# What GAPP skilled nursing covers at home in Georgia, and what decides your child's hours. By Ava Family Services Intake and Nursing Team, reviewed by Ava Family Services leadership. Published 2026-09-30. Source: https://www.avafamilyservices.com/guides/gapp-skilled-nursing-what-it-covers Publisher: Ava Family Services, LLC, (404) 905-7699, 275 Interstate North Cir SE, Suite 200, Atlanta, GA 30339 > GAPP skilled nursing pays for a licensed nurse to care for your medically fragile child at home, doing the tasks that need a nurse: trach and ventilator care, suctioning, tube feeding and medicines, seizure response and close monitoring. Your child's hours are not a standard package. They follow the doctor's plan of treatment and Georgia Medicaid's medical review. ## What does GAPP skilled nursing cover? GAPP skilled nursing covers a licensed nurse caring for your child at home for the tasks that need nursing skill. Georgia's Department of Community Health describes GAPP as care for children in their homes and communities, and in a medical daycare setting, as an alternative to a nursing facility. At Ava Family Services, nursing is provided when it is ordered by your child's doctor, medically necessary, within the nurse's scope of practice, and authorized by GAPP. ## What a GAPP nurse does at home Depending on your child's orders, an Ava nurse's shift can include: - Tracheostomy care, suctioning and trach changes - Ventilator, BiPAP, oxygen and other respiratory support - G-tube and J-tube feeding, and giving medicines through a tube - Seizure monitoring and response, including rescue medicine when ordered - Medication administration and close monitoring of vital signs - Watching for the early signs of trouble, and calling the doctor or 911 when needed - Hospital-to-home transitions, so the first nights home are covered. See [hospital-to-home care](https://www.avafamilyservices.com/pediatric-home-nursing/hospital-to-home). ## Skilled nursing or personal care: what's the difference? GAPP pays for two kinds of hours. **Skilled nursing** is care that needs a licensed nurse, like the tasks above. **Personal care** is hands-on help with daily living: bathing, dressing, feeding by mouth, toileting, turning and moving. The difference matters because the plan of treatment lists both, and because parents can be paid for [personal care hours](https://www.avafamilyservices.com/family-caregivers), but not for skilled nursing hours. ## What decides your child's nursing hours? Your child's hours come from three things, in this order: 1. **The care your child needs every day**, including overnight. 2. **The doctor's plan of treatment**, which shows the nursing and personal care recommended. 3. **Georgia Medicaid's medical review**, which approves services in advance. You'll see hour ranges quoted on other websites. Ava doesn't publish a typical number, because hours depend entirely on the child. The best thing a family can do is make sure the doctor sees a complete, honest picture of a real day. Our [guide to documenting daily care](https://www.avafamilyservices.com/guides/documenting-daily-care-for-gapp) shows how. ## Who Ava's nurses are Ava's nurses are Georgia-licensed and have at least three years of verifiable experience with medically fragile children. Every nurse is background checked, has verified references, is credentialed and is oriented to your child's specific plan of care before working with them. Families help choose their nurse: while GAPP approval is in progress, we learn your child's needs and your schedule, and you take part in interviewing and choosing. ## Talk to an Ava nurse Call Ava Family Services at [(404) 905-7699](tel:+14049057699), Monday to Friday, 9am to 5pm. Ava has no waitlist and is accepting new families. *Services, medical necessity and authorized hours are decided by Georgia Medicaid's GAPP medical review. Ava guides your family through the process and provides the care that is approved.* ## Frequently asked questions ### How many nursing hours will my child get? GAPP sets hours based on your child's medical need, the doctor's plan of treatment and medical review. We don't quote a typical number because hours depend on the child, and anyone who promises a number before review can't know it. ### Is GAPP nursing the same as private duty nursing? They are often used to mean the same thing. GAPP is the Georgia Medicaid program that pays for skilled nursing in the home for children under 21. ### Can a parent be paid for nursing hours? Parents can be paid for GAPP personal care hours, not skilled nursing hours. At Ava that is the [Family Caregiver](https://www.avafamilyservices.com/family-caregivers) program, always alongside an Ava nurse. ### Who are Ava's nurses? Georgia-licensed nurses with at least three years of verifiable experience caring for medically fragile children, plus background checks, verified references and training on your child's plan of care. ### Can we meet the nurse first? Yes. Families help choose their nurse at Ava. While approval is in progress, we learn your child's needs and your schedule, and you take part in interviewing and choosing. ## Official sources - [Community-Based Services, Georgia DCH](https://dch.georgia.gov/programs/hcbs/community-based-services) - [Georgia Pediatric Program (GAPP) Presentation, GAMMIS (June 2023)](https://www.mmis.georgia.gov/portal/Portals/0/StaticContent/Public/ALL/NOTICES/GAPP%20Presentation%20Finalized%20June%2026%2023%202%2020230630141655.pdf) - [Reimbursements Approved for Legally Responsible Individuals Under GAPP, Georgia DCH (Nov 2024)](https://dch.georgia.gov/announcement/2024-11-19/reimbursements-approved-legally-responsible-individuals-under-georgia)