GAPP Knowledge Center
Tracheostomy care at home under GAPP
Children with tracheostomies require skilled nursing oversight for routine trach care, emergency management, and monitoring. GAPP covers skilled nursing services for trach-dependent children in the home — allowing families to avoid long-term facility placement.
Skilled Nursing Tasks
Skilled nursing tasks Core Health Group Corp. provides for trach-dependent children
- Routine tracheostomy tube changes (as ordered by physician)
- Tracheostomy suctioning (oropharyngeal and endotracheal)
- Stoma site cleaning and skin care
- Inner cannula cleaning (for cuffed trach tubes)
- Secretion management and humidification
- Emergency trach dislodgement response
- Monitoring for signs of respiratory distress
- Coordination with pulmonologist and ENT care teams
- Family education and emergency training
- Documentation and communication with the physician
GAPP Authorization
GAPP authorization for trach care
Children with tracheostomies who require skilled nursing oversight typically qualify for GAPP authorization. The number of authorized hours depends on:
Ventilator Dependence
Whether the child is also ventilator-dependent — higher acuity generally results in more authorized hours.
Suctioning Frequency
The frequency of suctioning needs per day directly informs medical necessity for extended nursing coverage.
Medical Complexity
The child's overall medical complexity — including comorbid diagnoses — is considered in total authorization.
Caregiver Availability
Family caregiver availability and training level affect how nursing hours are allocated across the day.
Authorized hours are determined individually based on each child's clinical documentation, physician narrative, and overall medical complexity. Core Health Group Corp. coordinates the authorization process to ensure the request accurately reflects your child's needs.
Family Training & Emergency Planning
Family training and emergency planning
Core Health Group Corp. provides comprehensive family education as part of every tracheostomy care plan:
- How to recognize early signs of trach obstruction or displacement
- Emergency trach change procedures
- When to call 911 vs. when to troubleshoot at home
- Oxygen administration and BVM use
- Emergency kit contents and placement
- School and community notification planning
Our nurses work with families until they feel confident in emergency response — because the family is always the first responder.
Does my child need a ventilator to qualify for GAPP trach nursing?
No. Children with tracheostomies who require skilled nursing care for suctioning, trach changes, and monitoring can qualify for GAPP even without ventilator dependence.
Can an LPN perform tracheostomy care under GAPP?
Yes, with appropriate competency. In Georgia, licensed practical nurses (LPNs) can perform many tracheostomy care tasks under physician direction. Core Health Group Corp. ensures all nursing staff are competency-verified for each patient's specific protocols.
How often are trach tubes changed under GAPP nursing care?
Frequency is determined by the physician’s order. Most pediatric patients have routine trach changes weekly or every 2 weeks, with emergent changes as needed.
What if my child's trach is displaced and no nurse is on shift?
Core Health Group Corp. provides family emergency training as a core part of every trach patient's care plan. Families receive hands-on training and written emergency protocols. We also connect families to 24-hour clinical support.
Is suctioning included in GAPP skilled nursing hours?
Yes. Suctioning is a skilled nursing task and is included in authorized GAPP skilled nursing hours.
Free Eligibility Screening
Is your child's trach care covered by GAPP?
Core Health Group Corp. can review your child's diagnosis and insurance status at no cost. Most trach-dependent children on Georgia Medicaid qualify — let us check for you.