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Ensuring a smooth, safe transition

Last Modified: August 05, 2025

Family Medicine, Diseases & Disorders

 

Joe Houseman and his friends go to West Virginia every year to ride ATVs. When Joe’s vehicle landed on top of him, he sustained multiple injuries, including a broken pelvis, two broken ribs and a fractured elbow. When it came time to make decisions about his ongoing care, Joe knew he wanted to come back to Indiana. He wanted to be at Parkview LaGrange Hospital.

Joe’s stepdaughter, Emily Plant, an inpatient manager at Parkview LaGrange, knew just what to recommend when she got the call: the Continuing Care Program.

“The Continuing Care Program is for patients who are needing some short-term rehab before they go home to transition safely,” Emily said. “Swing beds, as we call them in the hospital setting, allows us to offer the same nursing ratios that we do for our acute care patients, as well as some other services. So, if you were to maybe need an X-ray, we can do that. We can do labs and monitor those patients that might be a little more medically complex.”

Referrals from Parkview or outside facilities come to a case manager, who helps determine the bet course. It’s all about finding what’s safest for the individual. The entire care team is involved in reviewing the patient’s needs, from physical and occupational therapy to the family, to discuss whether Continuing Care is a good fit.

“Our patients are seen by a physician, pharmacist, nurse, physical and occupational therapy, and if needed, respiratory and speech therapy,” Emily said. “It's very patient centered.”

An important part of the program is the care conference, a weekly interdisciplinary team meeting that includes the patient and their family. During these conversations, the group discusses progress as well as the home environment so that everyone is on the same page about when the patient is ready to be discharged.

“When I went home, I'd say I was 90%, and so the rest is just healing,” Joe said. “I hope Continuing Care is not necessary for anybody, but if they need it, they took care of me so well, I missed them when I went home.”

Emily agreed. “If I recommended it for my family member, which I wholeheartedly did, and he's doing amazing, I would absolutely recommend that for anybody else and their loved one.”

Learn more

If you’re concerned that you may not be ready to return home right away following a surgery, procedure or hospital stay, talk to a member of your care team about the Continuing Care Program. Or, contact Parkview LaGrange Hospital’s case manager team at 260-463-9279 to determine whether the program is right for you.