Programs that provide medically necessary, complex skilled nursing care in the home on a fee-for service basis. Services are provided by registered nurses (RNs) or licensed practical nurses (LPNs) who are also known as licensed vocational nurses (LVNs) in some locales. The purpose of private duty nursing (PDN) is to assess, monitor and provide skilled nursing care in the home on an hourly basis; to assist in the transition of care from a more acute setting to home; and to prepare competent caregivers for assumption of this care when the condition of the individual is stabilized. The length and duration of the services is intermittent and temporary in nature and not intended to be provided on a permanent ongoing basis. Such services are normally billed at an hourly or shift rate. The private duty nurse cannot be a member of the individual's immediate family or anyone living in the home.