When local skilled nursing options fall short, hospitals face difficult tradeoffs: extended inpatient length of stay, patient transfers out of the community, and lost revenue opportunities.
In this session, we will share how they AdventtHealth built a swing bed program from the ground up in response to rising inpatient length of stay, quality concerns within local skilled nursing facilities, and a commitment to keeping patients close to home.
Attendees will learn how AdventHealth evaluated the business case for a swing bed program, aligned leadership and clinical teams, designed operational workflows, and is set to launch a compliant, high-performing program. The discussion will explore how a swing bed program became not just a service line addition, but a strategic lever to improve throughput, strengthen community trust, and enhance care delivery.
Participants will leave with a practical framework for assessing whether swing bed is right for their organization and how to successfully implement it.
At the end of this session, participants will be able to:
- Assess the strategic and financial case for launching a swing bed program, including its impact on length of stay, patient retention, and community care access.
- Design the operational and clinical infrastructure required to build a swing bed program from scratch, including leadership alignment, staffing considerations, and compliance requirements.
- Leverage data and quality reporting tools to monitor performance and drive continuous improvement.
Q&A
As a PPS Hospital – Before accepting a patient with a known high-dollar infusion, you should gather the following information – the specific drug name, route, dose, frequency, and anticipated duration, then price it against expected PDPM reimbursement (IV medications, parenteral nutrition, and complex medication regimens all increase the NTA score and therefore the daily rate). Also, take into consideration opportunities for 340B, if eligible and if the IV drug is excluded from the consolidated billing.
As a CAH – if the CAH can get the drug and administer the infusion, then this cost would be included on the swing bed claim. Also, make sure you consider 340B and that the CAH can cover the cost of the drug until cost report settlements are made.
Skilled services can include: Management and evaluation of a patient’s care plan, observation and assessment of a patient’s condition, and teaching and training activities
Description of these scenarios and examples can be found in the Medicare Benefit Policy Manual – Chapter 8
You may be able to do either option. If you provide the IP dialysis as a CAH or under arrangement, that will be included on the swing bed claim. If the patient goes for OP dialysis, you can do a leave of absence, and the OP provider will bill Medicare ESRD for the service.
When in doubt, check with your MAC on specific billing questions.
Yes, for Medicare swing bed patients.
Similar to the TEAM – where patients are being sent to SNFs or lower cost post-acute care settings. CAH should be able to articulate their value to potential referral sources. How does your CAH compare to SNFs in terms of LOS, readmissions, clinical outcomes? Often high performance in these could outweigh the cost barrier.
CAHs interested in measuring their swing bed quality and clinical outcomes, should consider utilizing Stroudwater’s Swing Bed Quality Reporting Program.
