*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| F72 - Severe intellectual disabilities - as a primary diagnosis code | F72 - Severe intellectual disabilities - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 7.72 | |
| Readmission Rate (%) | 24.26 | |
| Unplanned Readmission Rate (%) | 11.93 | |
| Mortality Rate (%) | ||
| SNF Discharge Rate (%) | ||
| Home Discharge Rate (%) | ||
| PAYMENTS AND CHARGES | ||
| Total Medicare Payments | ||
| Payment Per Day | ||
| Payment Per Hospitalization | ||
| Total Medicare Charges | ||
| Avg. Charges | ||
| MARKET SIZING & INCIDENCE RATES | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - All) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - All) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Yes) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Yes) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations after Exclusion | ||
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 884: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | |
|---|---|
| Total Hospitalizations at DRG | 144,507 |
| Total Hospitalizations with ICD F72 - Severe intellectual disabilities | 117 |
| DRG Share of Total Hospitalizations | 0.44 |
| % of Total ICD F72 - Severe intellectual disabilities in DRG | 99.15 |
| Avg LOS at DRG | 11.23 |
| Avg LOS with ICD F72 - Severe intellectual disabilities | 12.38 |
| Readmission Rate at DRG | 20.52 |
| Readmission Rate with ICD F72 - Severe intellectual disabilities | 22.94 |
| Unplanned Readmission Rate at DRG | 12.21 |
| Unplanned Readmission Rate with ICD F72 - Severe intellectual disabilities | 11.93 |
| Total Medicare payments at DRG | $1,495,371,248 |
| Total Medicare payments with ICD F72 - Severe intellectual disabilities | $1,061,957 |
| Total Medicare payment per Day at DRG | $922 |
| Total Medicare payment per Day with ICD F72 - Severe intellectual disabilities | $733 |
| Total Medicare payment per Hospitalization at DRG | $10,348 |
| Total Medicare payment per Hospitalization with ICD F72 - Severe intellectual disabilities | $9,077 |
| Total Medicare Charges at DRG | $5,107,483,805 |
| Total Medicare Charges with ICD F72 - Severe intellectual disabilities | $4,143,833 |
| Avg Charges at DRG | $35,344 |
| Avg Charges with ICD F72 - Severe intellectual disabilities | $35,417 |
| Mortality Rate at DRG | 0.73 |
| Mortality Rate with ICD F72 - Severe intellectual disabilities | NA |
| SNF Discharge Rate at DRG | 38.43 |
| SNF Discharge Rate with ICD F72 - Severe intellectual disabilities | NA |
| Home Discharge Rate at DRG | 27.81 |
| Home Discharge Rate with ICD F72 - Severe intellectual disabilities | 68.38 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 178: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 885: PSYCHOSES | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD F72 - Severe intellectual disabilities | 6,344 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD F72 - Severe intellectual disabilities in DRG | 19.55 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD F72 - Severe intellectual disabilities | 7.36 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD F72 - Severe intellectual disabilities | 26.69 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD F72 - Severe intellectual disabilities | 22.43 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD F72 - Severe intellectual disabilities | $74,768,750 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD F72 - Severe intellectual disabilities | $1,601 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD F72 - Severe intellectual disabilities | $11,786 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD F72 - Severe intellectual disabilities | $356,810,230 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD F72 - Severe intellectual disabilities | $56,244 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD F72 - Severe intellectual disabilities | 6.57 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD F72 - Severe intellectual disabilities | 18.08 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD F72 - Severe intellectual disabilities | 38.51 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 101: SEIZURES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 100: SEIZURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 389: G.I. OBSTRUCTION WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 135,138 | ||||
| Total Hospitalizations with ICD F72 - Severe intellectual disabilities | 917 | ||||
| DRG Share of Total Hospitalizations | 0.41 | ||||
| % of Total ICD F72 - Severe intellectual disabilities in DRG | 2.83 | ||||
| Avg LOS at DRG | 3.28 | ||||
| Avg LOS with ICD F72 - Severe intellectual disabilities | 3.67 | ||||
| Readmission Rate at DRG | 16.48 | ||||
| Readmission Rate with ICD F72 - Severe intellectual disabilities | 16.69 | ||||
| Unplanned Readmission Rate at DRG | 10.54 | ||||
| Unplanned Readmission Rate with ICD F72 - Severe intellectual disabilities | 13.14 | ||||
| Total Medicare payments at DRG | $705,646,122 | ||||
| Total Medicare payments with ICD F72 - Severe intellectual disabilities | $4,908,790 | ||||
| Total Medicare payment per Day at DRG | $1,592 | ||||
| Total Medicare payment per Day with ICD F72 - Severe intellectual disabilities | $1,460 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,222 | ||||
| Total Medicare payment per Hospitalization with ICD F72 - Severe intellectual disabilities | $5,353 | ||||
| Total Medicare Charges at DRG | $4,131,642,258 | ||||
| Total Medicare Charges with ICD F72 - Severe intellectual disabilities | $25,597,059 | ||||
| Avg Charges at DRG | $30,574 | ||||
| Avg Charges with ICD F72 - Severe intellectual disabilities | $27,914 | ||||
| Mortality Rate at DRG | 0.2 | ||||
| Mortality Rate with ICD F72 - Severe intellectual disabilities | NA | ||||
| SNF Discharge Rate at DRG | 16.47 | ||||
| SNF Discharge Rate with ICD F72 - Severe intellectual disabilities | 11.34 | ||||
| Home Discharge Rate at DRG | 56.97 | ||||
| Home Discharge Rate with ICD F72 - Severe intellectual disabilities | 63.47 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 870: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | DRG 689: KIDNEY AND URINARY TRACT INFECTIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 443,386 | ||||
| Total Hospitalizations with ICD F72 - Severe intellectual disabilities | 610 | ||||
| DRG Share of Total Hospitalizations | 1.35 | ||||
| % of Total ICD F72 - Severe intellectual disabilities in DRG | 1.88 | ||||
| Avg LOS at DRG | 5.27 | ||||
| Avg LOS with ICD F72 - Severe intellectual disabilities | 6.06 | ||||
| Readmission Rate at DRG | 21.6 | ||||
| Readmission Rate with ICD F72 - Severe intellectual disabilities | 22.22 | ||||
| Unplanned Readmission Rate at DRG | 15.91 | ||||
| Unplanned Readmission Rate with ICD F72 - Severe intellectual disabilities | 18.4 | ||||
| Total Medicare payments at DRG | $3,812,834,208 | ||||
| Total Medicare payments with ICD F72 - Severe intellectual disabilities | $5,298,878 | ||||
| Total Medicare payment per Day at DRG | $1,632 | ||||
| Total Medicare payment per Day with ICD F72 - Severe intellectual disabilities | $1,433 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,599 | ||||
| Total Medicare payment per Hospitalization with ICD F72 - Severe intellectual disabilities | $8,687 | ||||
| Total Medicare Charges at DRG | $18,110,468,211 | ||||
| Total Medicare Charges with ICD F72 - Severe intellectual disabilities | $25,800,882 | ||||
| Avg Charges at DRG | $40,846 | ||||
| Avg Charges with ICD F72 - Severe intellectual disabilities | $42,297 | ||||
| Mortality Rate at DRG | 3.59 | ||||
| Mortality Rate with ICD F72 - Severe intellectual disabilities | 2.79 | ||||
| SNF Discharge Rate at DRG | 22.57 | ||||
| SNF Discharge Rate with ICD F72 - Severe intellectual disabilities | 12.95 | ||||
| Home Discharge Rate at DRG | 40.95 | ||||
| Home Discharge Rate with ICD F72 - Severe intellectual disabilities | 45.08 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 698: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 388: G.I. OBSTRUCTION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 172,705 | ||||
| Total Hospitalizations with ICD F72 - Severe intellectual disabilities | 458 | ||||
| DRG Share of Total Hospitalizations | 0.53 | ||||
| % of Total ICD F72 - Severe intellectual disabilities in DRG | 1.41 | ||||
| Avg LOS at DRG | 6.21 | ||||
| Avg LOS with ICD F72 - Severe intellectual disabilities | 6.58 | ||||
| Readmission Rate at DRG | 27.27 | ||||
| Readmission Rate with ICD F72 - Severe intellectual disabilities | 31.8 | ||||
| Unplanned Readmission Rate at DRG | 20.51 | ||||
| Unplanned Readmission Rate with ICD F72 - Severe intellectual disabilities | 25.12 | ||||
| Total Medicare payments at DRG | $1,773,015,083 | ||||
| Total Medicare payments with ICD F72 - Severe intellectual disabilities | $4,560,137 | ||||
| Total Medicare payment per Day at DRG | $1,652 | ||||
| Total Medicare payment per Day with ICD F72 - Severe intellectual disabilities | $1,513 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,266 | ||||
| Total Medicare payment per Hospitalization with ICD F72 - Severe intellectual disabilities | $9,957 | ||||
| Total Medicare Charges at DRG | $8,667,227,667 | ||||
| Total Medicare Charges with ICD F72 - Severe intellectual disabilities | $20,078,203 | ||||
| Avg Charges at DRG | $50,185 | ||||
| Avg Charges with ICD F72 - Severe intellectual disabilities | $43,839 | ||||
| Mortality Rate at DRG | 2.92 | ||||
| Mortality Rate with ICD F72 - Severe intellectual disabilities | NA | ||||
| SNF Discharge Rate at DRG | 33.71 | ||||
| SNF Discharge Rate with ICD F72 - Severe intellectual disabilities | 22.49 | ||||
| Home Discharge Rate at DRG | 25.53 | ||||
| Home Discharge Rate with ICD F72 - Severe intellectual disabilities | 37.55 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| CENTRA VIRGINIA BAPTIST HOSPITAL | 3300 RIVERMONT AVE | LYNCHBURG | VA | 24503 | 292 |
| ORANGE REGIONAL MEDICAL CENTER | 707 EAST MAIN STREET | MIDDLETOWN | NY | 10940 | 219 |
| CRENSHAW COMMUNITY HOSPITAL | 101 HOSPITAL CIR | LUVERNE | AL | 36049 | 200 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. SAEED A SHAH | 5906 CARMICHAEL PLACE | MONTGOMERY | AL | 36117 | 198 |
| Dr. SEBASTIAN PAUL AVOLESE | 7309 MYRTLE AVE | GLENDALE | NY | 11385 | 67 |
| Dr. CHARLES WILBUR STOTLER | 334 BLOOMFIELD ST | JOHNSTOWN | PA | 15904 | 21 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. SAEED A SHAH | 5906 CARMICHAEL PLACE | MONTGOMERY | AL | 36117 | 214 |
| Dr. CHARLES WILBUR STOTLER | 334 BLOOMFIELD ST | JOHNSTOWN | PA | 15904 | 117 |
| Dr. SEBASTIAN PAUL AVOLESE | 7309 MYRTLE AVE | GLENDALE | NY | 11385 | 102 |
| No | ICD Diagnosis Code | Description |
|---|---|---|
| 1 | R451 | Restlessness and agitation |
| 2 | G40909 | Epilepsy, unspecified, not intractable, without status epilepticus |
| 3 | F919 | Conduct disorder, unspecified |
| 4 | K5900 | Constipation, unspecified |
| 5 | E669 | Obesity, unspecified |