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My name is Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomy at home with 24/7 ICU (Intensive Care Unit) nurses, and where we provide tailor-made solutions at home for long-term ventilated adults and children on BiPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure) at home without tracheostomy with 24/7 critical care registered nurses, ICU nurses. We provide tailor-made solutions at home for clients with tracheostomy without ventilation, adults and children, at home with 24/7 ICU and critical care registered nurses.

 

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

 

Today I want to talk about something that very few people in the NDIS world talk about, or want to talk about openly, because it affects every family with a loved one on a ventilator, with a tracheostomy, or on BiPAP or CPAP at home, or with otherwise medical complexities.

 

Stay with me, because today I’ll show you the numbers straight from the NDIS’s own pricing schedule, and what families can do about it. Today’s topic is a systemic issue. It’s not about one family. It’s about every family with a loved one who’s ventilated, has a tracheostomy, or is on BiPAP or CPAP at home, or is otherwise medically complex as part of their disability, and is funded through the NDIS.

 

The question is simple. If your loved one is funded for a registered nurse but clinically needs a critical care registered nurse with ICU experience, who pays the difference?

 

Before I go any further, if your loved one needs critical care nursing at home, call us at intensivecareathome.com on one of the numbers on the top of our website, or book a call with me by clicking the schedule appointment button, or send me an email to [email protected], or you can simply call me on my mobile phone, 041 094 2230. We’re currently operating all around Australia, in all states and territories, but if you’re overseas, you can reach out to us as well. We can help you there as well. And grab our free NDIS Critical Care Nursing Evidence Checklist. The link is in the description and in the pinned comment.

 

So let’s look at the NDIS pricing schedule for 2026–2027. It came into effect on the 1st of July 2026. There are separate line items for an enrolled nurse, a registered nurse, a clinical nurse, a clinical nurse consultant and a nurse practitioner.

 

Before I dive further into this, you might be wondering what makes me qualified to talk about a topic like this. I’ve been working 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, and I’ve been running Intensive Care at Home here in Australia since 2012. I’m the founder, and I brought the concept to Australia after I worked with Intensive Care at Home services in Germany, in a pioneering service where we were the first service in Germany setting up Intensive Care at Home. I brought the concept to Australia in 2012. That’s how long we’ve been operating here. I’m also the founder of intensivecarehotline.com, where we provide consulting and advocacy for families in intensive care.

 

So let’s dive deeper into the price guide. For a weekday daytime hour in the NDIS price guide, the registered nurse rate is $128.50. The clinical nurse rate is $148.13. That’s about $20 an hour more. On a Sunday, an RN (Registered Nurse) is $210.90. A clinical nurse is $243.02. That’s almost $33 an hour more. And across every time band, the clinical nurse rate is about 35% higher.

 

So why do ventilated patients need critical care nurses? You might be wondering, why does all of this matter? Because a patient on a ventilator with a tracheostomy at home is an intensive care patient who happens to live at home. A tracheostomy tube can block. It can dislodge. A ventilator can alarm in the middle of the night or in the middle of the day, and the person there needs to know what that means, how to troubleshoot, and how to solve the alarm so it’s not alarming again. Oxygen levels can drop within seconds or minutes.

 

And as I’ve been saying here for a long time, you want a pilot in the cockpit who has flown through turbulence before, not someone who has only read the manual, like the cabin crew. That’s why our evidence-based Mechanical Home Ventilation Guidelines set out that home ventilation should only be provided by critical care trained nurses. That means registered nurses with at least 18 months of ICU experience, and a team leader with at least 3 years of recent ICU experience and a postgraduate critical care qualification. The link to the guidelines is in the description. And when I say you want the pilot and not the cabin crew, that’s basically what it means. If there are, for example, disability support workers, that’s like flying the airplane with the cabin crew instead of the pilot. ICU nurses are the pilot.

 

So here’s what happens on the ground. Many participants are funded at the registered nurse rate, but the treating doctors, or independent nursing assessments, or OT (Occupational Therapist) functional capacity assessments, or physio reports say this person needs an ICU nurse. Now, a critical care registered nurse is a registered nurse. So when we send a CCRN (Critical Care Registered Nurse) and bill the RN line item, the claim matches what we deliver. But in our view, the skill level of a CCRN fits the clinical nurse line item much better.

So what do we do? We don’t walk away. We don’t send someone less experienced to fit the budget. In the vast majority of cases, we send a critical care nurse anyway, and we charge the registered nurse rate. We absorb the difference.

 

And here’s the part nobody sees. ICU nurses are paid as specialist ICU nurses in hospital. If we want those nurses to leave the hospital, work for Intensive Care at Home and care for your loved one at home, we have to pay them what they’re worth. So we pay our critical care nurses rates in line with what they earn in hospital ICUs. That’s how we keep attracting only the best.

 

So the NDIS pays us the registered nurse rate, and we pay our nurses ICU rates, as any specialist nurse would get. The difference comes straight out of our pocket, out of our margin, every single shift. That’s what over-delivering really looks like.

 

Let’s do the maths for one participant on 24/7 nursing, which is typical for invasive ventilation and tracheostomy. At the RN rate, that’s about $25,500 a week. The clinical nurse rate would be about $29,500 a week. That’s a difference of about $4,000 every single week. Over a year, that’s more than $208,000 for one participant, and that’s before public holidays. And don’t forget, home ICU care already costs roughly half of what a long-term ICU bed costs. So, the NDIS saves twice.

 

But here’s my question to the NDIS. Under the NDIS Act, the NDIA (National Disability Insurance Agency) has to fund supports that are reasonable and necessary, effective and beneficial in line with current good practice, and value for money. When the doctors, nurses, OTs, physios and speech therapists have documented that someone needs an ICU nurse, and the NDIS’s own pricing schedule has a clinical nurse line item, in my opinion, that plan should reflect that.

We’ve absorbed this gap for years because we won’t compromise on safety. But a system that relies on providers quietly subsidizing it isn’t sustainable. If the funding doesn’t match the skills, ICU nurses go back to hospital, or participants die, and it’s participants who pay the price. You can take Noah Johnston as a warning example. I’ve talked about Noah Johnston on this blog many times.

And it’s part of a bigger trend. We keep seeing attempts to downgrade care from critical care nurses to support workers. That’s replacing the pilot with the passenger. And as you’ve seen with Noah Johnston, he passed away because the NDIS was downgrading critical care registered nurses to support workers. And there are other examples as well that I reported to the NDIS Quality and Safeguards Commission.

 

So what can families do? What can you do if your loved one is funded at the RN rate but needs a critical care registered nurse?

 

Number one, get the clinical evidence in writing. Ask the intensive care specialist, respiratory physician, neurologist or GP (General Practitioner) to clearly state that your loved one needs nursing by RNs with ICU experience, and why.

Number two, get a detailed independent nursing assessment that documents the risks and the skills needed.

 

Number three, get an OT functional capacity assessment, also clearly documenting, based on the nursing assessment and the doctor’s report, that the client needs 24-hour critical care registered nurses. The same with the physiotherapy report and the speech therapy report. Also get the medical records: discharge summaries, ICU notes, incidents. You have a right to request them.

Number four, point to the clinical nurse line item in the pricing schedule.

Number five, if the plan doesn’t match the evidence, ask for a review, and if you need to, go to the Administrative Review Tribunal.

 

And number six, work with a specialist NDIS support coordinator who understands complex respiratory care. We do provide Level 2 and Level 3 NDIS support coordination.

 

And also, our free checklist walks you through every one of these steps. The link is below.

 

So you might also be wondering, why Intensive Care at Home? Well, Intensive Care at Home in 2026 is Australia’s only third-party accredited Intensive Care at Home nursing service, accredited specifically for intensive care nursing at home. Our quality system is ISO (International Organization for Standardization) 9001:2015 certified for the delivery of intensive care nursing services at home, including ventilated patients, and we’re also a registered NDIS provider. You can see the certificates on our accreditation and quality page, again linked below. We’ve been doing this since 2012.

 

We employ hundreds of years of critical care nursing experience combined in the community, and we operate all around Australia, in all states and territories. And no other provider in Australia brings a higher skill level into the community than we do.

 

And if you are watching this and you’re in the US, in Canada, in the UK, in India, in South Africa, wherever you are, and you’re interested in Intensive Care at Home, please reach out to us as well. Call us on one of the numbers on the top of our website, or simply book a call with me by clicking the schedule appointment button. Call me on my mobile, 041 094 2230, or send me an email to [email protected].

 

Here’s the bottom line. We send ICU nurses because that’s what ventilated and tracheostomy patients need. In the vast majority of cases, we bill the RN rate, not the clinical nurse rate. That’s over $200,000 a year of clinical value for every participant on 24/7 nursing. We’re over-delivering, and I believe the NDIS needs to step up and fund what the evidence and its own pricing schedule already recognize. If you need help, call us on one of the numbers on the top of our website at intensivecareathome.com, and download the free checklist below. This is Patrik Hutzel from intensivecareathome.com.

 

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) and CPAP (Continuous Positive Airway Pressure)
• Tracheostomy care without ventilation
• home TPN (Total Parenteral Nutrition)
• 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.

 

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.