• Financial data for hospital cost report period ending 12/31/2016 (HCRIS - 2010).
  • Medicare IPPS claims data are for federal fiscal year ending 09/30/2016 (Final rule MedPAR).
  • Medicare OPPS claims data are for calendar year ending 12/31/2016 (Proposed rule OPPS).
  • Data from other sources and their effective periods are identified within report headers.
  • Errata: Please notify us by email of any corrections or updates.
Sample Hospital
Louisville, KY  11111
CMS Certification Number: 000000

Sample Report | Order Information

Identification and Characteristics

Name and Address: Sample Hospital
1 Main Street
Louisville, KY  11111
Telephone number: (555) 555-5555
Hospital Website: ahd.com
CMS Certification Number: 000000
   
Type of Facility: Short Term Acute Care
Sole Community Hospital (SCH): N
Rural Referral Center: N
Low Volume Hospital: N
Medicare Dependent Hospital: N
Type of Control: Voluntary Nonprofit, Other
Health Care System: Sample System
Louisville, KY 
System Website: ahd.com
   
General Med/Surg Beds: 1,061
Special Care Beds: 300
   
Total Employees: 7,637
Total Discharges: 69,187
Total Patient Days: 372,626
Total Patient Revenue: $6,602,018,185
   
County (FIPS code): KY111 - Jefferson, KY
CBSA (formerly MSA): 31140 - Louisville/Jefferson County, KY-IN
Latitude / Longitude: 33°16'N / 104°33'W
Helipad: No
   
Medicare Administrative Contractor (MAC): CGS Administrators, LLC
Urban / Rural Designation: Urban
Medicare Certified Beds: 1,730
     
 
N O T E S
 
     
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Key Contacts

CEO / President / Administrator: Sherman T. Potter
CFO / Financial Manager: Franklin D. Burns
CIO / IT Manager: John Francis Xavier McIntyre
CNO / Director Nursing: H.L. Houlihan
CMO / Chief of Staff: Dr. Benjamin F. Pierce
COO / Operations Manager: Maxwell Q. Klinger
Purchasing / Materials Manager: Walter Eugene O'Reilly

Components (Medicare Certified)

Type of Component Provider
Number
Medicare
Payment System
Medicaid
Payment System
Certified NPI
Hospital 000000  TEFRA None  
Hospital-Based CMHC 000000  TEFRA TEFRA  
Hospital-Based Health Clinic 000000  PPS PPS  
Hospital-Based Health Clinic FQHC 000000  TEFRA PPS  
Hospital-Based Health Clinic RHC 000000  Other PPS  
Hospital-Based HHA 000000  Other None  
Hospital-Based Hospice 000000  PPS None  
Hospital-Based NF 000000  None None  
Hospital-Based SNF 000000  PPS Other  
Other Component 000000  None None  
Outpatient Rehab Clinic 000000  PPS TEFRA  
Psych Subprovider 000000  PPS PPS  
Rehab Subprovider 000000  PPS TEFRA  
Renal Dialysis 000000  None Other  
Separately Certified ASC 000000  Other Other  
Subprovider 000000  PPS PPS  
Swing Beds - NF 000000  Other PPS  
Swing Beds - SNF 000000  TEFRA Other  

Associated NPIs

NPI Name Address Telephone
000000 Sample NPI 2 5309 Main Street
Louisville, KY  74277
(555) 555-5555
000000 Sample NPI 3 5500 Main Street
Louisville, KY  93056
(555) 555-5555
000000 Sample NPI 4 3803 Main Street
Louisville, KY  42701
(555) 555-5555
000000 Sample NPI 5 5679 Main Street
Louisville, KY  74236
(555) 555-5555

Group Purchasing Organizations (GPOs)

Primary
2 Main Street, Louisville, KY  11111
Phone: 5555555555

Accountable Care Organizations (ACOs)

Sample ACO
http://ahd.com
Sample ACO
http://ahd.com

Utilization Statistics by Payor

  Beds Revenue Inpatient Days
      Medicare Medicaid Other Total
Routine Services 1,061 $428,131,777 78,109 2,262 177,942 258,313
Intensive Care Unit 158 $155,511,270 15,406 3,949 29,759 49,114
Coronary Intensive Care 0 $0 0 0 0 0
Burn Intensive Care 0 $0 0 0 0 0
Surgical Intensive Care 0 $0 0 0 0 0
Psychiatric Intensive Care 0 $0 0 0 0 0
Pediatric Intensive Care 0 $0 0 0 0 0
Neonatal Intensive Care 142 $195,943,368 0 547 48,427 48,974
Trauma Intensive Care 0 $0 0 0 0 0
Detox Intensive Care 0 $0 0 0 0 0
Premature Intensive Care 0 $0 0 0 0 0
Nursery $14,749,102 N/A 122 16,103 16,225
Total Acute 1,361 $794,335,517 93,515 6,880 272,231 372,626
Labor and Delivery * 0 N/A 15 1,119 897 2,031
Psychiatric DPU 0 $0 0 0 0 0
Rehabilitation DPU 0 $0 0 0 0 0
Skilled Nursing (SNF) Unit 0 $0 0 0 0 0
Nursing (NF) 0 $0 N/A 0 0 0
Swing Beds - SNF N/A N/A 0 0 0 0
Swing Beds - NF N/A N/A N/A 0 0 0
Other Sub Provider 0 $0 0 0 0 0
Total DPU 0 $0 0 0 0 0
Total Hospital 1,361 $794,335,517 93,515 6,880 272,231 372,626
  • * Labor and Delivery figures are distributed among the Acute Utilization figures above. This line is detailed separately for reference.
    Discharges / ALOS / ADC
    Medicare Medicaid Other Total
Acute Discharges 17,480 1,033 50,674 69,187
Average Length of Stay 5.3 6.7 5.4 5.4
Average Daily Census 256.2 18.8 745.8 1,020.9
Psychiatric DPU Discharges 0 0 0 0
Average Length of Stay 0.0 0.0 0.0 0.0
Average Daily Census 0.0 0.0 0.0 0.0
Rehabilitation DPU Discharges 0 0 0 0
Average Length of Stay 0.0 0.0 0.0 0.0
Average Daily Census 0.0 0.0 0.0 0.0
Other DPU Discharges 0 0 0 0
Average Length of Stay 0.0 0.0 0.0 0.0
Average Daily Census 0.0 0.0 0.0 0.0
    Gross Patient Revenue
    Medicare Medicaid Other Total
Total Hospital Patient Revenue   $1,617,296,327 $1,586,996,063 $3,397,725,795 $6,602,018,185

HMO Utilization

  Medicare/ Medicaid HMO (not included above)
  Medicare Days Medicaid Days Medicare Discharges Medicaid Discharges
HMO Acute 41,553 130,736 7,093 24,898
HMO Inpatient Psychiatric Facility 0 0   0
HMO Inpatient Rehab Facility 0 0   0

Estimated Patient Volumes

Inpatient Surgeries: 25,300
Outpatient Surgeries: 74,900
Births: 6,900
Outpatient Visits: 359,200
Emergency Room (Not Admitted): 64,700
Emergency Room (Admitted): 48,600

Clinical Services

Cardiovascular Services
Cardiac Cath Lab
Cardiac Rehab
Cardiac Surgery
Carotid Stenting
Coronary Interventions
Electrophysiology
Vascular Intervention
Vascular Surgery
Emergency Services
Emergency Department
Trauma Center - ACS/COT Verified
Neurosciences
Electroencephalography (EEG)
Sleep Studies
Oncology Services
Chemotherapy
Radiation Therapy
Organ Transplant (Medicare certified)
Heart Transplant
Intestinal Transplant
Kidney Transplant (08/01/1986)
Liver Transplant
Lung Transplant
Pancreas Transplant
Orthopedic Services
Arthroscopy
Joint Replacement
Spine Surgery
Other Services
Helipad
Hemodialysis
Home Health
Hospice
Lithotripsy (ESWL)
Obstetrics
Radiology / Nuclear Medicine / Imaging
Computed Tomography (CT)
Computed Tomography-Angiography (CTA)
Digital Mammography
Intensity-Modulated Radiation Therapy (IMRT)
Magnetic Resonance Angiography (MRA)
Magnetic Resonance Imaging (MRI)
Positron Emission Tomography (PET)
Single Photon Emission Computerized Tomography (SPECT)
Rehabilitation Services
Physical Therapy
Speech Therapy
Special Care
Burn Intensive Care (BICU)
Coronary Intensive Care (CCU)
Detox Intensive Care
Intensive Care Unit (ICU)
Neonatal Intensive Care
Pediatric Intensive Care
Premature Intensive Care
Psychiatric Intensive Care
Surgical Intensive Care (SICU)
Trauma Intensive Care
Subprovider Units
Nursing Facility (NF)
Psychiatric
Rehabilitation
Skilled Nursing (SNF)
Swing Beds - NF
Swing Beds - SNF
Surgery
Inpatient Surgery
Radiosurgery
Robotic Surgery
Wound Care
Hyperbaric Oxygen
Wound Care

DNV Hospital Accreditation

  • Accredited for the period: 1/1/2017 - 12/31/2017

Joint Commission Accreditation

  • Current Status: 10/03/2016 - Accreditation with Full Standards Compliance

Verified Trauma Program

  • Verification status provided by The American College of Surgeons (ACS) Committee on Trauma (COT) Verification Program.
  • See ACS/COT website for more / Last updated 09/11/2015 / Definitions
  • Type: Level III Trauma Center

Teaching Status

  • Data are from multiple sources / Definitions
  • COTH data are from the Association of American Medical Colleges / Division of Health Care Affairs / Council of Teaching Hospitals
  • See COTH website for more / Last Updated 09/29/2016
  • Teaching status = Yes / Number of interns and Residents = 10 FTEs