INTENSIVE CARE AT HOME for Aged Care Patients Over 65: How Funding Reform Can Fix ICU and ED (Emergency Department) Bed Block in Australia

“Intensive Care at Home for aged care patients over 65: How funding reform can fix ICU and ED bed blocks in Australia.”

My name is Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide home care for ventilated adults and children without tracheostomy such as BIPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure), also tracheostomy care without ventilation, Home TPN (Total Parenteral Nutrition), home IV potassium, home IV magnesium, home IV antibiotic infusions, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line, central line, and port management at home, as well as cough assist management, ventilation weaning, palliative care services, nasogastric tube, nasojejunostomy (NJ) tube, PEG (Percutaneous Endoscopic Gastrostomy) tube, and PEJ (Percutaneous Endoscopic Jejunostomy) tube management at home as well.

Today, I want to talk about something that’s becoming a national crisis — hospital and ICU bed block, especially for aged care patients over 65 years of age, and how Intensive Care at Home is the missing link to our hospitals, ICUs, and emergency departments, freeing up beds while giving patients a much better quality of life.

Hospital and ICU bed blocking aged care patients over 65, let’s get real about what’s really happening in hospitals and in ICUs across Australia right now. Aged care patients, particularly those over 65, are often stuck in hospitals, ICUs, and emergency departments, far longer than medically necessary. Why? Because there’s nowhere safe to discharge them to once they’re stable but still need high acuity care such as ventilation, tracheostomy management, or other complex nursing support, including BIPAP, CPAP without ventilation, some of them might need TPN.

This is the classic hospital bed block problem. ICUs are full, emergency departments are overcrowded, and elective surgeries often get delayed because there are no beds available. But here’s the truth, many of those beds are occupied by patients who could be safely cared for at home with the right level of support and funding model. That’s exactly where Intensive Care at Home comes in.

So, how Intensive Care at Home solves hospital and ICU bed blocks? At Intensive Care at Home, we pride ourselves bringing ICU level care into the home, allowing patients who no longer need the full resource of an ICU to continue their recovery safely and comfortably at home. Here’s how it helps aged care patients over 65 and the entire health system:

1. Safe transition from ICU to home

Once an elderly patient is stable, they can be safely discharged home under our Intensive Care at Home model. Our ICU trained nurses provide 24/7 mechanical ventilation, tracheostomy care, suctioning, monitoring and early intervention if complications arise, all in the home care environment.

This is actually evidence-based. You can look up our Mechanical Home Ventilation Guidelines on our website and I’ll link towards it in the written version of this blog. This immediately frees up ICU and hospital beds whilst ensuring patient safety.

2. Better quality of life for patients and families

Being at home means less delirium, less ICU psychosis, fewer infections, better sleep, and emotional comforts surrounded by loved ones. Families are involved in care, decision making, staff selection, which improves outcomes and satisfaction for everyone involved.

3. ICU level quality and safety at home

I already mentioned it, but we follow the Mechanical Home Ventilation Guidelines as published on our website, to ensure all care is delivered according to ICU level quality standards in the community. That includes ICU trained nursing staff only, 24/7 on-call medical and clinical support, advanced monitoring and telehealth backup, strict infection control procedures, emergency escalation, and hospital transfer protocols. This means safety, quality, and compliance are never compromised.

4. Weaning, rehabilitation, and palliative care at home

Many aged care patients stay in ICU for way too long, sometimes weeks, sometimes even months, for ventilation weaning, tracheostomy weaning, rehabilitation, or end of life care. All of these can safely and effectively happen at home under Intensive Care at Home supervision and care model.

That’s much better for the patient and it saves hospitals thousands of dollars per day in unnecessary ICU stays and it frees up the most sought after beds in a hospital, which is the ICU bed. So, we’re really asking for a funding reform, the key to making Intensive Care at Home more accessible.

Now, here’s the real challenge: funding. At the moment, Australia’s healthcare funding model is designed for hospital-based care, not for home-based intensive care. That’s outdated and it’s costing the system billions. It’s costing family’s peace of mind. It’s costing patients’ peace of mind. It’s costing patients’ quality of life that can’t be measured in monetary terms. We need a funding model that follows the patient, not the hospital.

Here’s what that means:

1. Expand public funding to include Intensive Care at Home

Medicare, the NDIS, My Aged Care, and state health services must recognize Intensive Care at Home as a legitimate alternative to ICU and hospital care. Funding should cover 24/7 ICU nurses in the home for eligible patients, especially those over 65, who are clinically stable but require ongoing high acuity and intensive care.

2. Create integrated aged care and hospital funding pathways

Right now, aged care and hospital funding are siloed. We need a blended funding model that bridges aged care, acute care, community care, NDIS (National Disability Insurance Scheme), DVA (Department of Veteran Affairs), enabling seamless transition from ICU to home.

3. Extend activity-based funding to home ICU programs

Hospitals receive activity-based funding for inpatients, but this stops at discharge. Creating a new home ICU activity-based category would allow hospitals to be reimbursed for transitioning patients home safely under Intensive Care at Home programs.

4. Reward hospitals that reduce bed block

Health services must be incentivized when they reduce ICU and ED bed block through safe home transfers. This could include funding bonuses or shared savings when ICU beds are freed up faster.

I should say there, we have provided an emergency department bypass service for the Western Sydney Local Area Health District in 2023, and it was a massive success. We saved $2,000 per ED admission or per ED patient that we saw at home instead of ED. We were basically charging no more than $250 to prevent an ED admission, whereas otherwise it would have cost $2,000 to $2,500 dollars roughly. It was a massive success.

5. Invest in infrastructure and workforce for home

ICU government grants and hospital partnerships should fund the equipment, training and telehealth system required to safely expand Intensive Care at Home across Australia and other countries. The results speak for themselves.

With Intensive Care at Home, hospitals can free up ICU and ED beds within days instead of weeks, reduce hospital acquired complications and readmissions, save tens of thousands of dollars per patient per month, free up in-demand ICU beds, and of course, improve patient and family satisfaction dramatically. Meanwhile, aged care patients over 65 can finally receive dignified, high quality, ICU level care at home, which is where those patients belong.

So, let’s look at the conclusion:

The future of aged care and ICU relief lies at home. If Australia is serious about solving hospital and ICU bed blocks and the crisis that’s developing there, it’s time to fund and scale Intensive Care at Home as part of mainstream health policy. It’s safe, it’s proven.

We’ve been in business since 2012, and Intensive Care at Home has been around in other countries, particularly in Germany for over 25 years now, and it’s also been around in India for over 15 years. It’s a proven model, it’s cost effective, it’s improving quality of life for patients and their families, and that my friends, you can’t measure in monetary terms.

We already have the clinical expertise, the experience, the case studies, the safety standards, the testimonials, and the infrastructure. What’s missing is the political will and funding reform to make this available to every aged care patient who qualifies.

So, if you have a loved one over 65, stuck in ICU or in a hospital or an NDIS participant, it doesn’t matter. You want to know if an Intensive Care at Home is an option, go to intensivecareathome.com and call us on one of the numbers on the top of our website or send us an email to [email protected].

Now, with Intensive Care at Home, we are currently sending our ICU and critical care nurses into the home, 24 hours a day. We are providing the following:

• Home care services for ventilated adults & children with tracheostomies with critical care nurses 24 hours a day
• Genuine alternative to a long-term stay in intensive care or at long-term acute care
• Tracheostomy care for clients without ventilation
• Home care services for patients on non-invasive ventilation such as Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure)
• Home TPN (Total Parenteral Nutrition), which is also known as IV nutrition
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Providing nasogastric tube and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home
• Use cough assist machines for our clients for airway clearance at home
• Palliative care services at home
• Ventilator weaning 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 Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of them going to an emergency department.

That also means, we’re also in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs between $5,000 to $6,000 per bed day. Our services costs between $2,500 to $3,000 per bed day, 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. Of course, quality of life is much improved surrounded by families and by a team of dedicated intensive care nurses in the home care setting instead of in an intensive care unit.

With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas. We work with NDIS clients all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, Department of Veteran Affairs (DVA) all around Australia. 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 having policies and procedures for Intensive Care at Home nursing and we’ve built all the intellectual property for Intensive Care at Home since 2012. No other provider in Australia 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, which enables us to look after the highest acuity adults and children in the community in Australia safely.

If you’re at home already and you’re watching this, or you’re stuck in an ICU long-term, or if you’re going to the hospital and ED all the time, and you realize that you don’t have the right level of support at home, or if you are stuck in an ICU, I’ll give you a real-world example today, how we can help you.

One of our first clients when we first got started in 2012, was a client who was at home initially on a ventilator with a tracheostomy with a support worker model 24/7. Of course, support workers are not equipped to look after a client at home on a ventilator with a tracheostomy. That is dangerous and it’s simply negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with a cabin crew instead of the pilot. Because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies 24/7, or even at high risk of dying if they don’t have a team of dedicated critical care nurses looking after them 24/7 at home. This is actually evidence-based and is documented in our Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com.

Think about it, in an intensive care unit in a hospital, you wouldn’t have support workers looking after your critically ill loved one or after any critically ill patient on a ventilator with a tracheostomy. So, why would anyone in their right mind do that in the home care environment in the community?

So, this client at the time found out about us eventually, and the ICU that he was basically living in also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with this particular client, we sent him critical care nurses, 24 hours a day. He never ever went back into ICU ever again, as long as we were working with this client.

We can do the same for you if you’re not safe at home and help you with keeping you at home predictably. Otherwise, we would not be in business. Again, the same is applicable for those stuck in an ICU, similar to this case study that I’ve just given you, or if you’re going back to ED all the time, please reach out to us. We can help you with taking you through the right steps, including how to get funding with different funding bodies.

This is also why we are providing NDIS Support Coordination. We have a team of NDIS Support Coordinators, and they have a wealth of knowledge. I’ve done an interview with Amanda Riches, one of our NDIS support coordinators, and I’ll put a link to an interview with Amanda in the written version of this blog. 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 from another organization watching this, and you’re looking for nursing care for your participants, please reach out to us as well. If you need more evidence for nursing care, we are also writing NDIS nursing assessments with legal nurse critical care consulting nurses.

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

If you are looking for a career change as a critical care nurse, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, in Warragul in Victoria. If you have worked in critical care nursing for a minimum of 2 years pediatric ICU, ED, and you have already completed a postgraduate critical care nursing qualification, we will be delighted hearing from you.

I do have a disclaimer though, because we are offering a tailor-made solution for our clients, which includes regular staff, our clients also do want the same staff coming over and over again because they are so vulnerable and so special. That’s why we need regular staff. So, if you’re looking for agency work, where you can come and go, this will not be the right fit for you. We are 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 solid relationships with us and with our clients.

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 you 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, and you get the same level of care.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, and respiratory wards, or for home TPN, please reach out to us as well. We can help you eliminate your bed blocks very fast.

If you’re in the U.S. and in the U.K. 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].

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Thank you so much for watching.

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

Take care for now.