Mercy Health - Marcum and Wallace Hospital Invests in Swing Bed Program

Marcum and Wallace Hospital is a 25-bed, not-for-profit, Critical Access Hospital in Irvine, Kentucky. The Level IV Trauma Center and Accredited Chest Pain Center is the only hospital in a four-county service area. They provide acute care, emergency care, swing bed, rehabilitation therapies, imaging, lab, infusions, nutritional therapy, respiratory therapy, sleep studies, specialty clinics, and primary care through three Rural Health Clinics. Marcum and Wallace Hospital is a part of Bon Secours Mercy Health.  

Carla Wilber and Lindsay Corcoran, consultants with Stroudwater Associates, worked with Marcum and Wallace Hospital in 2017 through the Small Rural Hospital Transition (SRHT) project on a Transition of Care and Quality Improvement Project. Center staff spoke with Trena Stocker, Marcum and Wallace Hospital President, in November 2018 and again in May 2019 to discuss the implementation of the consultant recommendations.

What did you find to be successful regarding your project implementation?

The leadership team knew they wanted to work on the growth of the swing bed program to impact readmission.

To increase internal buy-in and ownership, Marcum and Wallace Hospital staff suggested names for the swing bed program to make the service less-confusing for patients. They ultimately named their swing bed program “Almost Home Skilled Nursing Care and Rehabilitation”. Staff are now more engaged, able to identify swing bed opportunities and are aware of their personal impact on quality scores. Additionally, Marcum and Wallace Hospital adopted processes to work with MCOs to develop criteria and began converting appropriate patients to swing bed. Pre-project, the readmission rate was 14%; they’ve been able to reduce that to 7.6% currently!

To increase external buy-in and community education about the program, the hospital has increased efforts to educate and promote their services, starting with hiring an experienced liaison. They decided to really focus on promoting their swing bed services with the rebranded name. They’re sharing patient stories through social media. They’ve reached out to case managers and have been presenting about swing bed to community groups. It has been eye-opening to utilize some of the quality data from the program – the swing bed program has a low infection rate, compared to sending the patient to a nursing home with higher infection rates. The swing bed program is getting a very good reputation and Marcum and Wallace Hospital is considering growing the program to work with trauma patients in the future. They have worked with tertiary centers to look for every opportunity to provide swing bed as an option for patients who meet the criteria.

Marcum and Wallace Hospital has been working on improving care management strategies in their clinics. They have received a HRSA grant that will support implementing a new model to address chronic care. They hope to create a clinic that oversees chronic care issues such as Hepatitis C and COPD.

In an effort to improve their quality infrastructure, Marcum and Wallace Hospital has developed a position for a part-time employee to focus on quality initiatives.

How do you believe this project has helped you move forward in the newly emerging system of health care delivery and payment?

“The SRHT project opened the discussions about becoming an ACO and now Marcum and Wallace Hospital will be part of Mercy Health Select, similar to an ACO.”