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If you want to know how the Administrative Review Tribunal for the NDIS (National Disability Insurance Scheme) is deciding in favor of NDIS participants needing 24-hour nursing care, stay tuned. I’ve got news for you.

My name is Patrik Hutzel from intensivecareathome.com and I have another video post for you today.

So, one of our clients who needs home TPN. Now for those of you that don’t know what TPN is, TPN stands for Total Parenteral Nutrition. It is also known as IV or intravenous nutrition. If someone needs intravenous nutrition, they need a central line, a PICC (peripherally inserted central catheter) line, a Hickman’s line, or a port access.

Now, any of these devices and the connection of TPN needs to be done sterile. Managing PICC lines, Hickman’s line, central lines, port management is the skill of a critical care nurse predominantly. So, therefore, NDIS participants that need TPN need critical care nurses.

Now in this situation, the client needs a hook on like a TPN connect at evening time and the disconnect in the morning so that the TPN can run overnight. If it’s not done sterile if the central line, or the PICC line, Hickman’s, or the port is not managed well, people can end up with line infections, sepsis, line blockages, and therefore, end up in ICU with the sepsis, and need the lines changed, which is an invasive procedure.

So, the NDIS was disputing why this particular NDIS participant would need nursing care for TPN connect and disconnect with, in this situation, a PICC line. Clearly, the skill of intensive care nurses and nothing else. They were suggesting that it could be delegated to support workers. It’s not even a skill of a registered nurse without critical care nursing experience and the NDIS was trying to delegate it to support workers.

The client would probably be dead by now if this would be done by support workers. You need to know how to prime the line, how to start the infusion pump, how to avoid air in line, how to avoid line blockages, how to connect and disconnect sterile, flush the line correctly so that it’s not blocking, and the list goes on. Sometimes we’re also needing to take bloods, to take electrolytes, and other blood results. Obviously, the dressing of the line needs to be changed once a week under sterile conditions as well.

So, interestingly enough, the case was going to the Administrative Review Tribunal from the NDIS. Lo and behold, just about a week before the hearing was scheduled with the NDIS providing “evidence” and us as a nursing service and registered nurses providing our evidence why this particular NDIS participant needs the nursing care.

I’ll read out the email from the client’s NDIS Support Coordinator, by the way, he’s a great NDIS Support Coordinator but I obviously don’t want to mention names here. He sent us an email a couple of days ago and it says, 

“Hi Patrik, 

We received an offer from the NDIS late last week. They have offered to provide all the support we have requested and to resolve the Administrative Review Tribunal application packet. They have done this on the condition that we can prove over the next 12 months that 4 hours per day of nursing is necessary.”

4 hours a day of nursing is necessary simply because it takes about 2 hours hook on, and then 2 hours hook off. But it’s also a case of even if it doesn’t take 2 hours, we need to offer 2 hours minimum engagement because we are competing against nurses going to hospitals for eight-hour shifts, 12-hour shifts, or going to some of our other clients for 8-hour shifts or 12-hour shifts. So, we need to offer them something to use their highly specialized skill for our clients to keep them out of hospital and maximize their quality of life. 

So, it is completely ridiculous the amount of money the NDIS wasted on lawyers and trying to provide evidence, which wasn’t there in the first place, and looking at our evidence with nursing assessments and OT assessments and then giving in a week before the hearing. The money they spent on lawyers and delaying a decision, not that care was ever interrupted for this client while the case was in front of the Administrative NDIS Review Tribunal. But it just goes to show that too many bureaucrats are just going to ruin the NDIS.

Now, just also what it comes down to, just for anyone watching this, when will the NDIS fund nursing care? The NDIS will fund nursing care if one of the NDIS diagnoses that are listed on their website are leading to a disability that requires nursing care. So, in this situation, the client has a very rare Bardet–Biedl syndrome that leads to gastroparesis, which means that the bowels and the stomach are paralyzed, i.e., food is not being digested, which leads the client to needing TPN or IV nutrition. As long as that’s on the diagnosis of the NDIS, the NDIS will fund nursing care. It’s as simple as that. It’s always been like that. As long as legislation is not going to change, it will continue like that.

So, I hope that explains the ART (Administrative Review Tribunal) situation to anyone that’s interested in this topic. Also, we’ve had other clients go to the ART or in the past it used to be the AAT (Administrative Appeals Tribunal) up until October last year.

The interesting part here is that all of our clients that have gone to the ART or AAT, the NDIS tribunal has always decided in the client’s favor to get, in other situations, 24-hour nursing care for ventilation, tracheostomy, BIPAP ventilation, PEG (Percutaneous Endoscopic Gastrostomy) and PEJ (Percutaneous Endoscopic Jejunostomy) tube, seizure management. It’s never been denied.

So, if you’re watching this and if your NDIS Support Coordinator is telling you, you can’t have funding for nursing care, it’s a lie. We would not be in business if it wasn’t true. Most of our clients have 24-hour NDIS funded nursing care.

So, don’t let anyone tell you what’s possible because our clients have 24-hour nursing care for conditions such as Rett syndrome, MND (Motor Neurone Disease), cerebral palsy, but also spinal injuries, but also home TPN for gastroparesis, or Ehlers-Danlos Syndrome. Don’t let anyone tell you what’s possible and what isn’t possible. We have shown what’s possible for our clients over and over and over again.

So, 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 a 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 without ventilation, Home TPN (Total Parenteral Nutrition), home IV potassium infusions, and home IV magnesium infusions, IV fluids, and IV antibiotics. We’re also providing ventilation weaning at home. We’re also providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home. We’re also providing nasogastric tube and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home, as well as palliative care nursing 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 Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of going to an emergency department. 

Therefore, we’re also in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs around $5,000 to $6,000 per bed day. Our services costs between $2,500 to $3,000 per day and we’re freeing up the most sought-after bed in the hospital, which is the intensive care bed. Most importantly, we’re improving the quality of life for patients and their families which is a win-win situation for all stakeholders.

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’re an NDIS approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme in Queensland), as well as the Department of Veteran Affairs all around Australia. Our clients and we, as a 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 in 2025. We have been achieving this high level of accreditation since 2012. No other provider has achieved this high level of accreditation in the community and has created more intellectual property for 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.

Now, if you’re at home already or if you’re stuck in an ICU long-term or your family member is stuck in an ICU long-term, and you’re watching this, and you realize that what you’re currently experiencing is no longer working and you want a change, that means you don’t have the right level of support whether that’s at home or in a hospital, that means you’re stuck in an ICU long-term,  or at home your struggling with support because you realize support workers are not going to handle, I’ll give you a very tangible example today. 

One of our first clients over 10 years ago, when we first got started, he 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 able look after a client at home on a ventilator with a tracheostomy safely. That is like flying the airplane with the cabin crew instead of the pilot because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies or dying if they don’t have a team of critical care nurses looking after them 24/7. This is actually evidence-based and is documented in the 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 a critical care patient on a ventilator with a tracheostomy. So, why would anyone in their right mind would do that in a home care environment in the community?

So eventually, this client who was in ICU found out about us, and the ICU found out about us. We were proving our concept with this client very fast. When we worked with the client, we sent him intensive care nurses, 24 hours a day. When we worked with him, he never, ever went back into ICU ever again and our concept was proven very fast.  

We can do the same for you if you’re not safe at home, which includes the advocacy for funding that goes along with it. We have always successfully advocated for our clients. Otherwise, we would not be in business. The same is applicable for those stuck in ICU, similar to our case today. If that’s what you’re looking for, reach out to us. We’ll make it happen for you and take you through the right steps in the advocacy process.

This is also why we are providing Level 2 and Level 3 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’re looking for funding for nursing care for your participants, and you don’t know how to go about it and what evidence to provide, I encourage you to reach out to us as well. We can 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.

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 are employing hundreds of years of critical care nursing experience combined. If you are looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, and 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 have a disclaimer, 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, and 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 availability for shifts and you’re really keen on building relationships with us and with our clients.

If you are 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 much more cost-effective than what you’re paying for in ICU and ED for 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, respiratory wards, home TPN, of course, please reach out to us as well. We can help you eliminate your bed blocks very fast.

If you’re in the U.S. or 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 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, 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, share the video with your friends and families, and comment below on what you learned about this video and what you want to see next.

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.