01
Tracheostomy Care
Suctioning, trach change schedules, site monitoring, and emergency decannulation protocols. Trach/vent-trained RNs and LVNs only.
Pediatric Private Duty Nursing
Built for your child’s
most complex days.
We staff tracheostomy, ventilator, and medically fragile pediatric cases across Greater Houston — so you can be the parent, not the nurse. RN and LVN coverage under Texas Medicaid managed care, verified by EVV every shift.
Greater Houston hospitals and pediatric subspecialty clinics welcome. We work with your discharge team.
The Megacare Complex Case Pathway
Houston
Home ICU.
For children moving from NICU, PICU, or pediatric subspecialty admission to home, the first twelve weeks set the trajectory. Our pathway pairs a senior RN, a trach/vent-trained LVN, and a family-training protocol built to match the standard of the discharging hospital.
When hospitals discharge complex cases, they call us — and this is why.
Between Parent and Nurse
Compassion.
When we are at the bedside, you can be the parent again. That is the whole point — and the hardest thing to teach.
Conditions We Staff
Hospital-level nursing,
at home.
Pediatric PDN is not general home health. Every nurse on a complex case has the acuity training to match. These are the conditions we accept and have experience supporting in Houston homes.
02
Ventilator Management
Pressure-support, volume-cycled, and BiPAP-dependent members. We coordinate directly with respiratory therapy and pulmonology teams.
03
G-Tube & J-Tube Feeding
Continuous and bolus feeding regimens, pump programming, site care, and formula administration per the physician order.
04
Seizure Management
Rescue medication administration (Diastat, Nayzilam), seizure log documentation, and real-time escalation to neurology.
05
TPN & Parenteral Nutrition
Central-line TPN administration, infusion-pump oversight, lab draws, and direct coordination with the ordering home-infusion pharmacy and physician.
06
Oxygen Therapy
Continuous and intermittent oxygen support with pulse-ox monitoring, titration per order, and equipment troubleshooting.
07
BiPAP & CPAP Support
Non-invasive ventilation setup, mask fit, leak assessment, and compliance monitoring for pediatric respiratory members.
08
Medication Administration
Complex medication schedules, IV and injectable therapies, and parental education so the care plan is safe on days we are not there.
09
Respiratory Therapy Coordination
Chest physiotherapy, nebulizer treatments, airway clearance (CoughAssist, vest), and direct coordination with the ordering physician.
10
Central Line & PICC Maintenance
Dressing changes, flush protocols, infection surveillance, and rapid response to line issues before they become an ED visit.
11
Neurogenic Bladder Management
Catheterization schedules, bowel programs, and skin integrity monitoring for spina bifida and spinal cord injury pediatrics.
12
Post-NICU / PICU Transitions
Structured hospital-to-home handoff for medically complex infants and children discharged from Greater Houston's major pediatric and adult hospital systems.
Have a condition not on this list? Call us. If we cannot staff the case safely, we will say so on the first call and refer you to an agency that can.
Intake Protocol
A predictable path
from referral to first shift.
Our pediatric PDN intake follows the same five-step protocol whether the referral comes from a hospital discharge planner, a Medicaid case manager, or a family directly. No black boxes, no waitlists.
- 01
Referral received
Phone, fax, or secure email from discharge planner, case manager, or physician. Referrals received during intake hours are typically acknowledged the same business day.
- 02
Clinical review
A registered nurse reviews the child's chart, POC, and authorization — before we commit. If we cannot staff the acuity, we say so on the first call.
- 03
Family visit
An intake nurse meets the family in the home. Environmental assessment, equipment walk-through, parent training plan, and skills checklist signed off.
- 04
Staffing assembled
We match the case to RNs and LVNs with the specific acuity experience — trach, vent, seizure, TPN. The nurse meets the family before the first full shift.
- 05
First shift
EVV-verified clock-in. Point-of-care tablet charting. RN supervisor available by phone. We prioritize a prompt start and coordinate closely with the family, MCO, and referring physician on timing.
Why Houston Families Choose Megacare
Four things we do that
most agencies don’t.
The founder still works bedside.
Ms. Elizabeth Okoye-Dike, DNP, takes PDN shifts herself when the schedule runs thin. Not a marketing claim — a staffing protocol.
22 years. Zero violations.
Continuous operation since 2003. Zero deficiencies on our most recent TX HHS inspection (Aug 2024). Medicare cert #673193 since 2005. BBB A+.
One nurse, one child, one shift.
Private duty means a caseload of one. Your nurse is not bouncing between patients. She knows your child's medications, equipment settings, and seizure triggers — cold.
Point-of-care tablet charting. EVV every shift.
No paper. No double-documentation. GPS-verified clock-in/out per Texas HHS requirements. Compliance lives in the system, not in our word.
The Third Shift
Medicine can be taught. Trust is built — one uneventful shift at a time.
MCHHS Pediatric PDN Team
Texas Medicaid Programs We Bill
Credentialed with the plans
that cover pediatric PDN.
Private Duty Nursing for children in Texas is covered primarily under Medicaid managed care. If you are unsure which plan your child has, call us.
- STAR Kids (Texas Children's Health Plan, Superior, Wellpoint, Aetna Better Health)
- STAR+PLUS (Molina, Wellpoint, Superior)
- Medically Dependent Children Program (MDCP)
- Community First Choice (CFC) nursing services
- Community-Based Alternatives (CBA)
- Private Duty Nursing (PDN) under Texas Medicaid
Have a Medically Complex Child at Home?
Talk to our pediatric
intake nurse.
If your child qualifies for Texas Medicaid PDN and we can staff the acuity safely, we will walk you through next steps on the first call.
Referring a patient? See the For Referrers flow.