes to the home on a schedule to carry out tasks that legally and practically require clinical training. The word that matters is intermittent: these are visits, not a nurse in the house.
Typical reasons a nurse is in a plan include wound care and dressing changes, injections, catheter or ostomy care, monitoring a condition that is unstable, teaching a family caregiver how to do something safely, and assessing whether what is happening clinically matches what the plan assumes.
Who it is for
A waiver member with a clinical need that a personal support worker cannot lawfully meet. That is the whole test. Personal support covers bathing, dressing, meals and moving safely. The moment the task requires a nurse, it is a different service with a different provider.
It is also for households where a family member is being asked to do something clinical. Teaching a daughter to manage her father’s wound care properly, and checking that it is going well, is a legitimate use of nursing visits and it is worth asking for rather than working it out from a leaflet.
How it gets into a care plan
The clinical picture comes in on the DMA-6 and through the assessment. Where skilled nursing is needed, the case manager writes it into the plan of care, which is approved by the member’s physician or by the case management agency’s medical director under General Services §602.11. The member chooses among the provider agencies available in their area, and that agency employs the nurse who visits.
Because clinical needs change quickly, this is a service that often triggers a plan review. A wound that is not healing, or a condition that has become unstable, is something the case manager should hear about promptly.
What it does not cover
- It is not continuous or overnight nursing. Visits are scheduled and task-based.
- It is not emergency care. If something is acutely wrong, that is a call to emergency services or the member’s physician, not a wait for the next visit.
- It is not the doctor. Nursing visits do not replace medical appointments or prescribing.
- It is not personal care. A nurse visiting for wound care is not there to give someone a shower. Both can be in the plan, and generally both should be if both are needed.
Questions people ask about this
Is this the same as home health after a hospital stay?
No, though they look alike. Short courses of skilled care after a hospital stay are usually paid by Medicare and are time-limited and recovery-focused. Waiver skilled nursing is part of an ongoing plan for someone living at home long term. A person can have had one and still need the other.
Will a nurse stay all day?
No. The service is intermittent, meaning scheduled visits for specific clinical tasks. Continuous nursing at home is a different level of service and is not what this covers.
Can the nurse manage my mother's medications?
Medication tasks that require a licensed nurse fall within skilled nursing, and what exactly is authorized comes from the assessment and the plan. Reminders and support are a personal support worker's role. Ask the case manager to be specific about which tasks sit where, because families are often surprised by the line.
Is this the same as the case manager's visits?
No. The case manager visits to assess and review the plan. Skilled nursing visits are clinical care delivered by a nurse from a contracted provider agency. The Lead Case Manager role at a case management agency must itself be held by a Georgia-licensed registered nurse, which is a different thing again.
Related questions
- What the waiver covers The services Georgia's EDWP waiver pays for at home, from a personal support worker to home-delivered meals, and how each one gets into a care plan.
- Medicare vs Medicaid at home Medicare pays for short skilled care after an illness. Medicaid's waiver pays for ongoing help with daily life at home. A plain comparison for Georgia families.
- Personal support services Personal support services send a trained helper to the home for bathing, dressing, meals and light housekeeping. Who it is for and how it gets into a care plan.