By Emily Koogler
Medical Social Worker-Case Manager, Blanchard Valley Health System

The extended recovery unit or “swing bed unit” offers personalized, resident-centered care in a quiet and private setting to help an individual reach an optimal level of recovery. Extended recovery unit residents are those who have exited acute care but still need a variety of recovery care and support in the health center setting. 

A swing bed unit is specific to Critical Access Hospitals, which are smaller rural hospitals that improve access to care and provide around-the-clock emergency services. The swing bed program allows critical access hospitals to use the same beds for both acute and skilled nursing services, providing greater flexibility in patient care. This can allow patients to receive skilled nursing care without requiring a transfer to another facility.

The insurance benefit used is the Skilled Nursing Facility (SNF) benefit. With Traditional Medicare, this benefit requires a 3-consecutive-night inpatient stay within 30 days of admission. With Non-Traditional or Medicare Advantage plans, prior authorization is required. This benefit allows patients to receive short-term rehabilitation in a hospital setting. 

Patients must be medically stable to qualify for a swing bed unit, indicating their illness or injury has improved, no longer needing hospital-level acute care, and the diagnostic phase is complete, with no additional extensive testing needed to assess their condition. In addition, their care no longer requires daily physician evaluation. However, patients will continue to be monitored and have access to a physician, who will adjust the care plan if needed. Swing bed units aim to help patients regain their prior level of function and independence in a small, private-room environment. A typical length of stay is less than 14 days. 

Patients admitted to the Swing Bed Unit need continued skilled nursing care on a daily basis and/or rehabilitation services 5 days a week or more in order to assist with recovery before safely returning home. Examples of skilled nursing services include wound care, tube feeding management, and intravenous antibiotics. The SNF benefit requires that an individual must need skilled services provided by skilled professionals in a skilled setting to be utilized.

The skilled professionals who provide care in swing bed units include registered nurses, physical therapists, occupational therapists, speech therapists, dietitians, pharmacists, social workers, case managers and on-site physicians. This team takes a collaborative approach to comprehensive discharge planning throughout a patient’s recovery stay.

After discharge, the social worker-case manager completes callbacks throughout the first 30 days. This can help connect to community resources or provide additional care and services if needed.

Swing bed units are key to providing personalized care to those who require skilled care throughout their healing journey. They play a crucial role in ensuring patients receive tailored support at every stage of recovery.