2581 Swing Beds | Medicaid

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Swing Beds

Effective Date:

February 2020

Chapter:

2575

Policy Number:

2581

Previous Policy Number(s):

MT 21

Updated or Reviewed in MT:

MT-58

Requirements

Designated small rural hospitals are allowed to assign certain hospital beds as nursing facility beds, called swing beds.

Basic Considerations

Hospitals approved as swing bed providers must have a provider number.

The swing bed hospital is required to obtain a level of care (LOC) approval on an approved LOC instrument (may or may not be a DMA-6) from GMCF.

Procedures

Follow the steps below to authorize a vendor payment for an individual placed in a swing bed:

Step 1

If the individual is receiving Medicaid when s/he is placed in the swing bed, proceed to Step 2.

If the individual is not receiving Medicaid when s/he is placed in the swing bed, determine his/her Medicaid eligibility under the Nursing Home or ABD Medically Needy classes of assistance (COA).

If Medicaid eligibility is determined under the Nursing Home, add a statement to the system generated approval notice informing the recipient that Medicaid is approved only through the month in which the swing bed/LOC approval expires unless the recipient is moved to an NH.

Step 2

Verify the approval of a level of care with an approved LOC instrument from GMCF upon admission to the swing bed. The LOC instrument may not indicate skilled or intermediate. If not, treat as if skilled care.

Step 3

Provide the applicant with all the same forms that are required for a regular NH applicant, including the Estate Recovery Form 315. Refer to forms section, Appendix F, Forms.

Step 4

Determine the recipient’s patient liability for the period of time approved for a LOC.

Step 5

Notify the A/R of the patient liability for each approved month.

Step 6

Authorize the vendor payment using the procedures for authorizing a limited stay. Refer to 2577 Limited Stays.

The NH must request an extension of the LOC approval with the receipt of a new LOC instrument from GMCF at the following intervals:

fourteen days following admission to the swing bed
every 30 days thereafter.

Step 7

The purpose of this special arrangement is to move the client to another appropriate place of care as soon as possible.

If a new communication from GMCF approving an extension of the LOC is received, approve an extension of the LOC. Refer to Chart 2577.1, Extending the Limited Stay. Notify the recipient of any change in patient liability.

If a new communication approving an extension of the LOC is not received by the day the previous approval expires and the A/R’s COA is Nursing Home, complete a CMD. Refer to 2052 Continuing Medicaid Determination.