As the population of ventilator-dependent children with tracheostomies grows, there are increasing demands to shift the care of technology-dependent children from hospital to home. Home care nurses are an integral part in the continuum of care for these children and their families after hospital discharge. Home care nurses help to facilitate a safe transition from the hospital and allow families and children to thrive in their home and community. The purpose of this article is to describe best practices in caring for children with tracheostomies and invasive home mechanical ventilation. Hypothetical case studies are presented.