Assessing the quality of care provided in rural swing bed hospitals

Hospital swing beds - beds that are used to provide either acute care or long term care - may allow an acute care hospital to provide care to patients who might traditionally receive care in a nursing home. Prior to implementation of the Medicare and Medicaid programs, hospital beds occasionally were used as swing beds. Stringent certification and licensure regulations, however, caused substantial decreases in the number of acute care hospitals providing long term care. Although the intent of these regulations was to ensure adequate care for long term care patients, they ultimately resulted in reduced access to adequate long term care in many rural communities. In addition to the quality of care evaluation, four other components of swing bed care were evaluated: a financial component; a utilization component; an organizational component; and a policy component. Results of the financial, utilization, and organizational components, as well as the quality of care evaluation, were synthesized into a series of policy recommendations that emphasized the potential for national implementation of the swing bed program.