Mission & History

The Guiding Principle — “Through delivery of professional and compassionate health care, we acknowledge the healing presence of God.” Luke 9:48

Mission Statement

PATCHES is a place where children with complex medical needs are given culturally sensitive, compassionate nursing care regardless of the ability to pay. By providing best practice interventions, our nurses and therapists help each child reach maximum health so they can develop, thrive, and grow.

The Patches Story

PATCHES began with a moment no nurse ever forgets.

A mother in Homestead, Florida, desperate to save her 18-month-old baby struggling with asthma, carried her child on foot from a migrant camp to the hospital. She had no transportation. No safe alternative. No bridge between home and emergency care.

Her baby did not survive the journey.

For Kyle Smith, a registered nurse then finishing her bachelor’s degree at the University of Miami School of Nursing, that loss became more than a painful memory. It became a mission. She saw the reality for many families in South Florida’s low-income rural communities: children with serious medical needs were being discharged home, but their families often lacked the transportation, equipment, nursing support, and training needed to care for them safely.

She could have stopped at identifying the problem. Instead, she chose to pursue solutions.

Drafting the Dream

Kyle’s first step was to push for bus stops at both the migrant camp and the hospital. Securing bus stops is not typical nursing work, but nurses are trained to advocate for whatever patients need. In the end, both the migrant camp and the old Homestead Hospital got bus stops.

In 1999, Kyle partnered with fellow nurses Joanie Ippolito, RN, and Patricia Catone, LPN, to create a new pediatric care model: a place where children could stay for up to three months while their families learned to care for them at home. They were nurses, not lawmakers, and they had never drafted legislation. But they understood the children, the families, and the dangerous gap in the system.

Through persistence, repeated trips to Tallahassee, and guidance from Miami lobbyist Bob Levy, the team helped draft legislation to make this type of care possible in Florida. In 2002, Governor Jeb Bush signed the bill into law, authorizing 4.5 million dollars. When the funding never arrived, Kyle and her colleagues decided to open a nonprofit PPEC or Prescribed Pediatric Extended Care center.

From Bill to Reality

Federal legislation recognizing PPECs had existed since the 1980s. PPECs are medical day-care centers that bridge the gap between hospital and home. PPECs are open for day care, They are usually from 6 a.m. to 6 p.m. weekdays. They provide children with complex medical conditions access to skilled nursing care in a safe, developmentally appropriate setting. They also gives give parents training, confidence, and the ability to keep working. Most of all, they offer families something invaluable: a reliable place where their child’s medical needs and dignity are both protected.

For the healthcare system, PATCHES demonstrates what compassionate, community-based care can accomplish happen. By providing skilled daily care outside the hospital, PPECs can help reduce unnecessary hospital use while supporting better continuity of care for children and families.

Growing to Meet the Need

Within three years, PATCHES had outgrown its original space. In 2008, the center expanded to a location in Florida City and opened a satellite center in Fort Pierce, where families faced the same painful gap in care. Fort Pierce children were being discharged from hospitals in Miami, Gainesville, and Orlando, but had limited access to appropriate ongoing care close to home.

Today, the two PATCHES locations have space for 160 children. These are children who may need feeding tubes, oxygen, medication management, respiratory support, seizure monitoring, developmental therapies, or careful nursing observation. But they are also children who need songs, stories, friendships, learning, laughter, and the chance to grow in a place designed for them.

For parents, PATCHES can mean the difference between choosing work and choosing safety. It can mean keeping a job while knowing their child is being cared for by trained professionals. It can mean fewer emergency room visits, fewer hospital readmissions, and more confidence in managing a complex health condition at home.

For the healthcare system, PATCHES demonstrates what compassionate, community-based care can accomplish. By providing skilled daily care outside the hospital, PPECs can help reduce unnecessary hospital use while supporting better continuity of care for children and families.

For the children, PATCHES is often much more personal.

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It is the nurse who notices a subtle change before it becomes a crisis.

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It is the therapist who helps a child reach a milestone once thought unlikely.

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It is the teacher who adapts a lesson to a child’s medical reality.

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It is the staff member who knows each child’s favorite song, comfort item, expression, and routine.

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It is a place where children are not defined by machines, diagnoses, or limitations. They are known by name.

What Comes Next

Kyle Smith and Joanie Ippolito have been recognized by organizations in Homestead, Tallahassee, Doral, and Miami and have been honored as Healthcare Heroes by the Greater Miami Chamber of Commerce. The University of Miami School of Nursing also recognized Kyle with the Barbara Buchanan Award. These honors matter, but they are not the heart of the PATCHES story.

The heart of the story is still the children.

That is why PATCHES is preparing for its next chapter: PATCHES The Village. Property has already been purchased. The vision is moving forward for expanded care and educational opportunities.

PATCHES began because one mother had no safe option.

Tomorrow, with continued community support, PATCHES The Village will help ensure that even more children have what every child deserves: expert care, human tenderness, and a place where they are protected, valued, and loved.

Leah S. Kinnaird, EdD, RN
PATCHES Board Member