American Hospital Directory - Fort Memorial Hospital (520071)

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Financial data for hospital cost report period ending 09/30/2023 (HCRIS 766018 - 2010).
Medicare IPPS claims data are for federal fiscal year ending 09/30/2023 (Final rule MedPAR).
Medicare OPPS claims data are for calendar year ending 12/31/2023 (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.

Fort Atkinson, WI 53538

CMS Certification Number: 520071

Name and Address:	Fort Memorial Hospital 611 Sherman Avenue East Fort Atkinson, WI 53538
Telephone Number:	(920) 568-5000
Hospital Website:	www.forthealthcare.com
CMS Certification Number:	520071

Type of Facility:	Short Term Acute Care
Type of Control:	Voluntary Nonprofit, Other
Total Staffed Beds:	49

Total Patient Revenue:	$434,946,844
Total Discharges:	1,278
Total Patient Days:	4,520
TPS Quality Score:	30.00
Patient Experience Rating:

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Cardiovascular Services: Cardiac Rehab
Emergency Services: Emergency Department
Orthopedic Services: Arthroscopy; Joint Replacement
Other Services: Obstetrics
Radiology / Nuclear Medicine / Imaging: Computed Tomography (CT); Computed Tomography-Angiography (CTA); Digital Mammography; Magnetic Resonance Imaging (MRI); Single Photon Emission Computerized Tomography (SPECT)

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	Number Medicare Inpatients	Average Length of Stay	Average Charges	Medicare Case Mix Index (CMI)
Cardiology	50	2.86	$30,864	1.2329
Medicine	123	3.52	$32,178	1.5430
Neurology	18	2.67	$32,384	1.4520
Orthopedic Surgery	31	4.10	$46,574	2.5330
Pulmonology	79	3.25	$31,882	1.3021
Surgery	53	5.55	$53,253	2.7545
Urology	34	3.53	$27,618	1.2219
Total	408	3.63	$35,140	1.6483

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Medicare Hospital Market Service Area File for calendar year ending 12/31/2023 / Definitions

ZIP Code of Residence	Discharges	Days of Care	Charges	Discharges Inc/(Dec)	Market Share
53538	204	740	$7,064,920	-11.7%	33.3%
53549	128	448	$4,365,645	21.9%	34.9%
53190	96	362	$3,384,539	0.0%	23.5%

APC Number	APC Description	Number Patient Claims	Average Charge	Average Cost
5115	Level 5 Musculoskeletal Procedures	120	$14,052	$3,046
8011	Comprehensive Observation Services	366	$1,185	$342
5012	Clinic Visits and Related Services	8,244	$193	$44
5025	Level 5 Type A ED Visits	908	$1,148	$332
5054	Level 4 Skin Procedures	256	$2,437	$534
5114	Level 4 Musculoskeletal Procedures	71	$14,974	$3,246
5312	Level 2 Lower GI Procedures	366	$5,244	$966
5024	Level 4 Type A ED Visits	1,019	$932	$269
5113	Level 3 Musculoskeletal Procedures	126	$9,714	$2,106
5693	Level 3 Drug Administration	1,130	$398	$101
5491	Level 1 Intraocular Procedures	128	$9,256	$2,007
5051	Level 1 Skin Procedures	1,458	$561	$123
5441	Level 1 Nerve Injections	721	$496	$109
5771	Cardiac Rehabilitation	294	$202	$44
5521	Level 1 Imaging without Contrast	2,334	$337	$38
5572	Level 2 Imaging with Contrast	547	$4,453	$496
5593	Level 3 Nuclear Medicine and Related Services	153	$5,348	$596
5311	Level 1 Lower GI Procedures	244	$4,573	$843
5052	Level 2 Skin Procedures	530	$955	$209
5522	Level 2 Imaging without Contrast	1,742	$1,423	$159

	Available Beds	Inpatient Days
HOSPITAL (including swing beds)
Routine Services	45	3,477
Special Care	4	423
Nursery		620
Total Hospital	49	4,520

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