The prevalence of children with medical complexity has increased over the past several decades as a result of advances in medical care and improved survival of children with chronic, congenital, and critical illness.^1,2 Most children with medical complexity receive care at home from families with or without the assistance of home health care and nursing; however, a small but growing proportion of sick children are served by skilled nursing facilities or pediatric long-term care facilities (pLTCFs).^3,4 These children require assistance with activities of daily living and have complex medical care needs, including use of medical devices and technology (eg, enteral feeding tubes, tracheostomies, and ventilators). Pediatric LTCFs also provide developmentally appropriate therapies and socialization with other residents, staff, volunteers, and visitors.

在过去的几十年中，由于医疗保健的进步以及患有慢性，先天性和严重疾病的儿童的存活率提高，具有医疗复杂性的儿童的患病率有所增加。^{1 ，2}多数患儿医疗的复杂性从家里带或不带的家庭医疗保健及护理援助的家庭得到照顾; 但是，只有一小部分但越来越多的患病儿童由熟练的护理机构或儿科长期护理机构（pLTCF）提供服务。^{3 ，4}这些儿童在日常生活活动中需要帮助，并具有复杂的医疗保健需求，包括使用医疗设备和技术（例如，肠内饲管，气管切开术和呼吸机）。儿科LTCF还提供与其他居民，员工，志愿者和来访者相适应的发展性疗法和社交活动。