Four years ago, the nursing staff of Children's Specialized Hospital, a pediatric rehabilitation facility in Mountainside, New Jersey, recognized the need to expand existing services to provide for the ventilator-dependent child. On February 11, 1985, the first patient was admitted to the program. Many patients who are ventilator-dependent benefit from transfer to a less acute facility where rehabilitative and developmental interventions augment ongoing medical, nursing, and respiratory management. Admission to the program at Children's Specialized Hospital is open to children with rehabilitative potential who, with intensive therapy and nursing support, can be weaned from the ventilator or can make the transition to a home-based program. This article describes the process of developing and implementing a program for ventilator-dependent children in a pediatric rehabilitation hospital. Special emphasis is placed on descriptions of the steps involved in the implementation process and on the nursing responsibilities for these patients.