GETTING TO KNOW NORTH SHORE HEALTH
North Shore Health Swing Bed Services
By Andrea Brobst, NSH Clinical Nurse Manager
At some point in time, you, a family member or friend may have been in the hospital and heard the term Swing Bed. What exactly is a Swing Bed? The term conjures up the image of a hammock, but you have never seen a swinging bed when you have been in the hospital! For ease of understanding, consider Swing Bed services from a patient perspective. If you have been a patient in the hospital but are not quite ready to go home and still need more services, either your physician, nurse or social worker (many times, all three) mention the option of a Swing Bed stay.
Swing Beds were established in the early 1980s, when hospitals in rural America had the inappropriate number of beds dedicated to the level of care at the time. Rural hospital beds were empty because patients were being referred to urban centers for acute treatment and not being referred back to their own community facility. According to the 2020 Centers for Medicare & Medicaid Services (CMS) interpretive guidelines for Swing Beds in Critical Access Hospitals (CAHs), "a 'Swing-Bed' is a change in reimbursement status." A CAH such as North Shore Health can use our beds interchangeably for either acute care or post-acute care. The reimbursement swings from billing for acute care services to billing for post-acute skilled nursing services, despite the fact that the patient usually stays in the same bed in the same room.
A Swing Bed is recommended when the doctor determines that a patient is stable and no longer needs acute care but skilled services would be beneficial. A Swing Bed stay is designed to be rehabilitative or restorative in nature and can help those patients who need:
- Long term IV antibiotics
- Wound care
- Therapy (Physical Therapy, Occupational Therapy and/or Speech Therapy) after a stroke, accident or injury
- Rehabilitation after surgery
- Rehab or skilled care after recent hospitalization to gain strength and mobility because of weakness or deconditioning
- Pain management
Our wonderful care team comprised of nurses, therapists, physicians and support personnel work with each patient to determine the best treatment plan developed with the patient’s specific needs in mind. Patients may remain in a Swing Bed for as long as they have skilled therapeutic goals to achieve. The average length of stay is generally between seven to 30 days. However, Medicare coverage is limited to 100 days of skilled Swing Bed care. When a patient has met their goals, they will be discharged to their home or to another setting.
There are rules that Medicare and the insurance companies have for the use of Swings Beds. These services are usually covered under the Skilled Nursing Facility benefit category. Medicare and state regulations provide the following patient eligibility guidelines:
- A patient must be hospitalized as an Acute Care Inpatient (not an Observation Patient) for a minimum of three consecutive midnights within a 30-day period.
- Admissions can come from any hospital, North Shore Health, Duluth, etc., after three consecutive midnights as an inpatient in acute care.
It is always best to verify with your insurance company about specific coverage for Swing Bed services. The Care Team, including Medical Records and the Business Office, will assist patients in contacting their insurance companies to verify coverage and/or obtain prior approval or a prior authorization. This prior approval is a requirement for certain insurance companies, particularly Medicare Advantage plans.
Swing Bed services allow patients to receive close to home patient-centered care where family, friends and even pets can visit. Questions about Swing Bed services can be directed to Rose Downey, Social Services Designee or Andrea Brobst, Clinical Nurse Manager at 218-387-3040.
For more information, visit: https://www.northshorehealthgm.org. Stay tuned for future informative Getting to Know North Shore Health articles published monthly in the Cook County News Herald.