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Swing Beds: Medicare Regulatory and Program Changes You Need to Know

Swing Bed Groundwork must be in place.

CAH and PPS swing bed programs need to understand the reason behind the initiation of swing beds and the reliance on understanding skilled nursing regulations to operate and successfully financially manage the program. Our education provides some historical, operational, regulatory, and management basics to review, both for existing swing bed programs and those thinking about initiating swing bed services.

Swing Bed Standards must be in place.

Swing Bed programs need to center programs around basics such as Medicare-required documentation and management decisions on programming, and move to successful operation models as skilled nursing goes through major changes this year.

Swing bed programs must adapt to the changing health care regulatory and program design changes.

This includes identifying the strengths of the current program, future patient flow initiatives, and how to coordinate with multi-level health care services to retain and/or grow swing bed programs. We offer a SWOT transitional analysis of your current operations to determine what areas your unit should focus on for this transitional change.

Medicine Best Practices:

In multiple defined areas of review and for seven distinct medication concerns, CMS is asking for all skilled facilities to be more diligent in reducing unnecessary medications, performing drug regimen reviews, scheduling gradual dose reductions, and building a team that does what is right for our LTC, skilled nursing, and swing bed patients. Through our education and examples, and by providing tools to assist you, our training will help swing bed leadership and team members initiate or improve compliance efforts.


For both PPS and CAH swing bed programs, reviews and audits are underway. Therapy services are the most audited and reviewed component to skilled nursing services, often because therapists have not been made aware of very specific and required elements of documentation. More importantly, in current reviews, increased importance has been placed on goals and improved outcomes prior to discharge. Review of key elements during and at the completion of therapy services is a necessary internal audit. This education will help seasoned and new therapists have a better understanding of Medicare intent for therapy services in a swing bed program.

What is the focus and intent of the Interdisciplinary Team (IDT)?

The Interdisciplinary Team (IDT) is mandated in federal regulations, and not following those guidelines can lead to survey issues with non-compliance. But, more importantly, a good IDT meeting is the best method for communicating, changes progress, discharge planning, medical necessity, and other key compliance issues to all key staff involved in patient care. Our education provides the learners with a heightened awareness of the focus and intent of the IDT and an understanding of why it is so vital for more successful clinical and operational outcomes.

If you are not 100% sure you are prepared for the Medicare changes underway for 2019 and beyond, please contact our post-acute care team today.

If you’d like to learn more about our post-acute care services, click here.

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