Sample Report | Order Information
Identification and Characteristics
- Last updated 09/18/2024. Definitions
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 |
General Med/Surg Beds | 1,176 |
Special Care Beds | 339 |
Total Employees | 8,579 |
Total Discharges | 74,196 |
Total Patient Days | 377,173 |
Total Patient Revenue | $9,523,079,870 |
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 |
CMS Urban / Rural Designation | Urban |
Medicare Certified Beds | 1,730 |
Notes
This map is for general reference and should not be used in seeking medical care.
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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 |
CMO / Chief of Staff | Dr. Benjamin F. Pierce |
CNO / Director Nursing | H.L. Houlihan |
COO / Operations Manager | Maxwell Q. Klinger |
Purchasing / Materials Manager | Walter Eugene O'Reilly |
Tax ID / EIN
Insurer | EIN | Associated NPIs |
---|---|---|
Aetna | XX-XXXXXXX | 0000000000 |
Anthem | XX-XXXXXXX | 0000000000 |
Cigna | XX-XXXXXXX | 0000000000 |
Humana | XX-XXXXXXX | 0000000000 |
Kaiser Permanente | XX-XXXXXXX | 0000000000 |
Kaiser Permanente | XX-XXXXXXX | 0000000000 |
United Healthcare | XX-XXXXXXX | 0000000000 |
Board of Directors/Governance Members
- PECOS information last updated 11/15/2024 / Definitions
Name | Role | Title |
---|---|---|
############### | Director | Board Member |
############### | Director | Board Member |
############# | Director | President & Ceo |
############# | Director | Board Member |
########## | Director | |
################ | Director | Board Member |
############ | Director | Board Member |
############ | Director | Board Member |
############ | Director | Board Member |
############### | Director | Board Member |
############## | Director | Board Member |
############ | Director | Board Member |
################# | Director | Board Member |
############## | Director | Board Member |
################# | Director | Board Member |
################## | Director | Board Member |
############## | Director | Board Member |
############### | Director | Board Member |
Components (Medicare Certified)
- NPI information last Updated 10/13/2024 / Definitions
Type of Component | CCN | Medicare Payment System |
Medicaid Payment System |
Certified | NPI |
---|---|---|---|---|---|
Hospital | 000000 | PPS | PPS | ||
Hospital-Based CMHC | 000000 | None | PPS | ||
Hospital-Based Health Clinic | 000000 | PPS | None | ||
Hospital-Based Health Clinic FQHC | 000000 | PPS | Other | ||
Hospital-Based Health Clinic RHC | 000000 | None | PPS | ||
Hospital-Based HHA | 000000 | Other | Other | ||
Hospital-Based Hospice | 000000 | PPS | TEFRA | ||
Hospital-Based NF | 000000 | PPS | PPS | ||
Hospital-Based SNF | 000000 | TEFRA | PPS | ||
Other Component | 000000 | PPS | TEFRA | ||
Outpatient Rehab Clinic | 000000 | None | PPS | ||
Psych Subprovider | 000000 | TEFRA | TEFRA | ||
Rehab Subprovider | 000000 | Other | PPS | ||
Renal Dialysis | 000000 | Other | PPS | ||
Separately Certified ASC | 000000 | PPS | TEFRA | ||
Subprovider | 000000 | PPS | Other | ||
Swing Beds - NF | 000000 | None | TEFRA | ||
Swing Beds - SNF | 000000 | Other | None |
Billing NPIs
- NPI information last Updated 10/13/2024. / Definitions
- Medicare IPPS claims data are for 4 quarters ending on 03/31/2024 (Inpatient SAF).
NPI | Component Type | Claims | Name | Address | Telephone |
---|---|---|---|---|---|
0000000000 | Hospital | 3,226 | ##################### ##################################### |
################# ##########, ## #####-#### |
(###) ###-#### |
0000000000 | Hospital | 3,924 | ##################### ############### |
################# ##########, ## #####-#### |
(###) ###-#### |
0000000000 | Hospital | 5,429 | ##################### ####################### |
################## ##########, ## #####-#### |
(###) ###-#### |
0000000000 | Hospital | 4,310 | #################### ########################## |
########################### ##########, ## #####-#### |
(###) ###-#### |
Associated NPIs
- NPI information last Updated 10/13/2024 / Definitions
NPI | Name | Address | Telephone |
---|---|---|---|
000000 | Sample NPI 2 | 1592 Main Street Louisville, KY 61442 |
(555) 555-5555 |
000000 | Sample NPI 3 | 5688 Main Street Louisville, KY 39025 |
(555) 555-5555 |
000000 | Sample NPI 4 | 9691 Main Street Louisville, KY 11430 |
(555) 555-5555 |
000000 | Sample NPI 5 | 2003 Main Street Louisville, KY 61147 |
(555) 555-5555 |
Group Purchasing Organizations (GPOs)
- Primary
-
2 Main Street, Louisville, KY 11111Phone: 5555555555
Accountable Care Organizations (ACOs)
Electronic Health Record System (EHR)
- Company: Electronic Health Record Company
Utilization Statistics by Payor
Beds | Revenue | Inpatient Days | ||||
---|---|---|---|---|---|---|
Medicare | Medicaid | Other | Total | |||
Routine Services | 1,176 | $588,991,802 | 56,211 | 15,602 | 201,089 | 272,902 |
Intensive Care Unit | 190 | $189,483,103 | 8,761 | 4,509 | 30,288 | 43,558 |
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 | 149 | $220,199,326 | 0 | 888 | 44,790 | 45,678 |
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 | $18,845,996 | N/A | 388 | 14,647 | 15,035 | |
Total Acute | 1,515 | $1,017,520,227 | 64,972 | 21,387 | 290,814 | 377,173 |
Labor and Delivery * | 0 | N/A | 0 | 1,963 | 1,739 | 3,702 |
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 | 1,515 | $1,017,520,227 | 64,972 | 21,387 | 290,814 | 377,173 |
- *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 | 12,185 | 1,304 | 60,707 | 74,196 |
Average Length of Stay | 5.3 | 16.4 | 4.8 | 5.1 | |
Average Daily Census | 178.0 | 58.6 | 796.8 | 1,033.4 | |
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 | $2,283,605,411 | $2,710,760,724 | $4,528,713,735 | $9,523,079,870 |
HMO Utilization
Medicare/Medicaid HMO (included in other and total above) | ||||
---|---|---|---|---|
Medicare Days | Medicaid Days | Medicare Discharges | Medicaid Discharges | |
HMO Acute | 85,838 | 121,067 | 13,285 | 20,202 |
HMO Inpatient Psychiatric Facility | 0 | 0 | 0 | |
HMO Inpatient Rehab Facility | 0 | 0 | 0 |
Estimated Patient Volumes
Inpatient Surgeries | 25,600 |
---|---|
Outpatient Surgeries | 126,900 |
Births | 8,400 |
Outpatient Visits | 660,400 |
Emergency Room (Not Admitted) | 78,300 |
Emergency Room (Admitted) | 53,800 |
Clinical Services
- Cardiovascular Services
- Cardiac Cath Lab
- Cardiac Rehab
- Cardiac Surgery
- Carotid Stenting
- Coronary Interventions
- Electrophysiology
- Vascular Intervention
- Vascular Surgery
- Emergency Services
- Emergency Department
- 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
- DNV Hospital Accreditation from DNV Healthcare Inc.
- Last updated 1/1/2017 / Definitions and Terms of Use
- Accredited for the period: 1/1/2017 - 12/31/2017
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.
Teaching Status
- Data are from multiple sources / Definitions
- CAHSE data are from the Association of American Medical Colleges / Division of Health Care Affairs / Council of Academic Health System Executives (CAHSE)
- See CAHSE website for more / Last Updated 01/03/2024
- Teaching status = Yes / Number of interns and Residents = 10 FTEs