GAPP services explained: what RN, LPN, and PCS actually cover

What happens when a GAPP nurse shows up at your house. The real day-to-day, not the policy language.

Three types of GAPP services

RN (Registered Nurse)

The most complex medical needs. Trach care, ventilator management, IV medications.

LPN (Licensed Practical Nurse)

Ongoing medical care. G-tube feedings, scheduled medications, wound care.

PCS (Personal Care Services)

Daily living help. Bathing, dressing, feeding, getting in and out of the wheelchair.

Registered Nursing (RN): what they do in your home

She arrives at 7am. She checks your child's trach, suctions as needed, and sets the ventilator settings for the day. She watches the monitors while your child eats breakfast. At 8am she gives medications through the G-tube and documents everything. If something goes wrong during her shift — a trach comes out, oxygen drops, a seizure starts — she handles it. You don't have to stand over her. That's the whole point.

What an RN does on a typical shift

Tracheostomy care and suctioning
Ventilator monitoring and adjustments
IV medication administration
Complex wound care
Seizure monitoring and response
Care plan development and updates
Training parents on equipment and procedures
Coordinating with your child's doctors

Your child probably needs an RN if:

They have a trach or ventilator
They need IV medications at home
They use complex medical equipment that requires clinical judgment
Their care requires a nurse who can make decisions on the spot

Read more about RN nursing through GAPP.

Licensed Practical Nursing (LPN): what they do in your home

She comes at 6pm for the evening shift. She checks vitals, gives the 6pm medications through the G-tube, and preps the overnight feeding pump. She does a wound dressing change, cleans the site, applies new gauze. She monitors your child through the evening, handles the 10pm meds, and writes up the shift notes. If something changes — a fever spikes, the feeding tube clogs — she calls the RN or doctor and follows their instructions.

What an LPN does on a typical shift

G-tube feeding and pump management
Medication administration (oral, G-tube, injections)
Blood sugar checks and insulin
Wound care and dressing changes
Vital sign monitoring
Catheter care
Reporting changes to the RN or doctor

Your child probably needs an LPN if:

They have a G-tube or feeding pump
They take scheduled medications that need a nurse to administer
They have wounds that need regular care
They need monitoring but don't have a vent or trach

Read more about LPN services through GAPP.

Personal Care Services (PCS): what they do in your home

She arrives in the morning. She helps your child get out of bed, runs the bath, gets them clean and dressed. She makes breakfast and helps them eat. She gets your child positioned in the wheelchair, does the range-of-motion exercises the therapist wrote up, and keeps them safe and comfortable. While she's there, you can take a shower, drive your other kid to school, or just sit down for twenty minutes. That's what PCS is for.

What a PCS aide does on a typical shift

Bathing and personal hygiene
Dressing and grooming
Feeding assistance (not tube feeding)
Toileting and diaper changes
Positioning and transfers (bed to wheelchair, etc.)
Range-of-motion exercises prescribed by a therapist
Light housekeeping related to the child's care
Companionship and safety supervision

Your child probably needs PCS if:

They need physical help with daily activities like bathing and dressing
They can't take care of themselves due to a disability
They need help with mobility and transfers
A family member is doing all of this right now and needs relief

Read more about personal care services through GAPP.

How to figure out which service your child needs

Here's the short version:

Medical equipment→Trach, ventilator, IV lines = you need an RN

Medical tasks→G-tube, medications, wound care = you need an LPN

Daily living help→Bathing, dressing, feeding, mobility = you need PCS

Not sure where your child falls? Your agency can help you figure it out. You can also try our eligibility screener to get a starting point.

Can you get more than one type of service?

Yes. Many children get a combination. A child with a trach might have an RN during the day and a PCS aide in the evening for bath time and bedtime routine. Another child might get LPN shifts for medication management plus PCS hours so a parent can work.

What you get depends on what the doctor orders and what Medicaid approves. Your agency handles the authorization for each service type. If you're in DeKalb County or anywhere else in Georgia, you can search for providers who offer the combination you need.

Common questions about GAPP services

How many hours of GAPP services can my child get?

It depends on the physician order and Medicaid authorization. Some children get 8 hours a day. Others get 24/7 nursing. Your agency submits the request based on what the doctor orders, and Medicaid decides how many hours to approve.

Can I choose which nurse comes to my home?

Your agency assigns nurses, but you can request changes if someone isn't a good fit. Most agencies try to keep the same nurses on your case for consistency. If you have a problem with a nurse, call your agency and ask for a switch.

What if the nurse doesn't show up?

Call your agency right away. They should send a replacement. If you're getting regular no-shows or missed shifts, that's a sign to start looking at other agencies. You can browse providers in our directory.

Can GAPP nurses go to school with my child?

GAPP is for in-home care. School nursing is handled through your child's IEP or 504 plan. Some families use GAPP hours for before and after school, but the nurse stays at home.

Do I have to be home while the nurse is there?

It depends on the care plan and your child's age. For younger children, most agencies want a parent in the home or reachable nearby. Talk to your agency about what's allowed under your specific plan.

Can a family member be a PCS aide?

In some cases, yes. A family member can be hired through a GAPP agency as a PCS aide. There are rules about which family members qualify. Check our paid caregiver page for details on how this works.