Research Alert: March 4, 2024

New Recap on Post-Acute Care in Rural Areas

Gateway has developed Rural Health Research Recaps to identify the key findings from the Rural Health Research Centers on specific rural health topics. The following Recap examines post-acute care in rural areas.

Post-Acute Care in Rural Areas: The Role of Swing Beds and Nursing Homes

• The post-acute care (PAC) phase acts as a bridge between the hospital and the next steps to recovery. Types of PAC services include skilled nursing facilities (SNFs), home health, hospice, inpatient rehabilitation facilities, and, unique to rural areas, swing beds.
• A swing bed is a change in reimbursement status which allows certain small, rural hospitals to use their beds for either acute care or PAC. A patient “swings” from receiving acute inpatient care services and reimbursement to receiving SNF-level services and reimbursement while often remaining in the same hospital or even the same physical bed.
• After PAC, some patients may require additional long-term care. Custodial care and skilled care are two types of long-term care. However, not all nursing homes provide SNF-level services, and nursing home closures in rural counties may result in nursing home residents being relocated to facilities farther from their home and social support networks. Furthermore, complex care needs and staffing shortages can make placement in a nursing home difficult.
• For individuals requiring SNF-level PAC and not long-term custodial care, swing beds may provide the most appropriate care that is closest to home.

Additional Resources of Interest:

• More information from the Rural Health Information Hub's topic guides: Critical Access Hospitals, Long-Term Care Facilities