By Emily Koogler, LSW, CCM
Social Worker-Case Manager, Bluffton Hospital

What is a swing bed?
The Centers for Medicare & Medicaid Services (CMS) grants approval to critical access hospitals to provide post-acute care in the hospital setting if the facility meets certain requirements. The swing bed concept allows a critical access facility to use its beds interchangeably for either acute care or post-acute care. The patient swings from receiving acute-care services and reimbursement to receiving skilled services and reimbursement while staying in the hospital setting.

What kinds of patients are seen in a swing bed unit?
Swing bed candidates are those who desire rehab in a post-acute care setting and have a daily skilled nursing need such as IV antibiotics, wound care, etc. or a skilled therapy need for five or more days a week with the goal of returning home after a rehab stay. Candidates also include those who are stable and no longer in the diagnostic phase or testing part of treatment.

Swing bed unit services
The types of service a patient can expect to receive in a swing bed unit include but are not limited to skilled nursing care; physical, occupational, and speech therapy; social services - case management; dietary management; individual and/or group activities; and home evaluations. This unit offers private rooms in a quiet, relaxed setting.

Referral process
If patients are at home, they could be admitted to a swing bed unit if they had a three-night inpatient stay within the past 30 days. Referrals can be made through a primary care physician or a home health office. A swing bed unit facility representative will then collaborate with the referral source to vet the referral process.

Length of stay and type of care provided   
For a typical swing bed unit, the length of stay averages around one to two weeks. An experienced staff is dedicated to treating patients with compassionate and considerate care. Some units hold weekly care conferences with an interdisciplinary team to provide a comprehensive approach for patients and families to optimize recovery. Ultimately, the goal of the swing bed unit and team is to help increase independence and confidence on an individualized basis prior to patients going home.