Hello, and welcome to another Intensive Care at Home live stream. Today’s topic is NDIS (National Disability Insurance Scheme) SDA (Specialist Disability Accommodation) for ventilated participants: why SDA is failing the most complex patients.

So welcome to today’s show. My name is Patrik Hutzel, your host of the show. We’re going for about 45 minutes to an hour, depending on how many questions you have along the way. I also want to welcome our viewers on replay, because I know we have a lot of viewers on replay as well.

Now, first of all, apologies that I couldn’t make a YouTube live last Sunday. For me, it’s Sunday morning, Melbourne time, 10:30 a.m. I had this topic scheduled for last Sunday, same time. I couldn’t make it. I had to attend to some more urgent things. That’s why I’m doing the topic today. So my apologies to anybody that was waiting last Sunday. Sometimes things happen here in real time with Intensive Care at Home that need urgent attention.

My name is Patrik Hutzel from Intensive Care at Home. Here at Intensive Care at Home, we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies at home with 24-hour critical care and intensive care nurses. We provide tailor-made solutions for long-term ventilated adults and children on BiPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure) with 24-hour critical care and intensive care nurses. We provide tailor-made solutions for adults and children with tracheostomies at home without ventilation with 24-hour intensive care and critical care registered nurses.

We provide home ventilation and tracheostomy weaning, and cough assist management, when appropriate. We provide home TPN (Total Parenteral Nutrition), home IV (intravenous) fluids, IV antibiotics, home potassium and magnesium infusions, central line, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line and port management at home, as well as nasogastric tube, nasojejunostomy tube, PEG (Percutaneous Endoscopic Gastrostomy) and PEJ (Percutaneous Endoscopic Jejunostomy) tube management at home, SPC (Suprapubic Catheter) and IDC (Indwelling Catheter) management at home, palliative care management at home, as well as Level 2 and Level 3 NDIS support coordination, as well as WorkSafe and TAC (Transport Accident Commission) case management.

Right now with Intensive Care at Home, we are operating all around Australia, in all states and territories, in all regional and rural areas and all metropolitan areas. And I know some of you are watching this in the US, in the UK, in Canada, in India, all around the world. If you want to know more about Intensive Care at Home, please reach out to us as well at intensivecareathome.com. We can help you internationally as well.

So, today’s topic is a big one: the NDIS housing crisis for ventilated and tracheostomy participants, and why SDA, which stands for Specialist Disability Accommodation, is failing the most complex patients.

And before I go on with today’s topic, you might be wondering what makes me qualified to talk about today’s topic. I have worked in critical care nursing for over 25 years in three different countries, where I worked as a nurse manager for over 5 years in intensive care. I started Intensive Care at Home here in Australia in 2012, and that’s how long we’ve been operating. I was also part of setting up Intensive Care at Home services in Germany in the early 2000s, where I was part of a pioneering service in Munich at the time, Brambring Jaschke. Big shout out to Jörg and Kristoff, who were instrumental in getting this off the ground in Germany at the time. I was part of it, and then I brought the concept to Australia in 2012. I did my nurse training in Germany, worked in ICU (Intensive Care Unit) there, worked with Intensive Care at Home, worked in the UK, worked in Australia in ICU, and then obviously started Intensive Care at Home.

As far as I’m aware, in 2026, and since 2012, we are the only nursing provider in Australia that is third-party accredited and NDIS registered for Intensive Care at Home nursing. No other provider has developed the intellectual property, the policies and the procedures to deliver Intensive Care at Home nursing. That is what my research has shown. I’m happy to stand corrected. If you have information that contradicts what I’m saying, please leave your comments in the chat. Also, if you like my videos, like the video, click the notification bell, subscribe to my channel so that you don’t miss any videos, and leave your comments and questions. All my videos are really user-generated, and I’ll create videos from the questions that you’re asking me here.

Okay. So before we dive further in: if you’ve got a loved one on a ventilator with a tracheostomy, on BiPAP or CPAP, or with a tracheostomy without ventilation, who needs ventilation weaning, tracheostomy weaning or cough assist management, and you’re being pushed towards SDA, specialist disability accommodation, or a discharge plan you’re not comfortable with, call us now at intensivecareathome.com. In Australia, call 1300 921 536, or you can call me directly on my mobile phone, 041 094 2230, or you can schedule a call with me by clicking on the schedule appointment button on our website at intensivecareathome.com, or you can simply send me an email to [email protected].

And grab our free Ventilated Participant Housing and Discharge Checklist. The link will be in the show notes and in the description. Don’t sign anything until you have gone through these 12 questions.

So, quick poll in the chat. Is your loved one currently in ICU, on a hospital ward, already at home, in an SDA, or in group living or SIL (Supported Independent Living)? Just type ICU, ward, home or SDA. Because here’s the question I keep getting from families, from NDIS support coordinators, sometimes from NDIS planners, and quite frankly from hospital discharge teams as well: “Our loved one is on a ventilator with a tracheostomy, and the NDIS is talking about specialist disability accommodation. Is that going to be safe?”

And I want to give you a really honest answer today. SDA can be a very good building. I’ve seen some beautiful high physical support apartments: wide doorways, ceiling hoists, backup power, plenty of room for the equipment. Nothing wrong with that.

But here’s the reality. A building does not manage an airway. A building doesn’t recognize a displaced tracheostomy tube at 3:00 in the morning or at 3:00 in the afternoon. A building doesn’t troubleshoot a high-pressure alarm on a ventilator, and it doesn’t suction a blocked tracheostomy tube.

So for the most complex NDIS participants, and I’m talking about three groups specifically, people on invasive ventilation with tracheostomy, people on non-invasive ventilation with BiPAP without a tracheostomy, and adults and children with a tracheostomy without a ventilator, the question that decides whether they live safely isn’t which building. The question is, who is in the room 24 hours a day? And that’s exactly what we’re going to unpack today.

Here’s the rough plan for the next 40 to 45 minutes. First, what SDA actually is, what it funds, and more importantly, what it doesn’t fund. Second, how big the housing and hospital discharge problem has become in 2026. Number three, the five reasons I believe SDA is failing ventilated and tracheostomy participants. Number four, a very sobering warning from the Noah Johnston case. Number five, what the evidence says ventilated and tracheostomy patients actually need at home. Number six, how to build your NDIS evidence. And then we will go into your questions.

So, just give me one second. I do apologize. I’ll be right back.

So, what SDA is and what it doesn’t fund. Let’s start with the basics, because a lot of families get confused here, and to be fair, a lot of professionals get confused as well. Specialist disability accommodation, or SDA, is NDIS funding for housing that’s designed for people with extreme functional impairment or very high support needs. It pays for the bricks and mortar. There are different design categories: improved livability, fully accessible, robust, and high physical support. For ventilated and tracheostomy participants, you’ll usually be talking about high physical support, because that category is designed for people with very high physical needs, and includes things like emergency power considerations and space for equipment. So far, so good. Sounds good, doesn’t it?

Now, here’s what SDA doesn’t fund. It doesn’t fund the actual care. It doesn’t fund the 24-hour registered nurse. It doesn’t fund the person who’s going to be sitting and working next to that ventilator at 3:00 in the morning or at 3:00 in the afternoon.

The nursing care inside an SDA home is funded separately, and very often it’s funded through something called supported independent living, or SIL. And SIL, in practice, is mostly a shared disability support worker model, often one worker supporting two, three, sometimes four residents, and I’ve seen up to six.

Now, I really want to be clear and very respectful here. Disability support workers do incredible, incredibly valuable work. They are the backbone of disability support in this country. And for the vast majority of NDIS participants, a disability support worker model is exactly the right model.

But there’s a category of patients, and it’s actually a very small category when you look at the NDIS in general. There are around 600,000 to 700,000 participants on the NDIS in Australia right now. Our research has shown that clients who have very complex needs and need 24-hour nursing care are roughly 1.5%, maximum 2%, of those 600,000 or 700,000 participants. So we are talking about a very small group of these participants: the ventilator-dependent patient with a tracheostomy, the patient who depends on BiPAP without a tracheostomy, the patient with a tracheostomy without ventilation, whose airway can block or displace. If they went back to hospital, they would go back to intensive care, not to a general ward. Back to ICU.

And in my clinical opinion, as a critical care registered nurse of 25 years, if the hospital equivalent is an intensive care bed, then the home equivalent needs intensive care skills, i.e., it needs Intensive Care at Home, and not a watered-down version of that. And that is exactly the gap we are talking about. A participant on a ventilator can be approved for a fantastic high physical support apartment and still end up with a care model that simply wasn’t built for someone who would otherwise be in an ICU.

So, has anyone in the chat, or anybody watching this, been told that SDA or SIL includes nursing? Type yes if you’ve heard that, because it’s a really common misunderstanding.

So let’s now look at how big this problem is in 2026. Let’s look at the numbers, because they tell you the system is under serious pressure.

First, the NDIS’s own specialist disability accommodation report for 2026 shows the number of participants actually using their SDA funding went up by about 8.4%, from 14,688 to 15,925. So the demand keeps climbing.

Second, and this one really struck me: earlier this month, in October 2026, Michael West Media published an investigation into what they described as “stranded patients.” They reported that around 1,140 NDIS participants nationally were stuck in hospital beds. In Victoria, a census in June this year found 214 NDIS participants who were clinically ready for discharge but couldn’t leave. In Queensland alone, as of August 2026, there were 319 NDIS participants stranded in hospitals, as part of a much bigger number of stranded patients overall.

Third, in September 2026, the ABC (Australian Broadcasting Corporation) reported on three men in Tasmanian hospitals who had been medically cleared to go home, who had been stuck there for between 3 and 5 months, because their requests for extra NDIS home support were knocked back.

And the Summer Foundation, big shout out to the Summer Foundation here, who have done a lot of research in this space, has found again and again that NDIS planning delays are one of the most common reasons participants stay in hospital far longer than they need to.

Now think about where a ventilated participant is stuck. It’s very often not a general hospital ward. It is an intensive care unit. In rare instances, it might be a high dependency ward or a respiratory ward. But the bottom line is, the most expensive bed in the hospital is the intensive care bed. It’s also probably the most sought-after and the scarcest bed in a hospital. Every day a ventilated participant waits in ICU for a housing decision is a day another critically ill patient may not get that bed, and a day that participant isn’t at home with their family.

I see this all the time: a young person with a spinal cord injury, a child with a neuromuscular condition, an adult with MND (Motor Neurone Disease). Medically stable on the ventilator, ready to go home, and stuck, because everyone’s waiting for a housing decision.

Let’s now look at five reasons SDA is failing ventilated and tracheostomy participants. So why is SDA failing the most complex patients? I’ve identified five reasons.

Reason number one: SDA funds the building, not the clinical skill. You can’t design out airway risk. You can’t design out intensive care risks. You can put in the widest doorways and the best backup power in the world, and make no mistake, that matters, but none of that recognizes a displaced tracheostomy at 2:00 p.m. or 2:00 a.m. Our own evidence-based Mechanical Home Ventilation Guidelines, which are best practice guidelines, and which you can find on our website under the mechanical ventilation guidelines section, are very clear. I’ll put the link in the show notes and in the transcript. Mechanical home ventilation, with or without tracheostomy, as well as tracheostomy care without ventilation, must only be delivered by 24/7 critical care trained nursing staff. That’s it. If people are stuck in ICU waiting to go home, how will they go home without the same setup?

Reason number two: shared support models do not fit ventilator or tracheostomy dependence. SIL, supported independent living, and group living houses are usually built around shared staffing. Now imagine three residents and one support worker overnight. One resident needs to be repositioned because they are immobile. Another one is unwell. And right then, the ventilator alarm goes off in the third room. A person who depends on a ventilator to breathe can’t share their critical carer with two housemates when that alarm goes off. Minutes or seconds matter with an unstable airway. That’s not a criticism of anyone. It’s simply the physiology. It is simply the reality.

Reason number three: the wait leaves people in ICU. While a participant waits for SDA approval, then for a vacancy, then for modifications, then for a SIL quote, then for a provider who will take them on, they’re losing condition. They’re losing confidence. They’re losing time with family and quality of life. And they’re doing all of that in the most expensive bed in the hospital, which is the ICU bed. More importantly, they might lose hope. They might get depressed. I’ve worked in ICU for decades. Any family who has had a loved one in ICU long term, any ICU doctor, any ICU nurse that has seen long-term ventilated patients, knows exactly what I’m talking about. You know that people lose hope. You know that people get depressed. So what are we going to do about it?

Reason number four: home doesn’t have to mean SDA. This is something families are very often not told. For many ventilated participants, the safest and most cost-effective option is their own home, or the family home, with the right equipment, the right home modifications, and a 24/7 critical care registered nursing team. We’ve been doing this since 2012. We’ve taken people home from ICU on ventilators, on BiPAP and CPAP, with tracheostomies, adults and children, into ordinary homes in suburbs and regional towns all over Australia.

That automatically leads to the question: is every home suitable? No, not every one, but most actually are. The guidelines say the home must be safe and accessible, with an adequate electrical supply. Sometimes modifications are needed. But the point is, SDA is one option, not the only option. And if someone tells you your loved one can only leave ICU if they move into a group home, please contact us today. Get a second opinion. The people who are telling you that are mostly nonclinical people who have zero, and I mean zero, understanding of what’s at stake here.

Reason number five: downgrading the workforce moves the risk. It doesn’t remove it. If a ventilated adult or child, with or without tracheostomy, moves into SDA with support workers overnight, instead of 24/7 ICU and critical care registered nurses, the airway risk doesn’t disappear. It just moves into a new building.

So picture this. You have a patient in ICU who’s ventilated, has a tracheostomy, and is ready to be discharged with a service like Intensive Care at Home. And all of a sudden, they’re being discharged home, or to SIL, or to SDA, with a disability support worker model. They basically go from 24-hour intensive care staffing, nurses and doctors, to disability support workers. That’s like going from flying the airplane with a pilot to flying the airplane with the cabin crew. A plane crash is waiting to happen, i.e., a patient dying or sustaining significant harm is waiting to happen.

And this brings me to a case I’ve talked about before on this channel multiple times, which I’ll keep talking about respectfully, but it matters greatly. Now, also, which one of the five reasons I just mentioned is the one you’re dealing with right now? Type one, two, three, four or five into the chat.

Because now comes the warning, which is the Noah Johnston case. The Noah Johnston case is a warning we must not ignore. I want to talk about Noah Johnston, and I want to do it very respectfully, and only based on what has been publicly reported.

Noah was a young man who was ventilator dependent with a tracheostomy, living at home. As reported in the Saturday Telegraph in January 2026, his NDIS supports and funding had been changed from 24/7 nursing to a model with nursing during the day and disability support workers overnight. In December 2025, his tracheostomy became displaced during the night. According to his mother, Kylie, there was no critical care registered nurse present, and Noah died.

His family made the very brave decision to share his story publicly in the Daily Telegraph. First of all, my heart goes out to Noah’s family, and to Kylie in particular. No family should ever have to go through that.

Now, here’s why I’m raising Noah in a show about disability housing. Noah’s case did not happen in an SDA building. It happened in his own home. And that is exactly the point. The safety of a ventilated and tracheostomy participant is decided by the skill of the person in the room, not by the address.

A displaced or blocked tracheostomy tube is a life-threatening airway emergency. It can become fatal within seconds or minutes if the person present doesn’t recognize it straight away and know exactly what to do. Reinserting a tracheostomy tube, managing a patient who’s desaturating, bagging them, troubleshooting the circuit: that’s exclusively intensive care nursing territory.

So when I hear that the answer to the NDIS housing crisis might be moving ventilated participants into SDA with a SIL support model overnight, I want families to understand the risk they’re being asked to accept.

On top of that, you have to ask about the medical backup of such a model. In our network, of course, we have clinical governance. We also work with a private intensive care specialist. No SIL or SDA provider works with a private intensive care specialist, because they’re not employing ICU nurses like we do, and they’re not accredited for Intensive Care at Home nursing.

In my professional opinion, cases like Noah Johnston’s are exactly why the evidence-based standard for invasive ventilation with tracheostomy, non-invasive ventilation without tracheostomy, and tracheostomy without ventilation is 24/7 ICU and critical care trained nursing. Not part-time, not daytime only, not nighttime only. 24/7, like in an ICU.

I mean, when will people wake up to the fact that you cannot take a patient home from 24/7 ICU nursing to a disability support worker model, or even to a registered nursing model where those registered nurses have no ICU experience? That is just absolutely crazy. It’s actually a crime, from my point of view, because people have died. Just because Noah Johnston was publicly mentioned doesn’t mean there are no other cases that were not publicly mentioned. There are plenty of cases. I’ve spoken about this.

So if what I’ve shared with you so far is hitting home, if your loved one is on a ventilator, on BiPAP or CPAP, or has a tracheostomy, and you’re being offered SDA, SIL, or a care model with disability support workers overnight, please, please call us today at intensivecareathome.com. If you’re in Australia, call us on 1300 921 536, or you can call me on my mobile phone, 041 094 2230. You can also book a call with me by clicking on the schedule appointment button, or you can simply email me at [email protected].

And download the free checklist from the link in the show notes and the transcript. It walks you through the 12 questions you need answered before you accept any housing or discharge plan.

And if you’re finding this YouTube live valuable, whether you’re here right now or you’re watching this on replay, hit subscribe, hit the like button, and hit the notification bell so that you don’t miss any updates or videos. And share this YouTube live with an NDIS support coordinator, an NDIS planner, or another family who needs to hear it. Share it with ICU nurses and ICU doctors. They also need to hear it. And leave your comments. Let me know what you think. Do you agree? Do you disagree? Can you give examples where things went right or things went wrong? Let me know.

Let’s go back to what the evidence says ventilated and tracheostomy patients need at home, because it all comes down to being practical. What does a ventilated person actually need at home, according to the documented evidence?

Once again, our evidence-based and best practice mechanical home ventilation guidelines are based on international guidelines, including, but not limited to, the German Respiratory Society’s guidelines on non-invasive and invasive ventilation for chronic respiratory failure. And by the way, in Germany, home ventilation has been standard practice for decades, since the early 2000s. I trained there. I was part of setting it up in Germany. It’s not experimental. It’s established. It’s been established for decades, just as we’ve been established, since 2012.

So here are excerpts of some of the minimum standards.

Number one, critical care and ICU trained nursing staff 24/7. The day-to-day nursing team should have at least 18 months of intensive care nursing experience. Our nurses actually have a minimum of 24 months intensive care nursing experience. We’re trying to raise the bar, not lower the bar. And there should be a designated specialist nurse organizing the care, with at least three years of recent ICU experience plus a postgraduate critical care nursing qualification.

As a side note, most of our nurses have 8 to 10 years ICU nursing experience. As a matter of fact, we are employing hundreds of years of ICU and critical care nursing experience combined in the community. And according to my research, no other provider in Australia can bring a higher skill level into the community than Intensive Care at Home does. That enables us to safely look after the highest acuity clients in the community in Australia.

Number two, back to the evidence and the home mechanical ventilation guidelines: nurse attendance needs to be 24/7 for people on permanent ventilation, whether that’s with or without tracheostomy, as well as for tracheostomy adults and children without ventilation.

Number three, a second identical ventilator plus an external battery pack when someone is ventilated for more than 16 hours a day.

Number four, a high-performance, battery-powered suction unit, a manual resuscitation bag, spare tracheostomy tubes in two sizes, one of the same size and one a size smaller for those difficult emergency changes, a tracheal dilator, a face mask, etc.

Number five, active humidification for invasive and non-invasive ventilation.

Number six, a safe, accessible home with an adequate electrical supply for the ventilator and all the associated equipment.

Now think about this list again. How many of those points are about the building? Really just the last one. Everything else is about people, skill, equipment, the unstable airway, and quite frankly, keeping someone alive. And that’s the whole argument of today’s show in one slide.

Because I always keep coming back to the pilot in the cockpit. When the plane is cruising, the sun is shining, the autopilot is on and everything’s calm, it might look like anyone could sit in that seat. But we put a trained pilot in the cockpit for the moment things go wrong. With an airway, things can go wrong in seconds. That’s why you need the pilot in the cockpit 24 hours a day.

So how do you build your NDIS evidence, or evidence for any other funding body? How do families and NDIS support coordinators actually get the NDIS to fund what’s needed? In my experience, the ones who succeed bring the evidence, not just vague requests. Here’s what to gather, quite simply.

Number one, ICU and hospital discharge summaries. Get the medical records: the ventilator settings, the hours per day on the ventilator, the airway history, any tracheostomy changes or emergencies.

Number two, letters from the treating intensivist, respiratory physician or neurologist, and make sure they address who must be present, not just where the participant should live. That’s a really important distinction for this topic. So the letters actually need to say that the client needs 24-hour critical care registered nurses.

Number three, an independent nursing assessment that maps the participant’s needs against evidence-based home ventilation standards.

Number four, a record of every incident, near miss, emergency call or readmission.

Number five, your housing evidence: the OT (Occupational Therapist) reports and the home modification options, sitting alongside the nursing evidence, not instead of it.

Number six, a physiotherapy assessment, also clearly stating that the client needs 24-hour critical care registered nurses, and why a delegated model of care wouldn’t work.

And here is why a delegated model of care wouldn’t work. AHPRA (Australian Health Practitioner Regulation Agency), the nursing and doctors’ regulatory body, does not allow a critical care registered nurse to train a disability support worker. That’s once again like the cabin crew flying the airplane instead of the pilot. There are no disability support workers in an ICU laying hands on a critical care patient. Imagine that. So why would that be any different in a home care environment?

Number seven, potentially a speech therapy assessment, also saying the patient needs 24/7 critical care registered nurses.

And number eight, an OT functional capacity assessment, also clearly highlighting that 24/7 critical care registered nurses are needed as per the client’s condition.

And if the NDIS makes a decision that doesn’t reflect the evidence, participants have review rights and can go to the ART (Administrative Review Tribunal). This is also exactly where Level 3 specialist support coordination comes in: making sure the plan matches the clinical need, rather than the clinical need being squeezed to fit the plan.

Like I’ve said many times here on this channel, we warned the NDIS and the NDIS Quality and Safeguards Commission many, many times of gaps in funding. Even though the independent clinical assessments all said clients needed 24-hour critical care nurses, the funding gap wasn’t closed, and patients passed away, just as we unfortunately predicted. In those cases, the families decided not to go public.

Next, how Intensive Care at Home helps. So how can we help here at Intensive Care at Home? At Intensive Care at Home, we provide 24/7 critical care registered nurses at home for the groups that I mentioned in the beginning: invasive ventilation with tracheostomy, non-invasive ventilation with BiPAP without tracheostomy, and tracheostomy care without ventilation, for adults and children, all around Australia, in all states and territories.

To our knowledge, and according to my research, we are the only third-party accredited Intensive Care at Home nursing service in Australia, accredited for Intensive Care at Home nursing through ISO (International Organization for Standardization) 9001:2015, as well as NDIS registered, for the delivery of intensive care nursing services at home, including services to ventilated and tracheostomy patients. You can see our accreditation and NDIS status at intensivecareathome.com/accreditation-quality.

Why does that matter? Because it means an independent body has audited our clinical governance, our processes and our quality systems. You don’t just have to take my word for it.

We also provide Level 2 and Level 3 NDIS support coordination, as well as TAC and WorkSafe case management. And just so you know, if we’re your support coordinator, you always keep the right to choose whichever provider you want. We disclose and manage any conflict of interest in line with our NDIS obligations.

And in my experience, 24/7 critical care registered nursing at home costs around half of what a long-term ICU bed costs, while giving people their home, their family and their quality of life back, and while giving the hospital its ICU bed back.

Okay, let’s now go to your questions. If you have any, drop them in the chat now. But quite a few of you have sent me questions leading up to this, so I’ll go to those if you don’t type any into the chat now.

So, questions that have come in.

Does NDIS SDA funding pay for nursing care? No. SDA funds the dwelling. Nursing and personal supports are funded separately in the participant’s plan.

Next question: can a ventilated participant live in SDA safely? The building might be suitable, especially a high physical support design. Whether it’s safe depends on who provides the care. For invasive ventilation with tracheostomy, the evidence-based standard is critical care trained nursing, 24/7. And just for the record, we can work in an SDA, and we can work in a SIL, as long as the funding is there for 24/7 critical care registered nursing.

Next: is SIL appropriate for someone on a ventilator? SIL is usually a shared, support worker-based model. In my clinical opinion, it isn’t designed for someone who would otherwise need an intensive care bed. But that’s, again, where the advocacy comes in, and where the reports that need to go to the NDIS come in. Have a conversation with us and our NDIS support coordinators about that, so the funding can be right from day one for 24/7 critical care registered nurses.

Next: does a ventilated participant have to move into SDA to leave hospital? Not necessarily. Many ventilated participants can go home to their own home or their family home, with the right equipment, modifications, and a 24/7 critical care registered nursing team.

Next question: what about BiPAP or CPAP? Does that need ICU nurses too? For participants who depend on BiPAP or CPAP without tracheostomy, especially with a weak cough, secretions, an inability to remove their own mask, seizure management, etc., 24/7 ICU and critical care nursing skills are needed. This should be assessed individually, of course.

What about participants with a tracheostomy without a ventilator? Well, a blocked or displaced tracheostomy tube is a life-threatening emergency whether or not a ventilator is attached. That’s why we include tracheostomy care without ventilation as one of our three core services with 24/7 critical care registered nurses. I have evidence that people have died at home with a tracheostomy without ventilation, and they died while we were not there, even though there was overwhelming independent evidence that the client needed 24/7 ICU and critical care registered nurses.

What if the NDIS says no to 24/7 ICU nursing? All participants can request an internal review and then apply to the ART, the Administrative Review Tribunal. Strong, strong, strong clinical evidence makes all the difference.

Next question: is Intensive Care at Home accredited and NDIS registered? We’re ISO 9001:2015 certified by a third-party certification body, and NDIS registered, for the delivery of Intensive Care at Home nursing services, including to ventilated and tracheostomy clients. And like I said, according to my research and to my knowledge, from what I’ve seen and researched, we are the only third-party accredited Intensive Care at Home nursing service in Australia in 2026. No other provider has created the intellectual property, the policies, the procedures and the evidence for what we are doing here.

Now, that is a wrap for today. I hope that answers all of your questions. Download your free checklist. Contact us here at intensivecareathome.com. And I wish you and your families only the best. And if you need help, contact us right now at intensivecareathome.com.

Thank you so much for joining me this Sunday morning, or if you’re in the US, Saturday evening. Like the video, subscribe to my YouTube channel, hit the notification bell, and leave your comments so I know what you want me to do.

This video is general advice only. You should discuss your loved one’s condition with the treating team. And if you need help from us doing that, please reach out. Take care.

 

With all of that said, with Intensive Care at Home, we are currently sending our critical care nurses into the home 24 hours a day. Therefore, we are providing a genuine alternative to long-term stay in intensive care for:

• Ventilation
• Tracheostomy
• Home BiPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure) ventilation without tracheostomy
• Tracheostomy care without ventilation
• Home TPN
• Home IV potassium
• Home IV magnesium
• Home IV antibiotics
• Home IV fluids

We’re providing:

• Cough assist management at home
• Ventilation weaning management at home
• Central line, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line as well as port management at home
• Nasogastric tube, nasojejunostomy tube, PEG (Percutaneous Endoscopic Gastrostomy), PEJ (Percutaneous Endoscopic Jejunostomy) tube management at home
• IDC (Indwelling Catheter) and SPC (Suprapubic Catheter) management at home
• Palliative care services at home

We’re also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully as part of the Western Sydney Local Health District’s In Touch program, saving approximately $2,000 per patient that we keep at home instead of them going into an emergency department.

That also means we’re in a position to cut the cost of an ICU bed by around 50%. An intensive care bed costs between $5,000 to $10,000 per bed day depending on location. Intensive Care at Home costs approximately 50% of that, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders.

Our Coverage and Accreditation

With Intensive Care at Home, we’re currently operating all around Australia, in all major capital cities, as well as in all regional and rural areas. We are an NDIS approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria as well as the Department of Veterans Affairs all around Australia.

We’re also ISO 9001:2015 accredited. Our clients and we as a service provider have also received funding through public hospitals, private health funds as well as departments of health.

We are the only service provider in Australia that has achieved third-party accreditation for Intensive Care at Home nursing in 2025. We have been achieving this high level of accreditation since 2012. No other provider in Australia has achieved the Intensive Care at Home level of accreditation in the community and has created more intellectual property when it comes to Intensive Care at Home nursing than we have.

This puts us in a position to employ hundreds of years of critical care nursing experience combined in the community. No other service provider in 2025 employs a higher skill level in the community than we do. And that enables us to look after the highest acuity adults and children in the community in Australia safely.

If You Need Help

If you’re at home already and you’re watching this or you’re stuck in an ICU and you realize that you don’t have the right level of support, I can give you many examples where we helped clients with funding, how we advocate for funding. We had to advocate successfully for funding from our first case study to many other case studies where we had to advocate successfully for funding with the right evidence of course because it is crystal clear that disability support workers for example or registered nurses without ICU experience cannot look after ventilated clients at home whether adults or children with or without a tracheostomy and it’s simply dangerous and negligent.

There are plenty of examples where clients with support worker models or even RN (registered nurse) models without ICU experience have died at home and I have evidence to back up everything that I’m saying here because it’s a bit like flying the airplane with a cabin crew instead of the pilot and it could simply be deadly.

This can be avoided by having simply 24-hour critical care nurses at home because our clients are at high risk of medical emergencies or worse without critical care nurses 24 hours. This is actually also evidence-based in the community and is documented in our evidence-based Mechanical Home Ventilation Guidelines on our website at intensivecareathome.com.

Think about it: in an intensive care unit in a hospital, you wouldn’t have support workers or general registered nurses looking after a critical care patient on a ventilator with a tracheostomy. So why would anyone in their right mind do that in a home care environment where there are fewer resources?

Clients that have found us have been at home long-term predictably and permanently with critical care nurses. Their alternative would have been to either die or stay in ICU long-term, and our clients don’t go back to ICU. They stay at home permanently and predictably and the insurance bodies save half of the cost of an ICU. But it’s a win-win situation all around.

We can do the same for you if you’re stuck in ICU or if you’re not safe at home, which includes the advocacy for funding and the network that goes along with it. We have always successfully advocated for our clients or we have the network to successfully advocate for you and for your family member, otherwise we wouldn’t be in business. The same again is applicable for those stuck in an ICU which is similar to many of our, if not most of our cases.

Our Support Coordination Services

This is also why we are providing Level 2 and Level 3 NDIS support coordination. We have a team of experienced NDIS support coordinators, and they have a wealth of knowledge. We’re also providing TAC case management and WorkSafe case management in Victoria with Lucy McCotter.

If you’re an NDIS support coordinator or a case manager or a social worker from another organization or a hospital watching this and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for funding for nursing care for your participants and you don’t know how to go about it and how to advocate for it, what evidence to provide, I encourage you to reach out to us as well. We have the network to make that happen. We will help you with the right level of funding and with the right level of advocacy.

We’re also providing NDIS specialist nursing assessments done by critical care nurses with a legal nurse consulting background.

Join Our Team

If you are a critical care nurse and you’re looking for a career change and you want to join a very progressive, dynamic, successful, and high-performing team of critical care nurses in the community, we are employing hundreds of years of critical care nursing experience combined.

If you’re looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, Albury-Wodonga, Bendigo, Geelong, Warragul, and also in Wyelangta in Victoria.

If you have worked in critical care nursing for a minimum of two years, adult ICU, pediatric ICU, ED and you have already completed a postgraduate critical care nursing qualification, we will be absolutely delighted hearing from you.

I have a disclaimer though: Because we are offering tailor-made solutions for our clients which includes regular staff, our clients do also want the same staff coming over and over again because they are so vulnerable and so special. That’s why we need regular, reliable staff.

If you’re looking for agency work where you can come and go, this will not be the right fit for you. We’re looking for consistency and our clients are looking for consistency. So please only apply with us if you can give us regular and consistent availabilities for shifts and you’re really keen on building relationships with us and with our clients. Reliability is also a must.

For Medical Professionals and Healthcare Executives

If you’re an intensive care specialist or an ED specialist, we also want to hear from you. We’re currently expanding our medical team as well.

We can also help you eliminate your bed blocks in your ICU and in your ED for your long-term patients or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help to take the pressure off your ICU and ED beds. In most cases, you won’t even pay for it. Even if you do pay for it, it is so much more cost-effective than what you’re paying for in ICU and ED settings, and you get the same level of care and simply more patient and family satisfaction because you also want to partner with your consumers.

If you are a hospital executive watching this, we can help you free up your ICU and ED beds.

International Support

If you’re in the U.S. or in the UK and you’re watching this and you need help, we want to hear from you as well. We can help you there privately with one-on-one consulting and with hiring nurses privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

If you like my videos, click the like button, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and intensive care. Click the like button, click the notification bell, and share this video with anyone who has a family member in intensive care long-term or needs to see this.

Your FREE Download: FAQ: NDIS SDA for Ventilated Participants

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I’ll talk to you in a few days.

Take care for now.