This study examines differences between patients discharged to swing beds versus skilled nursing facilities (SNFs), stratifying by admitting hospital type (i.e., rural Critical Access Hospital [CAH] versus rural Prospective Payment System [PPS] hospital).

Key Findings

• Using data from the 2019 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID), this study found that 4.0% of discharges from rural CAHs were discharged to swing beds, and 9.1% of rural CAH discharges were discharged to SNFs. In contrast, 0.2% of discharges from rural PPS hospitals were discharged to swing beds, and 10.7% of rural PPS hospital discharges were discharged to SNFs.
• Compared to those discharged to SNFs and adjusting for discharging hospital type (rural CAH versus rural PPS hospital), individuals discharged to swing beds were generally younger, more likely to be White, more likely to live in a rural ZIP code, more likely to be primarily insured via Medicare, and less likely to be primarily insured via private insurance. Individuals discharged to swing beds also had a lower average number of comorbidities.
• Compared to discharges to SNFs and adjusting for discharging hospital type, discharges to swing beds were more likely to be classified as surgery-related visits during acute care.

Discharges to swing beds exhibited several statistically significant differences from discharges to SNFs, both in terms of demographic characteristics (e.g., age, race/ethnicity, location of residence) and clinical characteristics (insurance status, length of acute care stay, number of comorbidities, service line, major diagnostic category, principal diagnosis, primary procedure classification). These results collectively suggest that swing bed versus SNF use for post-acute care is at least partially dependent on patient-level characteristics.