Welcome to the Rural Swing Bed Management Training Program Information page.  The RSBM Program is offered to individuals, facilities, groups, networks, or consortiums of both PPS or Critical Access Hospitals in order to help their hospital team utilize best practices for compliance and efficiency in order to grow their Swing Bed program.

The Need for Swing Bed Training

One of the challenges small or rural hospitals face today is a shrinking acute census. In fact the average daily census in rural hospitals across the country is under four. Under the Medicare program, rural hospitals with 100 or fewer licensed routine care beds are eligible to participate in the swing bed program, meaning that a bed can be used for either an acute care patient or a post-acute patient. Swing bed hospitals include both critical access hospitals (CAHs) and those paid under the Prospective Payment System (PPS). While financial considerations are different for each setting, the need for post-acute clinical care is increasing. Swing beds can strengthen relationships with local physicians, specialty physicians, and tertiary facilities. In both settings swing beds can improve occupancy and productivity in addition to increasing facility revenue. However, swing bed programs will do more harm than good if hospital leadership do not understand very specific skilled nursing regulations.

During the pandemic, the use of swing beds, particularly within Critical Access Hospitals, increased exponentially. Urban hospitals sought placement well beyond city limits as acute beds became scarce. Swing Bed Programs were already increasingly admitting clinically complex patients, and some swing bed programs were able to accept/care for vent patients.

Swing Beds have the opportunity to provide additional patient days to set up the most appropriate plan. This means that Swing Bed Programs had the ability to extend length of stay needed to care for COVID patients. Even with the more typical Swing Bed patient, traditional orthopedic/post-surgery patients have an average length of stay of 13 days, and the more clinically complex patients have an average length of stay of 18 days. With these types of admissions, along with the COVID admissions, swing bed programs have the ability to complete a true discharge plan, defining the next service the patient might need.

The case for swing beds.

Swing Beds are increasingly important in the financial health of  rural hospitals, particularly as acute admissions reduce and/or are helping meet the DRG or CAH 96-hour rules. Not only do they supplement reimbursement, but they produce more efficiencies in controlling cost. One clear example is with nurse staffing. As acute census fluctuates, there are increasing examples of nurse call-offs during a time when rural hospitals have critical nursing shortages. Swing Beds utilize acute nursing staff during a time when acute admissions are fewer; and, because the average length of stay is normally a week or more, these post-acute beds provide stabilization of nursing staff 24/7. Other examples might include ancillary services needing stabilization and cost absorption. Rural hospitals may staff for respiratory therapy 24/7 but are not necessarily utilizing staff time making the RT cost spread over multiple settings (acute, ED, swing bed). Other services, such as lab and radiology. also have an opportunity for better utilization. Swing Beds can also feed hospital outpatient services, such as therapy, wound care, respiratory, or lab.

This comprehensive swing bed education and training program will address rural swing bed issues and provide the necessary tools for patient care, compliance, efficiency and quality. The ability to utilize swing beds for CAHS not only reduces the Medicare costs per patient bed day PPS swing bed programs add a new service line while contributing to the retention of staff and the avoidance of transfer penalties. increases revenues and margins that can help support population health, wellness, and community health needs. Care can be provided closer to home, with less disruption in services and continuity of care improves. Rehospitalizations often decrease with more ready access to physicians and needed ancillary services for a population that is more typically elderly and has multiple chronic conditions. This education and training program for rural hospitals provide the basics for compliance, operational and fiscal awareness and assists in building a strong peer network.

The goal of the RSBM Training Program is to assist Prospective Payment System (PPS) and/or Critical Access Hospitals (CAHs) with expert training and guidance for their staff to:

• understand Swing Bed Conditions of Participation (CoP),
• review clinical care options,
• improve the quality of their swing bed programs,
• optimize patient outcomes, and
• increase utilization and revenue for post-acute care services.

Who should participate?

Hospital Administration/C-Suite with Swing Bed Programs or Nursing Homes, Nursing Home Administrators, DONs, Swing Bed Coordinators, MDS Coordinators, and other staff members involved in swing bed programs in CAH or PPS facilities.

Program Overview

The Rural Swing Bed Management Program is designed to allow teams to work through online education, while also benefiting from access to tools and resources and industry experts. Participants can utilize the online education in a manner that best fits their program and educational opportunities. Program leaders can take advantage of the digital toolkit and library that supports program activities and practical purposes, and our 'experts' are available to provide custom support via email and other means to ensure you are getting the right information to answer your questions and contribute to your program's success.