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Swing Bed Utilization: Optimizing for Hospitals

A well-managed swing bed program is essential to a critical access hospital. This program can improve patient outcomes and provide additional reimbursement opportunities creating a “win-win” for the patient and the hospital. In addition, the program can assist the hospital manage its average length of stay, utilizing unused beds while keeping staff busy.

Swing Bed Findings for Critical Access Hospitals

The Post Acute Care team at Blue has found that many critical access hospitals are potentially underutilizing their Swing Beds. When talking with our clients we discovered:

  1. Hospitals are trying to use a local Skilled Nursing Facility (SNFs) before considering their own swing beds. As a reminder, swing beds are a perfect place for those patients who need medical oversight past the traditional 3 days spent in the inpatient side.
  2. Hospitals are primarily dependent on therapy to skill patients for the swing beds. During the assessment, we often discover there are a number of patients who would have qualified for skilled nursing services, but the team did not fully understand the potential here.
  3. This model assists with managing the acute length of stay which is very important in the critical access hospitals.
  4. This model assists with reducing readmissions (those patients who are discharged to a freestanding SNF but who are not quite medically stable yet).

Improving Swing Bed Utilization for Hospitals

Typically a one-day assessment is needed to fully understand what is going on at the hospital and determine an appropriate approach. Before the assessment takes place, the hospital needs to prepare information on all patients who were discharged to skilled nursing 12 months prior. We will review their policies and procedures with particular attention to their admission criteria. Interviewees would include:

  • Case management/discharge planning
  • Nursing
  • Therapists
  • Hospitalist(s)

We will also ask for the number of emergency department transfers for 12 months with the intent at helping identify patients who should be followed and tracked to potentially return to their on Swing Bed unit in their own community.

Implementation – As we prepare your assessment with our findings, we will create a hospital specific implementation guide where you can expect the following:

  • Revision of the hospital’s policies and procedures, specifically, admissions criteria
  • Creation of the following:
    • Swing bed admissions team
    • Philosophical changes; “Why shouldn’t we swing this patient?”
  • Instill a focus on the patient’s medical stability
  • Hands-on education and support

Contact Us 

If you have any questions or would like assistance when it comes to Swing Bed utilization, please reach out to your local Blue & Co. Advisor or a member of our Post Acute Care team below.

Landon Hackett, CPA, MSA, Director

Stephanie Fitzgerald, RN, RAC-CTA, CPC, Manager

Kayla May, CPA, Manager

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