LA Hospital Inform - Profile definitions

Definitions - Hospital Profile

Hospital Characteristics

  • Identification (name, address, and phone number)
  • Website
  • System affiliation
  • Notes about the facility
  • Clinical services provided
  • Accreditation status (accrediting agency / effective date - expiration date)

Other information is taken from public data sources maintained by the American Hospital Directory:

  • Type of control is taken from a hospital's most recent Medicare cost report (HCRIS) file.
  • A hospital's geographic information (e.g. parish, and CBSA) are determined through commercial geocoding based on the hospital's address. Please note that CBSAs are based on the 2000 standards that supersede 1990 standards.
  • Medicare classifies a hospital as either "Urban" or "Rural" based on its Core Based Statistical Area. A hospital can, however, be reclassified from rural to urban if it meets certain criteria. A hospital's designation is taken from its most recent Medicare Cost Report.

Volumes by Type of Payer

Utilization statistics and volumes by type of payer are obtained from a hospital's most recent Medicare cost report. Data are updated on a quarterly basis as more recent information becomes available:

Beds: W/S S-3, part I, col 1
Inpatient Days: W/S S-3, part I, col 4-6
Discharges: W/S S-3, part I, col 15
Average Length of Stay: Calculated: Days / Discharges
Average Daily Census: Calculated: Days / 365

Clinical Services Provided

The presence of a clinical service is determined using data from a hospital's most recent Medicare Cost Report, Medicare inpatient claims data, Medicare outpatient claims data, and other sources.

The following specifications are based on the most common procedures within a clinical service and may not include less common procedures (i.e. the presence of the more common procedures was used to test for the presence of a service).  Due to AMA copyright restrictions CPT procedure codes for outpatient services are not published on the website.

The following is a list of all services that may be reported for a hospital:

Cardiovascular Services
  Cardiac Rehab More than ten Medicare outpatient claims for outpatient cardiac rehabilitation
  Cardiac Cath Lab More than ten Medicare outpatient claims for left heart catheterization AND/OR more than ten Medicare inpatient claims for left or combined right and left heart catheterization (ICD 37.22-37.23)
  Carotid Stenting Hospital meets the CMS minimum facility standards for performing carotid artery stenting for high risk patients.
  Coronary Interventions More than ten Medicare inpatient claims for removal of coronary artery obstruction and insertion of stent(s) (ICD 36.0x and 00.66)
  Cardiac Surgery More than ten Medicare inpatient claims for bypass anastomosis for heart revascularization (ICD 36.1x)
  Electrophysiology More than ten Medicare inpatient or outpatient claims for comprehensive electrophysiologic evaluation (ICD 37.26 or selected CPT codes)
  Vascular Surgery More than ten Medicare inpatient claims for resection of vessel with replacement (ICD 38.44-38.45) and/or aortic-iliac-femoral bypass (ICD 39.25)
  Vascular Intervention More than ten Medicare outpatient claims for percutaneous transluminal balloon angioplasty.
Emergency Services
  Emergency Department More than 50 emergency department visits (based on estimated volumes reported elsewhere on the hospital profile).
  ACS/COT Approved Trauma Program Verification status provided by The American College of Surgeons (ACS) Committee on Trauma (COT) Verification Program.
Neurosciences
  Electroencephalography (EEG) More than ten Medicare outpatient claims for routine EEG and/or special EEG tests.
  Sleep Studies More than ten Medicare outpatient claims for sleep testing AND/OR more than ten Medicare inpatient claims for polysomnogram (ICD 89.17)
Oncology Services
  Radiation Therapy More than ten Medicare outpatient claims for delivery of radiation therapy (6-19 MeV)
  Chemotherapy More than ten Medicare outpatient claims for chemotherapy (HCPCS C8953-C8955. J9000, J9999, and/or selected CPT codes)
Orthopedic Services
  Arthroscopy More than ten Medicare outpatient claims for arthroscopy with meniscectomy (medial or lateral)
  Joint Replacement More than ten Medicare inpatient claims for total hip replacement (ICD 81.51) and more than ten Medicare inpatient claims for total knee replacement (ICD 81.54).
  Spine Surgery More than ten Medicare inpatient claims for spinal fusion (ICD 81.00-81.08), refusion of spine (ICD 81.30-81.39), and/or certain other procedures on spine (ICD 81.63-81.66)
Organ Transplant (Medicare certified)
  Heart Medicare certification date as reported in the hospital's most recent cost report (W/S S-2, part I, line 127, column 2)
  Intestinal Medicare certification date as reported in the hospital's most recent cost report (W/S S-2, part I, line 131, column 2)
  Kidney Medicare certification date as reported in the hospital's most recent cost report (W/S S-2, part I, line 126, column 2)
  Liver Medicare certification date as reported in the hospital's most recent cost report (W/S S-2, part I, line 128, column 2)
  Lung Medicare certification date as reported in the hospital's most recent cost report (W/S S-2, part I, line 129, column 2)
  Pancreas Medicare certification date as reported in the hospital's most recent cost report (W/S S-2, part I, line 130, column 2)
Radiology / Nuclear Medicine / Imaging
  Computed Tomography (CT) Scanner More than ten Medicare outpatient claims for CT of head or brain, pelvis, or abdomen
  Computed Tomography Angiography (CTA) More than ten Medicare outpatient claims for CTA of chest, abdomen, pelvis, or neck
  Digital Mammography More than ten Medicare outpatient claims for digital mammography (selected CPT codes)
  Intensity-Modulated Radiation Therapy (IMRT) More than ten Medicare outpatient claims for IMRT
  Magnetic Resonance Angiography (MRA) More than ten Medicare outpatient claims for MRA of abdomen (HCPCS C8900-C8902), chest (HCPCS C8909-C8911). or lower extremity (HCPCS C8912-C8914)
  Magnetic Resonance Imaging (MRI) More than ten Medicare outpatient claims for MRI of brain or spinal canal
  Positron Emission Tomography (PET) More than ten Medicare outpatient claims for PET imaging of heart, brain, and/or tumor (selected CPT codes)
  Single Photon Emission Computerized Tomography (SPECT) More than ten Medicare outpatient claims for SPECT single or multiple studies
Rehabilitation Therapies
  Speech Therapy More than ten Medicare outpatient claims for aural rehabilitation
  Physical Therapy More than ten Medicare outpatient claims for therapeutic exercises to develop strength, endurance, range of motion, and flexibility.
Surgery
  Bariatric Surgery Hospital meets the CMS minimum facility standards for bariatric surgery and has been certified by ACS and/or ASBS.
  Inpatient Surgery More than ten Medicare inpatient claims for surgical DRGs
  Radiosurgery More than ten Medicare claims for CyberKnife, GammaKnife, SRS, etc. (HCPCS G0339, G0340, G0173, G0251 and selected CPT codes)
  Robotic Surgery More than ten Medicare claims for computer assisted robotic surgery (ICD 17.41-17.49 and selected CPT codes)
Wound Care
  Hyperbaric Oxygen More than ten Medicare outpatient claims for hyperbaric oxygen (HCPCS C1300)
  Wound Care More than ten Medicare outpatient claims for removal of devitalized tissue from wounds (selected CPT codes)
Other Services
  Hemodialysis More than ten Medicare inpatient claims for hemodialysis (ICD 39.95)
  Home Health Hospital-based home health agency per the hospital's most recent cost report (W/S S-2, part I, line 12, column 2 or 3)
  Hospice Hospital-based hospice per the hospital's most recent cost report (W/S S-2, part I, line 14, column 2 or 5)
  Lithrotripsy (ESWL) More than ten Medicare outpatient claims for extracorporeal shock wave lithotripsy
  Obstetrics More than 50 births (based on estimated volumes reported elsewhere on the hospital profile).
Subprovider Units
  Psychiatric Beds designated in a psychiatric distinct part unit (DPU) per the hospital's most recent cost report (W/S S-3, part 1, line 16, column 2)
  Rehabilitation Beds designated in a rehabilitation distinct part unit (DPU) per the hospital's most recent cost report (W/S S-3, part 1, line 17, column 2)
  Skilled Nursing (SNF) Designated skilled nursing beds per the hospital's most recent cost report (W/S S-3, part 1, line 19, column 2)
  Nursing Facility (NF) Designated nursing facility beds per the hospital's most recent cost report (W/S S-3, part 1, line 20, column 2)
  Swing Beds - SNF Designated SNF swing bed revenue per the hospital's most recent cost report (W/S G-2, part 1, line 5, column 3)
  Swing Beds - NF Designated NF swing bed revenue  per the hospital's most recent cost report (W/S G-2, part I, line 6, column 3)
Special Care
  Intensive Care Unit (ICU) Beds designated in an ICU per the hospital's most recent cost report (W/S S-3, part 1, line 8, column 2)
  Coronary Intensive Care (CCU) Beds designated in a CCU per the hospital's most recent cost report (W/S S-3, part 1, line 9, column 2)
  Burn Intensive Care (BICU) Beds designated in a BICU per the hospital's most recent cost report (W/S S-3, part 1, line 10, column 2)
  Surgical Intensive Care (SICU) Beds designated per the hospital's most recent cost report (W/S S-3, part 1, line 11, column 2)
  Psychiatric Intensive Care Beds designated per the hospital's most recent cost report (W/S S-3, part 1, line 12.05, column 2)
  Pediatric Intensive Care Beds designated per the hospital's most recent cost report (W/S S-3, part 1, line 12.10, column 2)
  Neonatal Intensive Care Beds designated per the hospital's most recent cost report (W/S S-3, part 1, line 12.15, column 2)
  Trauma Intensive Care Beds designated per the hospital's most recent cost report (W/S S-3, part 1, line 12.20, column 2)
  Detox Intensive Care Beds designated per the hospital's most recent cost report (W/S S-3, part 1, line 12.25, column 2)
  Premature Intensive Care Beds designated per the hospital's most recent cost report (W/S S-3, part 1, line 12.30, column 2)
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