As a Critical Access Hospital, we transfer patients from our Inpatient status to our Swing Bed (SWB) status.  As these 2 statuses must be submitted to CMS on separate claims, we must "discharge" the inpatient account and "readmit" to a SWB account.  Patient is remaining in the same bed, on same unit and has same provider; therefore, all inpatient medications are being "discharge transferred" and continued to the SWB account. These medications are being included in the numerator.  We are proposing there should be an exclusion for accounts discharged to another level of care at the same facility.