1. (1) Definition.  A swing bed is a licensed hospital bed that can be used for either a hospital or skilled nursing home patient. A swing bed program is authorized in Alabama to include hospitals that meet the criteria as specified in Federal laws and regulations. In accordance with the appropriate directive and this State Health Plan, a swing bed hospital must meet the following requirements:

   1. (a) must meet the federal requirements addressing the facility size, location, and utilization factors;
   2. (b) must have a valid provider agreement under Medicare;
   3. (c) must meet the discharge planning and social services standards applicable to participating skilled nursing facilities;
   4. (d) must not have a waiver for 24-hour nursing coverage;
   5. (e) must be granted a Certificate of Need by the State Health Planning and Development Agency to provide skilled nursing facility services;
   6. (f) any provider seeking to offer swing beds as a new service is limited to an initial allotment of ten (10) beds;
   7. (g) Subject to the procedure provided in paragraph (2) below, each participating hospital is limited to twenty-five (25) swing beds;
   8. (h) the average length of stay for swing bed patients must not exceed 30 days;
   9. (i) beds authorized as swing beds will remain licensed as general hospital beds and be included in the general acute care inventory and bed need methodology;
   10. (j) critical access hospitals shall be given special consideration in any application for a Certificate of Need for swing beds.
2. (2)  A participating hospital may apply for additional swing beds if it can demonstrate an average occupancy rate for its existing swing beds greater than eighty percent (80%) for the most recent twelve (12) month period. That hospital may apply for no more than five (5) additional swing beds in any given twelve (12) month period, and its application cannot result in a total number of swing beds exceeding the maximum number set forth in paragraph (1)(g) above.

3. (3) Any hospital certified and operating as a Critical Access Hospital which is located in a county in which only one Nursing Home is licensed and providing service is not required to meet the occupancy rates in paragraph (2) but must adhere to all other requirements set forth in this section in order to apply for additional swing beds.

   For a listing of hospitals with CON authorized swing beds contact the Data Division as follows:

   MAILING ADDRESS                 STREET ADDRESS
   (U. S. Postal Service)          (Commercial Carrier)
   PO BOX 303025                   100 NORTH UNION STREET, SUITE 870
   MONTGOMERY, AL 36130-3025       MONTGOMERY, AL 36104

   TELEPHONE:                      FAX:
   (334) 242-4103                  (334) 242-4113

   EMAIL:                          WEBSITE:
   data.submit@shpda.alabama.gov   http://www.shpda.alabama.gov

Author: Statewide Health Coordinating Council (SHCC)

Statutory Authority: Code of Ala. 1975, §22-21-260(4).

History: Effective May 18, 1993. Amended: Filed June 19, 1996; effective July 25, 1996. Repealed and New Rule: Filed October 18, 2004; effective November 22, 2004. Amended (SHP Year Only): Filed December 2, 2014; effective January 6, 2015. Repealed and New Rule: Published March 31, 2020; effective May 15, 2020. Repealed and New Rule: Published April 30, 2024; effective June 14, 2024.