Patient classification systems can be valuable tools for identifying trends in acuity and for justifying budgeted nursing care hours. A valid and reliable patient classification system can greatly facilitate the delivery of cost-effective, high-quality care. However, the more highly specialized the institutional population, the more difficult it becomes to use a standardized system. In this article, the authors address the development of a patient classification system for a postacute rehabilitation pediatric facility. Included is a discussion of the various pilot phases, the implications for clinical nursing practice, and the impact on family-centered care.