From Gap to Growth: How One Hospital Built a Swing Bed Program to Improve Care Delivery

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.
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Q&A

How do people stay on top of all the payer newsletters to sort through everything to pull out applicable information for the facility/provider? Who typically is going through the newsletter to gather the information to share with other staff?

Our billing specialists are organized by payer, allowing them to develop deep expertise in their respective areas. Each specialist subscribes to their payer’s newsletters to stay informed about updates and changes. Additionally, our team leads, Supervisor, and Director of Patient Accounts—along with the Prior Authorization Team—collaborate to share key insights and ensure the entire team stays up to date. This collective approach enhances our ability to navigate payer policies efficiently and provide the best possible service. 

What leadership structure do you have in place for your revenue cycle and who or what do you use for training when billers or coders need it? Especially for new service lines or common denials?

Our billing specialists are supported by a structured leadership team, including two team leads, one Supervisor, and one Director. Training for billing specialists is conducted by our Supervisor and team leads to ensure consistency and expertise. Additionally, billing specialists meet weekly with leadership to review denials and identify payer-specific trends. For new coders, who are required to be certified, training is led by our Coding Lead to maintain high standards of accuracy and compliance.

Are the billers assigned based on an alphabetical split or by insurance type, such as Medicare and Medicaid specialists?

Billers are first assigned by insurance type and then further divided by alphabetical split. Since each insurance type has multiple billers, the alpha split helps distribute the workload efficiently.

Since we have union employees, how could we implement a similar incentive to Kindal’s while ensuring compliance with union regulations?

This would depend on the specifics of your union contract. Stroudwater can work with you to review the contract and develop a compliant incentive model.

Does your Coding/HIM department manage CPT coding, modifiers, and ICD-10, or do they focus solely on ICD-10?

Our Coding team handles all aspects of coding, including CPT, modifiers, and ICD-10. They thoroughly review all provider documentation to ensure accuracy and compliance.