Why swing beds should be a strategic priority for rural hospitals

For most rural and critical access hospitals (CAHs), swing bed programs remain an underutilized opportunity. When empty acute-care beds can be used for post-acute care services, hospitals can drive revenue while providing a vital service for their community.

In fact, Carolyn St. Charles, chief clinical officer for HealthTech, says that swing beds can offer a real financial benefit, but many CAHs have yet to maximize the promise of the program relative to volume and community benefit.

“If you want swing beds to be an asset to the organization, an asset to patients and an asset to the community, then you have to think about the program not just as an extension of acute care but as a separate service line,” St. Charles says.

Elevating a swing bed program to a service line would mark it as a strategic priority for the organization. This shift would mean that there would be more attention paid to meeting the volume and outcome goals of the program, as well as staff and provider education and competency.

The processes related to admission, continuing care and discharge are different than acute care, and can feel tedious and unnecessary to hospital staff and providers. St. Charles says that there are definitely additional steps in caring for swing bed patients. However, providing staff and providers with not only the tools to care for swing bed patients, but also developing core competencies like any other service line can benefit not only the hospital but also patients.

Oftentimes, recognizing criteria for swing bed admissions is another missed opportunity for hospitals. St. Charles says there is a common misconception that swing beds are just for patients who need physical therapy, but in reality there are many nursing reasons for a patient to be admitted to a swing bed that may be completely overlooked.

Just as elevating swing beds to a service line can drive revenue, the strategic decision can also place more emphasis on the value of the program and more emphasis on the outcomes of the program. For swing beds, tracking specific patient outcomes should include at a minimum number of admissions, length of stay, readmission rates, discharge disposition and patient satisfaction.

“Once you have revamped and identified swing beds as a service line, it is very important to review the program on a regular basis to ensure it is meeting the program goals that have been established or if not, developing corrective actions,” St. Charles says. She also recommends including the swing bed team in the evaluation process as critically important.

Realistically, if done right, most rural and critical access hospitals could revamp and revitalize their swing bed program in as few as three to six months, she says.


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