Tide + Timber Nursing Services LLC

Tide + Timber Nursing Services LLC Tide + Timber Nursing Services LLC - Independent Registered Nurse specializing in medically complicated pediatric patients requiring skilled nursing services.

Also providing adult/geriatric services. As the sole owner/employee, my patient load is limited.

03/25/2026

Hello from Tide + Timber ☺️

It’s been a little while since I’ve posted, but I wanted to reconnect and say hi. I’ve been quietly working behind the scenes and am still here providing care in our community.

I wanted to clear a couple of things up.
First of all, I am not an agency.

In my role, I typically bill MaineCare under Section 96 PDN Services. I provide private duty nursing care, which means I’m in the home for extended periods of time providing ongoing, skilled care—not typically short, intermittent visits, which is more of something that a nursing agency would provide.

For example, a visiting nurse from an agency might come a few times a week for a single service l like wound care. My role is a little different—I care for individuals who need a nurse there more consistently for monitoring, support, and real-time care throughout the day or a portion of the day, and if wound care is needed as a part of that ongoing care, then I am able to provide wound care in addition to the other needed services.

My main focus is pediatric care for medically complicated children, but I also take on select adult cases when that level of care is needed.

Some of the care I provide includes:
• Tracheostomy and ventilator care
• Airway support and suctioning
• G-tube/enteral feedings
• Medication administration
• Seizure monitoring
• Ongoing assessment and support
• Select adult services, including wound care when appropriate, if comorbidities require more than just intermittent care. I have learned that I can not bill MaineCare for wound care alone.

I am also able to bill as private pay, which does open services up to short, intermittent visits such as wound care.

If you ever have questions or aren’t sure what kind of care is needed or can be provided by me, I’m always happy to connect 🤍

Thank you,
Briana Knizeski, BSN, RN

🎄 Merry Christmas from Tide + Timber Nursing Services LLC 🎄As the year comes to a close, I’m so thankful for the familie...
12/25/2025

🎄 Merry Christmas from Tide + Timber Nursing Services LLC 🎄

As the year comes to a close, I’m so thankful for the families who trust me, the children I get to care for, and the community that supports my work. It truly means the world to me.

Hoping your Christmas is filled with quiet moments, cozy days, and time well spent with the people you love. May the New Year bring health, hope, and happiness to your home.

With gratitude,
🤍 Tide + Timber Nursing Services LLC

10/30/2025

Independent Skilled Nurses can do all of the same things that an agency nurse can do. However, insurances, such as MaineCare have different sets of rules. Private pay allows for more flexibility in providing services. Below is a detailed breakdown of some of the medically necessary nursing interventions that require an RN’s professional skill and judgment:

Comprehensive assessments: Vital signs, respiratory, cardiac, neurological, and developmental checks.

Medication administration: Oral, injectable, G-tube, or IV medications as prescribed.

Feeding tube management: G-tube, J-tube, or NG-tube feedings and care.

Ventilator or trach care: Routine suctioning, trach changes, ventilator monitoring, and emergency airway management.

Wound care: Dressing changes, infection prevention, and skin integrity monitoring.

Seizure management: Observation, documentation, and administration of rescue medications if ordered.

Catheter care: Foley or suprapubic catheter maintenance and output tracking.

Oxygen therapy: Monitoring and equipment management for children requiring supplemental oxygen.

*The Independent Skilled Nurse also provides a great deal of developmental & family support by:

Monitoring developmental milestones and alerting families or providers of delays.

Teaching families and caregivers how to safely perform daily care tasks (e.g., tube feedings, suctioning).

Promoting age-appropriate activities within the child’s health limitations.

Helping parents navigate medical systems, appointments, or care coordination.

*The Independent Skilled Nurses also handle all administrative and clinical documentation themselves:

Writing nursing care plans and updating them as the child’s condition changes.

Documenting each skilled visit or shift, noting progress, interventions, and any physician communication.

Coordinating with physicians, therapists, schools, and specialists through release-of-information forms (ROI).

Maintaining HIPAA-compliant records and ensuring family rights and responsibilities are clearly communicated.

*The Independent Skilled Nurse also acts as the business operator:

Verifies orders from the child’s provider before initiating skilled services.

Ensures compliance with state nurse practice act and home health regulations.

Manages billing and documentation (private pay, MaineCare).

Maintains professional liability insurance, licenses, and continuing education.

Creates required forms such as consent for nursing services, patient rights and responsibilities, and discharge from care notices.

Here is a side by comparison of Independent Nurse Vs Agency Nurse in Skilled Home Care
10/30/2025

Here is a side by comparison of Independent Nurse Vs Agency Nurse in Skilled Home Care

Address

Richmond, ME

Telephone

+12074800455

Website

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