I have a student who might be getting a trach placed over the summer for breathing support during sleep, not during the day.  This is uncharted territory for me, so all insight and voices of experience are welcome so I can best prepare for this possibility.  The mom specifically asked if there was a requirement for 1:1 care in NH standards.  I couldn't find anything so I doubt it, but again, if you know otherwise please share here.  Thanks so much!