The Transitional Care Program at The Children’s Center Rehabilitation Hospital serves children from newborn to 20 years old who would benefit from an individualized plan of care for their unique medical and therapy needs. Each patient in the Transitional Care Program is evaluated by the interdisciplinary team and receives a comprehensive plan to address their specific functional and medical goals. Families of patients in the Transitional Care Program are encouraged to room-in with their child and participate as a member of the care team.

The Transitional Care Program Team includes:

  • Physical Therapist
  • Occupational Therapist
  • Speech Therapist
  • Music Therapist
  • Teachers
  • Recreation Therapist
  • Child Life Specialist
  • Case Managers
  • Social Workers
  • Medical Team:  Pediatrician, Nurses, Respiratory Therapists, Nurse Practitioners
  • Dietitians
  • Behavioral Health Team:  Pediatric Neuropsychologist, Child Psychologist

Consultation and evaluation by the following sub-specialists is also provided as warranted:

  • Audiology
  • Dentistry
  • Ear, Nose, and Throat (ENT)
  • Endocrinology
  • Gastroenterology
  • Genetics
  • Nephrology
  • Neurology
  • Neuropsychology
  • Ophthalmology
  • Optometry
  • Orthopedic Surgery
  • Palliative Care
  • Physical Medicine and Rehabilitation
  • Psychology
  • Pulmonology
  • Urology

Programs within the Transitional Care Program:

  • Brain Injury Responsiveness Program – designed for patients with disorders of consciousness following a recent severe brain injury. Focuses on medical management, therapeutic intervention, and family training. Patients usually discharge home or to another rehabilitation program, based on their needs, in 12-16 weeks.
  • Optimization of Care – an 8-week program for children living at home who would benefit from an interdisciplinary assessment of medical management, equipment needs, therapy intervention, and educational resources. This program also focuses specialty consultations as needed and collaborative discharge planning with family to ensure continuity of care and social supports at home.
  • Thrive Inpatient Feeding and Development Program – a program for infants transitioning from the NICU to home with medical, feeding, and/or developmental needs. Families are provided with the training, support, and resources needed to ensure a smooth transition.
  • Intensive Feeding Program – a structured, three-week program designed for patient’s ages 2-6 years old with feeding difficulties that would benefit from intensive therapy. Our feeding and swallowing team will determine an individualized plan of care based on the patient’s specific goals, which may include learning to increase the amount of food consumed, increasing the variety of foods, overcoming sensory aversions, and/or decreasing tube feedings.
  • Post-operative care – designed for patients who would benefit from medical management, nursing care, and equipment evaluations after complex surgeries, or for those patients who would benefit from rehabilitative therapy after surgeries. Training is also provides to caregivers so patients can continue their healing process at home.
  • Wound Care Program – Assists patients with complex wounds requiring frequent specialized care in an inpatient setting to optimize healing and function. This program includes negative pressure wound therapy and those patients who require long-term IV antibiotics with need for continual nursing care and medical management.

Payment Sources

The Children’s Center Rehabilitation Hospital accepts private pay, insurance and Sooner Care.  The Hospital also offers a financial assistance program.  If you have concerns about your ability to pay for your child’s care, or applying for financial assistance, please call (405) 789-6711, ext. 1202.

If you would like to make a referral to the Transitional Care Program, please call our referral line at (405) 470-2247 or email at referrals@tccokc.org.