The Nurses' Guide to Bed Leasing: What You Should Know

Hospitals across the country are increasingly turning to a new strategy to address persistent challenges with patient flow and discharge delays: leasing beds in skilled nursing facilities (SNFs). While still relatively uncommon, bed leasing is gaining traction as hospitals seek solutions to inpatient overcrowding and transitioning patients who no longer need acute care but aren’t ready to return home.

How Does Bed Leasing Work?

In a typical bed leasing arrangement, a hospital contracts with a nursing facility to reserve a set number of beds for its patients. The hospital pays a daily rate for each bed, ensuring that when a patient is ready for discharge but needs continued care, a spot is available without delay.

This model guarantees the SNF a steady stream of patients and reliable payment. Likewise, the hospital can move patients out of high-cost acute care beds more efficiently. Other financial and operational benefits of bed leasing include:

• Cost Savings: Hospitals are reimbursed at fixed rates for many patients, regardless of length of stay. Prolonged hospitalizations for patients awaiting placement can result in significant financial losses. Leasing SNF beds helps hospitals avoid these costs by expediting discharges.
• Revenue for SNFs: Nursing facilities benefit from guaranteed occupancy and payment, which is especially valuable in a sector still recovering from pandemic-related financial strain.

Case Studies: California Health Systems Leading the Way

Becker’s Hospital Review examined how three California healthcare systems structure their bed leasing programs and the impact they've seen:

• UC Davis Health began leasing SNF beds in 2022 to address a backlog of patients with nowhere to go after hospital care. The program now includes 30 beds, serving about 800 patients annually. The average stay is 30–40 days, and the initiative has reduced avoidable inpatient days, saving millions in costs by shortening hospital stays.
• Stanford Health Care launched a similar program, initially leasing 10 beds for complex discharges. The focus has since narrowed to five beds, but the impact remains significant: in 2024, Stanford saved about 1,200 bed days and nearly $2 million.
• Scripps Health in San Diego started leasing beds during the COVID-19 pandemic. Since January 2023, Scripps has saved over 14,700 bed days through this arrangement, helping to alleviate hospital crowding and improve discharge rates.

Bed Leasing Benefits for Nurses and Patients

• Improved Patient Flow: By moving stable patients to SNFs quicker, hospitals free up acute care beds for new admissions, reducing emergency department boarding and hospital congestion.
• Enhanced Care Coordination: These programs often include dedicated teams, including physicians, nurse practitioners, case managers, and pharmacists, who oversee the transition and ongoing care to ensure continuity and quality of care.
• Job Satisfaction: Nurses benefit from less overcrowding and more manageable workloads on hospital units. With smoother discharges, nurses can focus more on acute care patients and less on complex discharge planning for patients who are ready to leave but have no placement.
• Better Outcomes: Coordinated transitions to SNFs can reduce readmissions and improve patient satisfaction, as patients receive the appropriate level of care in a timely manner.

The Bottom Line: How Will Bed Leasing Affect Nursing and Care Delivery?

Bed leasing might sound like just another hospital policy, but it can actually make a big difference in your day-to-day work. Bed leasing programs help patients move from the hospital to SNFs quickly and efficiently, easing the pressure on crowded units. By freeing up hospital beds, nurses can focus more on patients in need of acute care. It’s a win-win: better patient flow, smoother discharges, and less stress for nurses.

But it’s not all simple. Hospitals must follow strict rules to run bed leasing programs for the right reasons. They must conduct bed leasing to meet actual care needs, not to fill beds or generate extra revenue. The Office of Inspector General has guidelines to ensure fairness and compliance, so it’s essential for hospitals to handle these programs carefully.

As demand for SNF beds grows, nurses should keep an eye on how these changes affect patient care and their workloads. Being in the know helps you stay ahead and ensures these new ideas make things better for everyone.

🤔Does your organization lease beds? What has been your experience with the program? Tell us your thoughts in the discussion forum below.