• Financial data for hospital cost report period ending 12/31/2018 (HCRIS - 2010).
  • Medicare IPPS claims data are for federal fiscal year ending 09/30/2018 (Final rule MedPAR).
  • Medicare OPPS claims data are for calendar year ending 12/31/2018 (Final 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

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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
Operating Status: Operating
Type of Facility: Short Term Acute Care
Sole Community Hospital (SCH): N
Rural Referral Center: N
Low Volume Hospital: N
Medicare Dependent Hospital: N
Participates in 340B: Y
Type of Control: Voluntary Nonprofit, Other
Health Care System: Sample System
Louisville, KY 
System Website: ahd.com
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

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

Associated NPIs

NPI Name Address Telephone
000000 Sample NPI 2 4261 Main Street
Louisville, KY  47257
(555) 555-5555
000000 Sample NPI 3 2888 Main Street
Louisville, KY  27172
(555) 555-5555
000000 Sample NPI 4 9175 Main Street
Louisville, KY  45376
(555) 555-5555
000000 Sample NPI 5 2187 Main Street
Louisville, KY  21256
(555) 555-5555

Group Purchasing Organizations (GPOs)

2 Main Street, Louisville, KY  11111
Phone: 5555555555

Accountable Care Organizations (ACOs)

Sample ACO
Sample ACO

Electronic Health Record System (EHR)

  • Company: Electronic Health Record Company

Clinical Services

Cardiovascular Services
Cardiac Cath Lab
Cardiac Rehab
Cardiac Surgery
Carotid Stenting
Coronary Interventions
Vascular Intervention
Vascular Surgery
Emergency Services
Emergency Department
Pediatric Trauma Center
Trauma Center
Electroencephalography (EEG)
Sleep Studies
Oncology Services
Radiation Therapy
Organ Transplant (Medicare certified)
Heart Transplant
Intestinal Transplant
Kidney Transplant (08/01/1986)
Liver Transplant
Lung Transplant
Pancreas Transplant
Orthopedic Services
Joint Replacement
Spine Surgery
Other Services
Home Health
Lithotripsy (ESWL)
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)
Skilled Nursing (SNF)
Swing Beds - NF
Swing Beds - SNF
Inpatient Surgery
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: 10/08/2019 - Accreditation with Full Standards Compliance

Verified Trauma Program

  • Type: Level III Trauma Center
  • Type: Level II Pediatric Trauma Center

University Affiliation

No university affiliation data is available for this facility.