• Financial data for hospital cost report period ending 12/31/2017 (HCRIS - 2010).
  • Medicare IPPS claims data are for federal fiscal year ending 09/30/2017 (Final rule MedPAR).
  • Medicare OPPS claims data are for calendar year ending 12/31/2017 (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
Participates in 340B: Y
Type of Control: Voluntary Nonprofit, Other
Health Care System: Sample System
Louisville, KY 
System Website: ahd.com
   
General Med/Surg Beds: 1,058
Special Care Beds: 306
   
Total Employees: 7,852
Total Discharges: 72,972
Total Patient Days: 375,268
Total Patient Revenue: $6,907,698,749
   
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  None PPS  
Hospital-Based Health Clinic 000000  None TEFRA  
Hospital-Based Health Clinic FQHC 000000  None None  
Hospital-Based Health Clinic RHC 000000  Other PPS  
Hospital-Based HHA 000000  None Other  
Hospital-Based Hospice 000000  None Other  
Hospital-Based NF 000000  None Other  
Hospital-Based SNF 000000  PPS PPS  
Other Component 000000  TEFRA Other  
Outpatient Rehab Clinic 000000  None Other  
Psych Subprovider 000000  TEFRA PPS  
Rehab Subprovider 000000  PPS Other  
Renal Dialysis 000000  Other PPS  
Separately Certified ASC 000000  TEFRA Other  
Subprovider 000000  Other PPS  
Swing Beds - NF 000000  TEFRA None  
Swing Beds - SNF 000000  TEFRA PPS  

Associated NPIs

NPI Name Address Telephone
000000 Sample NPI 2 4878 Main Street
Louisville, KY  73066
(555) 555-5555
000000 Sample NPI 3 7206 Main Street
Louisville, KY  43201
(555) 555-5555
000000 Sample NPI 4 1613 Main Street
Louisville, KY  35428
(555) 555-5555
000000 Sample NPI 5 7043 Main Street
Louisville, KY  71175
(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

Electronic Health Record System (EHR)

  • Company: Electronic Health Record Company

Utilization Statistics by Payor

  Beds Revenue Inpatient Days
      Medicare Medicaid Other Total
Routine Services 1,058 $438,631,824 77,385 2,561 183,221 263,167
Intensive Care Unit 161 $160,001,705 14,127 4,229 32,301 50,657
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 145 $184,716,671 0 530 45,458 45,988
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 $14,228,440 N/A 44 15,412 15,456
Total Acute 1,364 $797,578,640 91,512 7,364 276,392 375,268
Labor and Delivery * 0 N/A 22 1,398 1,847 3,267
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 1,364 $797,578,640 91,512 7,364 276,392 375,268
  • *Days during which a maternity patient is in the labor and delivery room at midnight at the time of census taking, and not included in the census of the inpatient routine care area because the patient has not occupied an inpatient routine bed at some time before admission. These days are not included in the acute care figures above.
    Discharges / ALOS / ADC
    Medicare Medicaid Other Total
Acute Discharges 18,090 1,134 53,748 72,972
Average Length of Stay 5.1 6.5 5.1 5.1
Average Daily Census 250.7 20.2 757.2 1,028.1
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   $1,758,869,414 $1,617,455,930 $3,531,373,405 $6,907,698,749

HMO Utilization

  Medicare/ Medicaid HMO (not included above)
  Medicare Days Medicaid Days Medicare Discharges Medicaid Discharges
HMO Acute 48,124 127,472 8,512 22,309
HMO Inpatient Psychiatric Facility 0 0   0
HMO Inpatient Rehab Facility 0 0   0

Estimated Patient Volumes

Inpatient Surgeries: 26,500
Outpatient Surgeries: 86,000
Births: 7,700
Outpatient Visits: 394,600
Emergency Room (Not Admitted): 62,700
Emergency Room (Admitted): 53,000

Clinical Services

Cardiovascular Services
Cardiac Cath Lab
Cardiac Rehab
Cardiac Surgery
Carotid Stenting
Coronary Interventions
Electrophysiology
Vascular Intervention
Vascular Surgery
Emergency Services
Emergency Department
Pediatric Trauma Center
Trauma Center
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: 07/13/2018 - Accreditation with Full Standards Compliance

Verified Trauma Program

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