Prescribed Pediatric Extended Care (PPEC) is a specialized healthcare service designed for children who have complex medical needs but do not require continuous, intensive hospital care. This model offers an alternative to prolonged inpatient stays or relying solely on intensive private duty nursing within the home. The PPEC center functions as a medical daycare, providing a safe environment where medically fragile children receive physician-prescribed skilled nursing care and developmental support throughout the day. It allows these children to maintain community integration while ensuring their health requirements are consistently met by trained professionals.
The Prescribed Pediatric Extended Care Model
The PPEC model is a non-residential, facility-based program, distinct from traditional childcare and in-home health services. Care is delivered within a licensed clinic or center equipped with the technology and trained staff necessary to manage pediatric medical complexity. This structure operates during standard business hours, typically for up to 12 hours a day, supporting parents who need to work or attend to other family responsibilities.
This facility-based approach provides the least restrictive environment possible while maintaining high medical oversight. PPEC centers handle needs that a standard daycare cannot, such as ventilator management or complex medication schedules, ensuring constant medical monitoring is available. The extended care concept focuses on providing a consistent, structured medical environment that promotes the child’s well-being.
Who Qualifies for PPEC Services
Eligibility for Prescribed Pediatric Extended Care centers on the medical necessity for skilled, continuous care. A child must be under the age of 21 and have a complex medical condition that requires skilled nursing care or therapy daily. These conditions often include technology dependence, such as ventilator support, tracheostomy care, or specialized enteral feedings through a gastrostomy tube (G-tube).
The child must also be medically stable enough to be transported to and receive care in a non-hospital environment. This stability ensures the facility-based care is appropriate and safe, as PPEC centers are not equipped for acute emergencies. A physician’s prescription is mandatory to initiate and continue services. The required daily care must be beyond what an unskilled caregiver can provide, necessitating the continuous presence of a licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN) for monitoring and intervention.
Comprehensive Medical and Developmental Support
The care delivered within a PPEC center encompasses a wide array of skilled nursing and therapeutic services integrated into the child’s day. Skilled nursing care is a core component, including:
- Administration of complex intravenous medications.
- Wound care.
- Managing respiratory support, such as oxygen or ventilator settings.
- Managing seizure protocols.
- Providing specialized feedings, such as continuous tube feeds, which require precise delivery and monitoring for tolerance.
PPEC centers also provide integrated developmental therapies. These include physical therapy to improve mobility and gross motor skills, occupational therapy focused on fine motor control and skills for daily living, and speech-language pathology services addressing communication and swallowing difficulties.
These services are combined with opportunities for socialization and early childhood enrichment not typically available in a home-care setting. This holistic approach supports the child’s cognitive and social development alongside their physical health. The coordinated care plan is developed collaboratively by the PPEC staff, the child’s physician, and the family.
Daily Operations and Payment Structure
PPEC facilities operate during daytime hours, typically up to 12 hours per day, five days a week, aligning with the needs of working parents. This schedule allows for consistent care delivery and developmental activities. The centers maintain high nurse-to-patient ratios to ensure immediate and specialized attention is available for medically fragile children.
The payment structure relies heavily on government programs, making the care accessible to families who meet medical and financial criteria. PPEC services are covered by state Medicaid programs, which pay the centers directly for medically necessary services. For children who qualify for Medicaid, the services are often fully covered with no out-of-pocket costs. Some private insurance plans may also cover PPEC services, provided medical necessity is clearly documented.