• Financial data for hospital cost report period ending 12/31/2015 (HCRIS - 2010).
  • Medicare IPPS claims data are for federal fiscal year ending 09/30/2016 (Proposed rule MedPAR).
  • Medicare OPPS claims data are for calendar year ending 12/31/2015 (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

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: 1,064
Special Care Beds: 298
   
Total Employees: 7,354
Total Discharges: 68,639
Total Patient Days: 369,644
Total Patient Revenue: $6,316,663,864
   
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 TEFRA  
Hospital-Based CMHC 000000  PPS Other  
Hospital-Based Health Clinic 000000  TEFRA TEFRA  
Hospital-Based Health Clinic FQHC 000000  Other TEFRA  
Hospital-Based Health Clinic RHC 000000  PPS Other  
Hospital-Based HHA 000000  None Other  
Hospital-Based Hospice 000000  TEFRA PPS  
Hospital-Based NF 000000  Other None  
Hospital-Based SNF 000000  TEFRA TEFRA  
Other Component 000000  Other TEFRA  
Outpatient Rehab Clinic 000000  PPS Other  
Psych Subprovider 000000  TEFRA Other  
Rehab Subprovider 000000  Other Other  
Renal Dialysis 000000  Other TEFRA  
Separately Certified ASC 000000  TEFRA PPS  
Subprovider 000000  TEFRA None  
Swing Beds - NF 000000  None Other  
Swing Beds - SNF 000000  PPS Other  

Associated NPIs

NPI Name Address Telephone
000000 Sample NPI 2 8074 Main Street
Louisville, KY  58827
(555) 555-5555
000000 Sample NPI 3 1187 Main Street
Louisville, KY  87944
(555) 555-5555
000000 Sample NPI 4 7679 Main Street
Louisville, KY  14109
(555) 555-5555
000000 Sample NPI 5 1738 Main Street
Louisville, KY  86891
(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 1,064 $427,639,104 81,935 2,193 175,104 259,232
Intensive Care Unit 157 $146,366,951 15,670 3,260 27,432 46,362
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 141 $187,932,554 0 284 46,413 46,697
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 $15,650,598 N/A 64 17,289 17,353
Total Acute 1,362 $777,589,207 97,605 5,801 266,238 369,644
Labor and Delivery * 0 N/A 22 1,400 1,160 2,582
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 1,362 $777,589,207 97,605 5,801 266,238 369,644
  • * 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 17,508 876 50,255 68,639
Average Length of Stay 5.6 6.6 5.3 5.4
Average Daily Census 267.4 15.9 729.4 1,012.7
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   $1,634,316,673 $1,501,182,792 $3,181,164,399 $6,316,663,864

HMO Utilization

  Medicare/ Medicaid HMO (not included above)
  Medicare Days Medicaid Days Medicare Discharges Medicaid Discharges
HMO Acute 40,459 133,232 6,930 24,250
HMO Inpatient Psychiatric Facility 0 0   0
HMO Inpatient Rehab Facility 0 0   0

Estimated Patient Volumes

Inpatient Surgeries: 24,400
Outpatient Surgeries: 83,600
Births: 7,400
Outpatient Visits: 278,700
Emergency Room (Not Admitted): 69,600
Emergency Room (Admitted): 45,800

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