Monroe County Hospital increases swing bed program census by 21% in less than 12 months, then up to 40% after 18 months.
WATKINSVILLE, GA / ACCESS Newswire / July 9, 2025 / Inpatient beds that can move from acute care to skilled nursing, as needed-known as swing beds-help patients transition from hospital to home. They can also help rural hospitals transition from struggling to success.
This is particularly true for Critical Access Hospitals (CAHs), which can receive higher reimbursement rates from Medicare for swing bed services compared to larger Prospective Payment System (PPS) hospitals.
However, even though swing beds can be a game changer, building a swing bed program or strengthening an existing one takes time and strategic planning, often requiring overcoming internal and external hurdles. Many rural hospitals simply do not have the resources to take this on by themselves.
A Swing Bed Census That Plateaued
Monroe County Hospital is a 25-bed CAH located in Forsyth, Ga. Like many rural hospitals, it faced challenges. Some were large, others smaller. Some they could tackle. But others weren't getting better, and they knew they needed help.
In the fall of 2023, Monroe's leadership partnered with Aletheia Health Partners, a strategic advisory firm specializing in rural hospital transformation, to help address their challenges and find the best ways to move the hospital forward.
Aletheia's data analysis team got to work studying the numbers to gain clarity on what had been happening in many areas of the hospital, including the swing bed program.
Data showed that over the three most recent years, Monroe's swing bed census had plateaued, hovering between 8.8 and 12.3 average daily patients. Yet the analysis revealed that instead of requiring a major overhaul to turn things around, an increase of just a couple of patients a day could bring in enough additional revenue to help make a significant difference in Monroe's financial health.
Laying Groundwork to Obtain More Referrals
Data also showed that most of Monroe's swing bed census came from referrals from other hospitals, so laying the groundwork to attract more of them was key. Marketing resources were developed and a campaign began, promoting the availability of Monroe's swing beds and the quality of the program.
Kerry Trapnell of Aletheia, who serves as Monroe's Interim Chief Executive Officer, explains why, in addition to marketing, improving the referral intake processes was critical in shoring up the swing bed program, too.
"Referrals are usually sent out to multiple swing bed providers," he says. "Ultimately, those who are able to respond the fastest and in the most professional manner - and have the right quality services that are needed - are chosen."
Creating a High-Touch Culture
On face value, it could appear the work needed to strengthen the program was mostly done: marketing was raising visibility of Monroe's swing beds to referring hospitals, and effective intake processes had been put in place to help ensure more patients came to Monroe. Marketing had also been developed to promote services to Forsyth and the surrounding area.
But the program still needed more - something less tangible, but arguably even important than the work that had been done.
"In swing bed care, where patients may stay for weeks, every interaction - from the nurse to the aide who delivers the meal to the physical therapist - is an opportunity and a powerful touchpoint. Our focus, therefore, was on empowering not just clinical staff, but everyone at the hospital to deliver compassion and support, transforming each encounter into a positive reflection of the hospital. It's all about the culture," says Trapnell.
Expanding Clinical Capabilities and Services
A final component increasing not just a sustainable, but thriving, swing bed program was to address the growing need for skilled care for more complex patients, so a wider group of patients could be accepted into Monroe's swing bed program.
Monroe now offers a full range of services and capabilities for swing bed patients, from complex wound care to respiratory therapy for patients with lung or breathing issues to physical, occupational and speech therapy and more.
View Monroe County Hospital's Swing Bed Program web page: https://www.monroehospital.org/services/swing-bed-program/
Impact Worth the Effort
The partnership between Monroe and Aletheia and implementation of these strategies yielded worthwhile results:
Pre-Intervention (3-year average): 11.0 daily patients
Post-Intervention (12 months): 14.2 daily patients (29% increase)
Post-Intervention (18 months): 15.5 daily patients (40% increase)
Aletheia's Recommendations for Rural Hospitals
For hospitals examining their own swing bed programs, Trapnell recommends the following:
Assess Your Swing Bed Potential: Conduct a thorough internal assessment to identify opportunities for growth and optimization.
Invest in Your Culture: Cultivate a culture where every staff-patient interaction will reinforce quality and compassion.
Communicate Your Value: Market to and actively engage with your community and potential referral sources to highlight your capabilities and quality.
Develop Your Intake Processes: Implement efficient systems for referral management and patient admissions to ensure timely and seamless transitions.
Assess Your Capabilities: Evaluate your capacity to care for swing bed patients with complex needs, addressing a growing need and potentially increasing length of stay and revenue.
Assess Your Bandwidth: Evaluate how much time, effort and expertise will be needed for strategic planning and implementation. If your resources are thin but you want to achieve more with your swing bed program, contact Aletheia at kerryt@aletheiahp.com to learn more about how we can help.
Aletheia Health Partners helps rural hospitals become solid and strong so they can focus on what matters most: patient care. As a community-focused hospital management company, Aletheia Health Partners provides management and operations service modules including human resources, revenue cycle management, and pharmacy services - all with the goal of creating a path for rural hospitals to remain sustainable for the communities they serve. To learn more, visit https://aletheiahp.com.
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CONTACT:
Aletheia Health Partners
info@aletheiahp.com
706-389-9500
SOURCE: Aletheia Health Partners
View the original press release on ACCESS Newswire
