Texas County Memorial Hospital has experienced steady growth for swing bed patients in the past five years, TCMH board members heard at last week’s monthly meeting.
“With new, expanded information available from the Hospital Industry Data Institute (HIDI), we are able to compare our swing bed days and discharges with other hospitals across the state,” explained Wes Murray, TCMH chief executive officer. “Since 2008, our number of swing bed discharges has grown every year.”
A swing bed admission is for a patient that has had at least three days of hospitalization in an acute care setting for a condition such as stroke or surgery. Patients are admitted to a hospital swing bed where they can receive round the clock care while continuing to recover.
Swing bed patients have access to a social worker and case manager, many types of therapy, weekly physician visits, a dietitian and other services available through the healthcare facility.
According to Murray, many patients and their family members choose to be transferred to TCMH for swing bed care after a hospitalization at a larger healthcare facility. Some patients also are changed over to swing bed status while at TCMH for a surgery or other illness if the patient requires additional care.
In 2008, TCMH had 28 swing bed discharges compared to an average of 78 discharges at other hospitals in the state. In 2013 TCMH had 175 swing bed discharges compared to an average of 91 discharges at other hospitals in the state.
“Our physicians are really embracing the swing bed process,” Murray said.
Murray described swing bed care as “less intensive” but important in a hospital where the average patient age is over 70.
“Hospitals everywhere are managing their average length of stay for patients more aggressively, so the need for swing bed care is rising,” Murray said.
The HIDI data also shows that TCMH swing bed patients average shorter long term stays than swing bed patients at other hospitals in the state. In 2013 the average length of stay for a TCMH swing bed patient was 3.63 days and the statewide average was 5.49 days.
“Swing beds are very beneficial for our patients and for the families of the patients,” Murray said.
Murray credits the uptick in swing bed usage to Dr. Jeffrey Kerr, emergency department medical director at TCMH. Kerr also works as medical director at several area nursing homes, and he has a strong background in geriatric issues.
“Dr. Kerr began encouraging our medical staff in utilizing swing beds with their hospitalized patients, and he educated our physicians about the importance of accepting new swing bed patients that were transferred from other hospitals,” Murray said.
According to Murray, swing bed care is covered by most private insurance, including Medicare. Private insurers may require prior authorization for swing bed care and vary in coverage options.
To qualify for Medicare reimbursement of a swing bed stay, the patient must have spent at least three days within the last 30 days in an acute setting. Medicare will cover 100 percent of a patient’s stay for the first 20 days, as long as the patient is receiving skilled services of some type. These skilled services include IV medication, diabetes management, physical or speech therapy, respiratory therapy, frequent medication changes, lab monitoring or surgery that includes dressing changes or other post-op care.
On the 21st day of a patient’s swing bed stay, Medicare will continue to pay 80 percent of the cost and the patient is responsible for the remaining 20 percent of the cost if there is no co-insurance. Medicare replacement may cover the co-insurance portion and require prior authorization.