How Many Nursing Hours Will GAPP Cover for My Child?

What determines your child's hours

The approved hours reflect how much skilled care your child genuinely needs to stay safe at home. Reviewers weigh the complexity of your child's condition, the clinical tasks involved, and how much hands-on nursing those tasks require.

• The severity and complexity of your child's medical condition
• Reliance on medical technology (ventilator, feeding tube, etc.)
• The frequency and skill level of required nursing tasks
• Physician documentation supporting the level of care

Why hours vary from child to child

Because approval is tied to documented medical necessity, a ventilator-dependent child who needs continuous monitoring may be approved for far more hours than a child whose needs are significant but intermittent. This isn't arbitrary — it's meant to match care to need.

It also means strong, detailed physician documentation directly affects the outcome. Vague notes tend to produce conservative approvals; thorough notes paint the full picture.

Hours can change over time

Your child's approved hours aren't necessarily permanent. As their condition changes — for better or worse — the plan of care can be reviewed and adjusted. If your child's needs increase, updated physician documentation can support a request for more hours at the next review.

If the hours don't fit your child's needs

If you feel the approved hours don't reflect your child's reality, talk with your care coordinator and your child's physician. Often the path forward is clearer documentation of medical necessity. Our team helps families understand their approval and, when appropriate, pursue a review.