Medical daycare, therapeutic daycare, and traditional daycare serve different children with different needs. Traditional daycare works for typically developing kids. Therapeutic daycare integrates therapy for children with developmental delays. Medical daycare provides skilled nursing for medically complex children.
Every child’s needs are different. A no-obligation consultation can help you understand which care path best supports your child.
The Three Types: Quick Overview
These daycare options exist on a spectrum of medical complexity and developmental support.
Traditional daycare provides basic childcare—play, early learning, and supervision from early childhood teachers. No medical care or therapy services included.
Therapeutic daycare integrates speech, occupational, and physical therapy into the daily schedule. Special education teachers and therapists work with children who have developmental delays but don't require medical monitoring.
Medical daycare (called PPEC, or Prescribed Pediatric Extended Care) provides skilled nursing care from registered nurses. Children who use ventilators, feeding tubes, or oxygen receive medical interventions while participating in play and developmental activities.
Traditional Daycare Basics
Traditional daycare employs early childhood teachers with basic first aid training. They supervise play-based learning, provide structure, and teach foundational skills like letters and numbers.
Who it serves: Typically developing children without chronic health conditions or developmental delays.
Staff ratios: Most states require 1:10 to 1:15 ratios for preschoolers (Virginia requires 1:10 for ages 3-5, Florida requires 1:15 for 3-year-olds).
What they cannot provide: Traditional daycares cannot administer complex medications, perform skilled nursing interventions, or provide integrated therapy services. Staff don't have medical or therapy licenses.
Cost: Traditional daycare averages $1,094 per month nationally, with infant care costing approximately $1,485 per month. This is 100% out-of-pocket with no insurance coverage.
Not sure which environment best supports your child’s needs? This article compares both options clearly.
Therapeutic Daycare: Developmental Support
Therapeutic daycare integrates therapy services into the school day for children with developmental delays.
Who it serves: Children need therapy (speech, occupational, physical) but don't require medical monitoring or skilled nursing care.
Staffing and Services
Therapeutic programs employ special education teachers alongside licensed therapists (SLPs, OTs, PTs). Staff-to-child ratios typically range from 1:6 to 1:8.
Key distinction: Therapeutic daycares don't have registered nurses on staff. They cannot provide medical interventions like medication administration or equipment management.
Who Benefits
Children who might benefit include those with:
- Speech or language delays
- Autism spectrum disorder (mild to moderate, no medical complications)
- Sensory processing challenges
- Motor delays (fine or gross motor)
- Social-emotional developmental needs
- ADHD or behavioral challenges (not requiring medical intervention)
Cost
Therapeutic daycare costs $1,200 to $2,500 per month. Some insurance plans cover therapy portions, particularly for children with autism diagnoses in states with ABA therapy coverage mandates.
Unsure whether your child qualifies for Medicaid-covered care? This article explains eligibility in plain terms.
Medical Daycare (PPEC): When Nursing Care Is Needed
Medical daycare is a licensed medical facility staffed by registered nurses who provide skilled nursing throughout the day.
What Medical Daycare Provides
PPEC centers deliver continuous medical monitoring, skilled nursing interventions, medication administration, emergency response, integrated therapies, and developmental activities—all in one location.
According to the American Academy of Pediatrics, children with medical complexity have "multiple chronic conditions, functional limitations, high healthcare utilization, and dependence on medical technology." Medical daycare serves this population.
Not sure what happens inside a PPEC? This overview explains services, staffing, and daily care.
Who Qualifies
Children qualify when they require medical technology or skilled nursing interventions:
Medical Technology:
- Tracheostomy requiring suctioning
- Ventilator or BiPAP dependence
- G-tube or J-tube for feeding
- Oxygen monitoring or supplementation
- Apnea monitors
- Central or PICC lines for IV medications
Skilled Nursing Needs:
- Seizure disorders requiring monitoring
- Complex medication schedules
- Chronic lung disease requiring treatments
- Conditions requiring catheterization
A physician must prescribe PPEC services based on medical necessity.
Skilled Nursing Interventions
Registered nurses perform medical interventions throughout the day, including tracheostomy suctioning (every 4-8 hours minimum), ventilator management, feeding tube care, complex medication administration, vital sign monitoring, and emergency response.
Children also participate in age-appropriate play, therapy sessions, and developmental activities. Medical care happens alongside childhood—not instead of it.
Coverage and Cost
Medical daycare costs $0 with Medicaid coverage. Zero copays, zero out-of-pocket expenses.
Medicaid's EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefits cover all medically necessary services for children under 21, including PPEC. This includes nursing care, therapies, transportation, meals, and medical supplies.
Children qualify with Medicaid coverage, a medical need requiring skilled nursing, and a physician prescription.
Middle-income families: Katie Beckett waivers allow children to qualify for Medicaid based only on the child's medical needs—not family income. These waivers are available in 30+ states.
Want complete details on medical daycare? Read our comprehensive guide to PPEC.
Side-by-Side Comparison
The critical difference: Staff credentials determine what services can be provided. Only registered nurses can perform skilled nursing interventions like tracheostomy suctioning, ventilator management, or complex medication administration.
Which Type Does Your Child Need?
Use this framework to identify the right daycare type.
Does Your Child Use Medical Technology?
If your child uses any of these, they need medical daycare:
- Tracheostomy (trach)
- Ventilator or BiPAP
- G-tube or J-tube for feeding
- Oxygen monitoring or supplementation
- Apnea monitor
- IV medications via central line or PICC line
- Requires frequent suctioning
- Has seizures requiring medication and monitoring
These interventions require a licensed nurse present at all times.
If No Medical Technology: Does Your Child Have Developmental Delays?
If your child needs therapy services (speech, OT, PT) for developmental delays but doesn't require medical monitoring, therapeutic daycare fits.
If Typically Developing
If your child meets age-appropriate milestones, has no chronic health conditions, and doesn't need specialized support, traditional daycare works well.
Not Sure Where Your Child Fits?
PPEC centers can assess whether your child's medical needs qualify for medical daycare. Children with g-tubes alone, seizure disorders, or oxygen needs often qualify—not just ventilator-dependent children.
You can transition to less intensive care later if appropriate. Moving from traditional to specialized care after challenges arise is more difficult.
Schedule a free consultation to have our medical team assess your child's needs and recommend the appropriate care level.
What Medical Daycare Looks Like
Medical daycare integrates skilled nursing care into a child-centered environment. Nurses perform medical interventions—suctioning, medications, monitoring—while children participate in circle time, art projects, adaptive playground time, and peer play.
At medical daycare, your child socializes with peers who have similar medical needs. Feeding tubes, oxygen monitors, and wheelchairs are normalized. Children build friendships with others who share their experiences.
Parents receive real-time updates throughout the day. Transportation is provided with medical staff on the vehicle. The PPEC center coordinates with your child's medical team, handling appointments and medication consistency.
Why Families Choose Spark Pediatrics
Spark Pediatrics operates 13 centers across Florida (plus expanding Texas locations), making us Florida's largest PPEC network.
Medical Expertise
Every Spark center is continuously staffed by at least one nurse with NICU or PICU experience. These nurses have managed medically complex, unstable children in hospital settings. They recognize subtle changes in breathing patterns, skin color, or behavior that signal developing issues.
We maintain 1:3 staff-to-child ratios at all centers.
Documented Outcomes
Research shows PPEC programs achieve 15% fewer non-primary care outpatient visits and 75% of parents report reductions in hospitalizations and ER visits. Spark families report significant reductions in hospital admissions, fewer ER visits, and improved developmental progress.
Simplified Enrollment
Our enrollment specialists handle all paperwork, Medicaid authorizations, and physician coordination. Enrollment typically completes in 1-2 weeks.
We offer multilingual staff fluent in Spanish and Haitian Creole, parent support groups, and educational workshops.
Find a Spark location near you or schedule your free consultation.
Frequently Asked Questions
Can traditional daycares accommodate children with medical needs?
Traditional daycares can provide basic first aid and sometimes give oral medications with parent permission. They cannot legally perform skilled nursing interventions like tracheostomy suctioning, ventilator management, or feeding tube care. Staff are teachers without nursing licenses.
Does my child still get to play at medical daycare?
Yes. Medical daycare integrates age-appropriate activities, play, art, music, and outdoor time alongside medical care. Children participate in circle time, sensory activities, and adaptive playground time while nurses provide monitoring. Therapists conduct sessions during the day.
How quickly can enrollment happen?
Enrollment typically takes 1-2 weeks and includes medical assessment, physician prescription, Medicaid authorization, and care plan development. The PPEC center handles paperwork. Most centers offer tours during the enrollment process.
What if our family income exceeds Medicaid limits?
Your child may qualify through Katie Beckett waivers, which use only the child's income (not family's) for eligibility. These waivers are available in most states for medically complex children. The PPEC center can guide you through the application process.
Can we tour before enrolling?
Yes. Tours are encouraged. You'll meet staff, see facilities, observe daily routines, and ask questions. Spark offers both in-person and virtual tours with no obligation. Contact us to schedule.
Next Steps
Traditional daycare serves typically developing children (cost: $800-$1,500/month out-of-pocket). Therapeutic daycare provides integrated therapy for developmental delays (cost: $1,200-$2,500/month with partial insurance). Medical daycare delivers skilled nursing care for medically complex children (cost: $0 with Medicaid).
If medical daycare fits your child's needs:
Schedule Your Free Consultation
Our medical team will assess your child's needs, answer your questions, and help determine if PPEC is appropriate.