The new regulations for Private Duty Nursing is impossible to adhere to due to the lack of Nurses world wide.  The individuals we care for have very high medical needs and we provide a nurse for direct care 24 hours a day in the homes.  Under the new guidelines, I would no longer only need 2 nurses a day but now 8 nurses a day (an impossible task in todays job market).  Also, at the current reimbursement rate for Private Duty Nursing which is $26,36.  In our region, LPN's now make between $25 to $28 and hour.  Under the new regulations I would be making $35.52 a day just on nurses salaries alone. This does not include taxes, benefits and equipment needed for their jobs.  If this goes through we will have to close our business and put close to 50 people out of work.  This is all bad news but this is not the worst of it.  Our individuals would be forced to return to living in much more restrictive environment such as a long term care facility or a nursing home. They will no longer go to the park, the zoo, the beach....they will stare at the 4 walls of their facility room.  Also, they will get sub par care.  The nursing ratio in these facilities are much worse, sometime 1 nurse to 30 patients.  So for our individuals they will be forgotten as they don't speak and they cant pick up the nurses button to call for attention.  This is a disgrace and must be changed immediately.