Research Article Health AffairsVol. 6, No. 3 Swing-Beds: Current Experience and Future DirectionsHila Richardson and Anthony R. KovnerPUBLISHED:Fall 1987No Accesshttps://doi.org/10.1377/hlthaff.6.3.61AboutSectionsView articleView Full TextView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions View articleAbstractPrologue:In an era when the long-term care needs of the elderly are growing, the federal government has been reluctant to embrace new policies that would expand the availability of such services. The concern of government has revolved around the potential high cost of long-term care. In the absence of major new policies, Congress has authorized a number of demonstrations, seeking to identify what may work and what should be discarded as possible future program directions. One of these demonstrations authorized small rural hospitals to use their beds interchangeably to provide either acute, skilled, or intermediate care for their Medicare patients. In this article, authors Hila Richardson and Anthony Kovner discuss the evolution of the so-called swing-bed concept since Congress enacted this provision seven years ago. One of the interesting details they discuss is the degree to which this provision, a seemingly practical solution to the twin problems of a shortage of nursing home beds and a decline in rural hospital occupancy, became a subject of controversy. Some of the controversy was provoked by the competing economic interests of hospitals and nursing homes. This conflict is not limited to the swing-bed provision. At the state level, the hospital and nursing home lobbies are constantly engaged in economically based struggles over serving the elderly patient. Richardson, who holds a doctorate in public health from Columbia University, is senior director of the Office of Long-Term Care, New York Health and Hospitals Corporation. Kovner is a professor of public administration at New York University and director of its graduate program in Health Policy and Management. Richardson and Kovner were, respectively, associate director and director of The Robert Wood Johnson Foundation's Rural Health Care Program. The program will award $9 million in grants and $7.5 million in loans to some fifteen groups of hospitals that plan to reconfigure their health services and, in the process, improve their financial viability.TOPICSSwing-bed hospitalsNursing homesLong-term services and supportsAcute careHospital medical staffAccess to careMedicareHospital costsPatient careCost containment Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article MetricsCitations: Crossref 5 History Published online 1 January 1987 InformationCopyright © by Project HOPE: The People-to-People Health Foundation, Inc.PDF downloadCited byHospital Provision of Institutional Long-Term Care1 October 2000 | The Gerontologist, Vol. 40, No. 5Swing Beds and Rural Hospitals in New York, 1991 to 1994The Journal of Rural Health, Vol. 14, No. 1State Legislation and Policy Affecting Rural Hospital Conversion and ClosureThe Journal of Rural Health, Vol. 12, No. 5Market Competition and the Quality of Nursing Home CareJournal of Health Politics, Policy and Law, Vol. 19, No. 3Acute and Long-Term Care Linkages: A Literature Review19 August 2016 | Medical Care Review, Vol. 47, No. 1