Hospitals are under pressure from society to improve the efficiency of their bed management processes. Among the various effects of inefficiency, the lack of beds to meet the demand stands out, which has increased significantly due to COVID-19, aggravating the overcrowding of emergency departments. Effective management of hospital production capacity includes bed management processes, which can be improved in order to leverage hospital performance. Thus, this study sought to understand how bed management works and identify the main factors that influence its management. The study was performed through a case study, with data collected from semi-structured interviews and bibliographic research, which were triangulated. Thematic content analysis of the case and cross-analysis were performed. As a result, the main factors that influence bed management were identified: communication between teams and units; definition of performance goals; decisions shared between units; occupation and discharge planning by the teams; length of stay; nurses; and COVID-19. The greatest difficulties in the management process are related to these factors.