PPEC or nursing at home: how do I choose?

By Superhero Kids PPEC care team · Updated October 19, 2026 · 6 min read

AI-made picture of a nurse holding a smiling baby next to white cribs. Not a photo of anyone at Superhero Kids.

PPEC and private duty nursing are both Florida Medicaid nursing care for children under 21, with no copay. At a PPEC, your child spends up to 12 hours a day at a licensed center with nurses and therapists. With private duty nursing, a nurse cares for your child at home. Families choose by their child's needs and their daily schedule.

Many parents hear about both on the same day, often at hospital discharge. This guide compares them side by side, so you can talk with your child's doctor about what fits your family.

Talk with your child's doctor before you choose. The right fit depends on your child's care, not only on your schedule.

At a glance

Both are Florida Medicaid services for children under 21, with no copay ¹².
Both start with an order from your child's doctor ²³.
PPEC: care at a licensed center, up to 12 hours a day ⁴.
Private duty nursing: a nurse at home, up to 24 hours a day if needed ¹.
Medicaid does not pay for private duty nursing inside a PPEC ¹.

What is the difference between PPEC and private duty nursing?

The biggest difference is where care happens. PPEC is care at a center. Private duty nursing, often called PDN, is a registered nurse or licensed practical nurse caring for your child at home or in the community ¹.

	PPEC	Private duty nursing (PDN)
Where	A licensed center	Your home or the community ¹
Hours	Up to 12 a day ⁴	Up to 24 a day, set by need ¹
Who cares for your child	Nurses, therapists and care staff, with at least one staff member for every three children ⁵	One nurse at a time, from a home health agency or an independent nurse ¹
Therapy and play	Developmental therapies, play and other children, in one place ²	Therapy is arranged separately
Rides	Medicaid's transportation benefit, with an escort the rules require the center to send ²	No rides needed
Who approves	Florida Medicaid, every 180 days. The state pays the center directly ²⁶	Your Medicaid health plan, or the state's reviewer if your child is not in a plan, at least every 180 days ¹⁷
Cost to the family	No copay ²	No copay ¹

Which one fits a working parent?

It depends on your child's care and on your day. Florida law says private duty nursing hours are set by your child's condition, how much care your family can give, and your family's schedule for work, school and sleep ³.

Private duty nursing does not cover babysitting, or care so a parent can run personal errands ¹. Its hours follow your child's medical needs.

At a PPEC, your child can spend up to 12 hours a day at the center ⁴. Rides to and from the center come through Medicaid's transportation benefit ². For many working parents, this gives the day a set shape: drop-off, a full day of care, and pickup.

At Superhero Kids, the center is open Monday to Saturday, 7 am to 7 pm.

Can my child have both?

Sometimes, but with limits. Medicaid does not pay for private duty nursing inside a PPEC, and it does not pay for two services that do the same job ¹². The rules read for this article do not say a child cannot have a PPEC day and home nursing at other hours.

Before you plan a schedule with both, ask your child's health plan or Florida Medicaid to confirm what they will approve. Every child's plan is reviewed on its own.

What if home nurses keep canceling shifts?

Home nurses can be hard to find. Florida lawmakers said so in 2023 when they created a program that lets trained family members be paid to help ⁸.

Under that program, a parent or relative can be paid as a family home health aide. They must finish at least 76 hours of training and work for a home health agency ⁷. They can work up to 12 hours a day and 40 hours a week, and those hours replace some nursing hours ¹⁷.

A PPEC is another option. Florida sets minimum staffing for every center: at least one staff member for every three children, with licensed nurses making up about half ⁵.

How do I decide what fits my child?

Bring these questions to your child's doctor and case manager:

How many hours of nursing care does my child need each day?
Does my child do better with one nurse at home, or with therapy and other children around?
How much of the care can our family give safely?
What does our week look like: work, school, other children, sleep?
Is my child at high risk from colds and other infections? A PPEC reviews this for each child before they start ⁹.

There is no wrong answer. Some families start with one and change later, with a new order and approval.

What does PPEC look like at Superhero Kids?

Superhero Kids PPEC in Boynton Beach is licensed for 82 children, the largest licensed capacity of any PPEC in Palm Beach County ¹⁰. Our nurses care for children from birth through age 20, Monday to Saturday.

Want to see it before you decide? Call (561) 877-2152. Open Monday to Saturday, 7 am to 7 pm.

Questions parents ask

Do we pay anything for either one?

Not with full Florida Medicaid. Neither PPEC nor private duty nursing has a copay ¹².

Who decides how many nursing hours my child gets at home?

If your child is in a Medicaid health plan, the plan approves the hours. If not, the state's reviewer visits your home, and a team recommends the hours ¹⁷.

Can the home nurse come with my child to the PPEC?

No. Medicaid does not pay for private duty nursing inside a PPEC ¹.

Can a parent be paid to care for their child?

In some cases. A trained family member who works for a home health agency can be paid as a family home health aide ⁷.

Can we switch from home nursing to PPEC later?

Yes. Talk with your child's doctor. A change needs a new order and a new approval.

Keep reading

Sources

Florida Medicaid, Private Duty Nursing and Family Home Health Aide Services Coverage Policy, February 2026, adopted in Rule 59G-4.261. Read October 14, 2026. https://www.flrules.org/gateway/RuleNo.asp?ID=59G-4.261
Florida Medicaid, Prescribed Pediatric Extended Care Services Coverage Policy, February 2018, adopted in Rule 59G-4.260. Read October 14, 2026. https://www.flrules.org/gateway/RuleNo.asp?ID=59G-4.260
Florida Statutes, section 409.905(4). Read October 14, 2026. https://www.flsenate.gov/Laws/Statutes/2026/409.905
Florida Statutes, section 400.914(2)(a). Read October 14, 2026. https://www.flsenate.gov/Laws/Statutes/2025/400.914
Florida Administrative Code, Rule 59A-13.010 (nursing services). Read October 14, 2026. https://www.flrules.org/gateway/readFile.asp?sid=0&tid=22755053&type=1&file=59A-13.010.doc
Florida Statutes, section 409.968(3). Read October 14, 2026. https://www.flsenate.gov/Laws/Statutes/2025/409.968
Agency for Health Care Administration, questions and answers on private duty nursing and family home health aide services, September 14, 2026. Read October 14, 2026. https://ahca.myflorida.com/file/FHHA/FAQs_PDN_and_FHHA_Services_09.14.2026.pdf
Florida Senate, bill analysis for CS/CS/SB 452 (2023). Read October 14, 2026. https://www.flsenate.gov/Session/Bill/2023/452/Analyses/2023s00452.fp.PDF
Florida Administrative Code, Rule 59A-13.007 (admission). Read October 14, 2026. https://www.flrules.org/gateway/readFile.asp?sid=0&tid=1823617&type=1&file=59A-13.007.doc
Agency for Health Care Administration, FloridaHealthFinder facility locator, PPEC centers. Counted October 14, 2026. https://quality.healthfinder.fl.gov/Facility-Provider/PPECC?&type=1