Who qualifies for a Medicare-covered Swing Bed?

To qualify for Medicare-covered skilled nursing care in a Swing Bed, patients must: be enrolled in Medicare Part A and Part B with available skilled days, have been admitted to the hospital for at least three consecutive midnights before beginning Swing Bed service, have been admitted for medical care within days of discharge, be admitted for the same condition treated in the hospital, be certified by a doctor as needing skilled services daily, and require daily skilled services on an inpatient basis that cannot be provided in a lesser care setting.

What is the difference between skilled and custodial care?

Skilled care includes services like physical and occupational therapy (with documented progress), intravenous medications, new tube feedings needing adjustment, complex wound care, new catheters for active disease, Stage III or IV pressure ulcers, and patient/family education for new conditions. Medicare does not pay for custodial care, which includes general assistance with oral medications, bathing, dressing, walking, turning, repositioning, supervision, or assistance with incontinence.

What services are included in the Swing Bed Program?

Services may include physical, occupational, and speech therapy; rehabilitation; daily intravenous medications; tube feeding management; wound care; and access to providers, nurses, laboratory services, and imaging around the clock.

What happens after discharge from the Swing Bed Program?

Our Case Management and discharge planning staff work to help patients return to their prior living situation as soon as possible. If a change in living arrangements or financial assistance is needed, a case manager can assist with arranging home health care, durable medical equipment, caregiver assistance, and connecting patients with community resources.

Do commercial insurance plans cover Swing Bed services?

Swing Bed services are approved and paid for by Medicare. Prior authorization is required for commercial and Advantage plans. Contact your insurance provider or our Case Management team for specifics about your coverage.

Swing Bed Program | Memorial Health

Photograph of a healthcare worker assisting an elderly woman seated in a beige transit wheelchair in a hospital hallway.

A Swing Bed is a unit within an acute care hospital where a patient receives skilled nursing care. The Swing Bed program gives patients additional time to recover from a surgery, illness or injury. Swing Bed patients will have easy access to high-quality nursing care and evidence-based treatments. Our goal is for Swing Bed patients to return as close to their prior level of independence. Swing Bed patients enjoy round-the-clock access to our providers and nurses and 24/7 access to our lab and imaging services.

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Swing Bed services may include any of the following depending on patient needs:

Physical, occupational, speech or rehabilitation
Rehabilitation
Daily IV
Tube feedings
Wound care

Our goal is to have patients return to their prior living situation as soon as possible.

Swing Bed patients are encouraged to be gradually responsible for daily tasks such as hygiene, bathing and dressing. Our care team works together to determine specific goals. Our Case Management staff assists in arranging services for additional needs like home care assistance.

Swing Bed service is approved and paid for by Medicare. Prior authorization is required for commercial/Advantage plans.

To qualify for a Medicare-covered skilled/swing nursing benefit, patients must:

Be enrolled in Medicare Part A and Part B and have skilled days available
Have been admitted to the hospital for at least three consecutive midnights (traditional Medicare only) before beginning Swing Bed service
Have been admitted to a hospital for medical care within days of your discharge from the hospital
Be admitted for the same condition for which you were treated in the hospital
Be certified by a doctor as needing skilled services on a daily basis
Require daily skilled services on an inpatient basis (services that cannot be provided in a lesser care setting)

If the patient requires a change in living arrangements, or if financial assistance is necessary, speak with a case manager as soon as possible.

If aid is required upon discharge, the necessary arrangements will take time. Discharge planner will assist with needs such as home health, durable medical equipment, caregiver assistance and other necessary items prior to discharge. A list of area options can be provided or information is available at medicare.gov.

Community resources may provide in-home nursing, meals and some homemaking services.

The Difference between Skilled and Custodial Care

This is important for the patient and family to understand. Medicare does not pay for custodial care. Custodial care is general nursing care, such as assistance with oral medications, bathing, dressing, walking, turning, repositioning, supervision or cleaning up after incontinence.

What may be considered skilled services?

Skilled therapy from physical therapy and occupational therapy (must participate and show progress toward goals)
Intravenous medications
New tube feedings needing adjustment
Complex wound care treatment
New catheters to treat an active disease process
Stage III (3) or IV (4) pressure ulcers
Patient/family education for a new condition

Contact a case manager for more information about patient qualifications.