Transitional Care at Valley Health
Advanced Nursing Care & Extended Physical Rehabilitation Services
Valley Health’s Transitional Care program, more commonly known as
a “swing bed program,” offers comprehensive short-term post-acute
rehabilitation services. These services include skilled nursing, physical
therapy, occupational therapy, and speech therapy; along with other services
that are normally provided in a hospital.
The goal of transitional care is to help patients focus on increasing independence
and quality of life to seamlessly move from an acute hospitalization to
the next level of care. Most commonly, patients who benefit from transitional
- Neurologic- stroke, Parkinson’s disease
- Orthopedic- total joint replacement, compound fractures, hip fracture,
- Cardiac- heart attack, open heart surgery, congestive heart failure
- Pulmonary- chronic obstructive pulmonary disease, pneumonia
- Medically complex conditions
- Weakness after an extended hospitalization resulting in inability to care
for yourself at home
Who pays for Transitional Care?
In general, Medicare Part A will pay for Transitional Care if a patient
meets the following criteria:
- The visit must be linked to an acute 3 night hospital stay in the last 30 days
- The patient must require inpatient skilled nursing or therapy services
on a daily basis under the supervision of healthcare professionals.
Medicare will cover the first 20 days at 100% with a co-pay required for
additional service days as needed. Many commercial insurances, as well
as, Medicare HMOs, also offer a transitional care (swing bed) benefit,
which would need to be verified by the hospital prior to an admission
to a Valley Health Transitional Care program.
How long can I stay in a Transitional Care program?
In general, a patient can stay in a Valley Health Transitional Care program
as long as they are making clinically meaningful progress as determined
by the interdisciplinary care team in conjunction with the insurance benefit
guidelines. The average length of stay for a transitional care patient
at Valley Health is 8-14 days. Upon completion, patients will be discharged
to one of the following:
- Home with no follow up services
- Home with home health for nursing and/or rehabilitation services
- Home with an order for outpatient rehabilitation services
- Assisted living facility
- Skilled nursing or long term care facility
- Home with hospice
How do I find out more information?
For assistance requesting admission to a Valley Health Transitional Care
Program, please contact the hospital nearest you:
Hampshire Memorial Hospital
363 Sunrise Blvd.
Page Memorial Hospital
200 Memorial Dr.
Shenandoah Memorial Hospital
759 S. Main St.
War Memorial Hospital
1 Healthy Way
Berkeley Springs, VA