Swing beds
Swing beds are units within acute care hospitals where patients receive the same skilled level of care that is available at skilled nursing facilities (SNFs).
Swing beds are subject to the same coverage and billing requirements as SNFs, paid under the SNF prospective payment system (PPS) and subject to consolidated billing.
Note: Critical access hospitals with swing beds are not subject to Part A SNF PPS.
The main difference between swing beds and SNFs are the bill types used to report services.
Covered skilled level of care
Services rendered to patients receiving a covered Part A skilled level of care in a swing bed are submitted on bill type 18X.
Services excluded from SNF PPS and Consolidated Billing is billed by the hospital under its provider number with bill type 13X. These claims are billed as outpatient Part B services and payable under the outpatient prospective payment system (OPPS) to hospitals subject to OPPS.
Swing bed patients who exhaust their SNF benefits days may have covered ancillary services submitted on bill type 12X. These claims are billed as inpatient Part B services and payable under OPPS to hospitals subject to OPPS.
Noncovered level of care
Patients who go from a skilled level of care to a non-skilled level of care, but remain an inpatient in the swing bed unit, may have covered services submitted on bill type 12X. These claims are billed as inpatient Part B services and payable under OPPS to hospitals subject to OPPS.
Quality measures
Quality measure specifications are available in the Minimum Data Set (MDS) 3.0 Quality Measures Users’ Manual. MDS is part of the federally mandated process for clinical assessment of all residents in Medicare and Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing home staff identify health problems. For more information, please visit the CMS Quality Measures page.
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