*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| J168 - Pneumonia due to other specified infectious organisms - as a primary diagnosis code | J168 - Pneumonia due to other specified infectious organisms - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 10.87 | |
| Readmission Rate (%) | 29.94 | |
| Unplanned Readmission Rate (%) | 13.89 | |
| 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 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 417,755 | ||||
| Total Hospitalizations with ICD J168 - Pneumonia due to other specified infectious organisms | 1,062 | ||||
| DRG Share of Total Hospitalizations | 1.27 | ||||
| % of Total ICD J168 - Pneumonia due to other specified infectious organisms in DRG | 38.58 | ||||
| Avg LOS at DRG | 3.9 | ||||
| Avg LOS with ICD J168 - Pneumonia due to other specified infectious organisms | 4.64 | ||||
| Readmission Rate at DRG | 16.53 | ||||
| Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 20.26 | ||||
| Unplanned Readmission Rate at DRG | 11.52 | ||||
| Unplanned Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 11.79 | ||||
| Total Medicare payments at DRG | $2,493,587,688 | ||||
| Total Medicare payments with ICD J168 - Pneumonia due to other specified infectious organisms | $9,123,520 | ||||
| Total Medicare payment per Day at DRG | $1,529 | ||||
| Total Medicare payment per Day with ICD J168 - Pneumonia due to other specified infectious organisms | $1,851 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,969 | ||||
| Total Medicare payment per Hospitalization with ICD J168 - Pneumonia due to other specified infectious organisms | $8,591 | ||||
| Total Medicare Charges at DRG | $11,318,800,289 | ||||
| Total Medicare Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $34,641,479 | ||||
| Avg Charges at DRG | $27,094 | ||||
| Avg Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $32,619 | ||||
| Mortality Rate at DRG | 0.87 | ||||
| Mortality Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 1.6 | ||||
| SNF Discharge Rate at DRG | 17.03 | ||||
| SNF Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 13.84 | ||||
| Home Discharge Rate at DRG | 53.31 | ||||
| Home Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 56.21 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 163: MAJOR CHEST PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|
| Total Hospitalizations at DRG | 181,637 | |||
| Total Hospitalizations with ICD J168 - Pneumonia due to other specified infectious organisms | 46 | |||
| DRG Share of Total Hospitalizations | 0.55 | |||
| % of Total ICD J168 - Pneumonia due to other specified infectious organisms in DRG | 1.67 | |||
| Avg LOS at DRG | 7.0 | |||
| Avg LOS with ICD J168 - Pneumonia due to other specified infectious organisms | 8.65 | |||
| Readmission Rate at DRG | 32.53 | |||
| Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | NA | |||
| Unplanned Readmission Rate at DRG | 19.84 | |||
| Unplanned Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | NA | |||
| Total Medicare payments at DRG | $2,845,609,163 | |||
| Total Medicare payments with ICD J168 - Pneumonia due to other specified infectious organisms | $791,655 | |||
| Total Medicare payment per Day at DRG | $2,237 | |||
| Total Medicare payment per Day with ICD J168 - Pneumonia due to other specified infectious organisms | $1,989 | |||
| Total Medicare payment per Hospitalization at DRG | $15,666 | |||
| Total Medicare payment per Hospitalization with ICD J168 - Pneumonia due to other specified infectious organisms | $17,210 | |||
| Total Medicare Charges at DRG | $14,794,146,746 | |||
| Total Medicare Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $4,374,708 | |||
| Avg Charges at DRG | $81,449 | |||
| Avg Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $95,102 | |||
| Mortality Rate at DRG | 25.14 | |||
| Mortality Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 36.96 | |||
| SNF Discharge Rate at DRG | 19.06 | |||
| SNF Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | NA | |||
| Home Discharge Rate at DRG | 20.69 | |||
| Home Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER | 1515 HOLCOMBE BLVD | HOUSTON | TX | 77030 | 155 |
| CHEROKEE REGIONAL MEDICAL CENTER | 300 SIOUX VALLEY DR | CHEROKEE | IA | 51012 | 83 |
| KING'S DAUGHTERS MEDICAL CENTER | 2201 LEXINGTON AVE | ASHLAND | KY | 41101 | 68 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. VIVEKANANDA VARMA DATLA | 2201 LEXINGTON AVE | ASHLAND | KY | 41101 | 13 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. CHRISTOPHER J. VANDELUNE | 300 SIOUX VALLEY DR | CHEROKEE | IA | 51012 | 31 |
| Dr. TIMOTHY G. RICE | 300 SIOUX VALLEY DR | CHEROKEE | IA | 51012 | 21 |
| Dr. WESLEY A. PARKER | 300 SIOUX VALLEY DR | CHEROKEE | IA | 51012 | 18 |
*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 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD J168 - Pneumonia due to other specified infectious organisms | 1,710 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD J168 - Pneumonia due to other specified infectious organisms in DRG | 16.48 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD J168 - Pneumonia due to other specified infectious organisms | 8.28 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 24.71 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 16.3 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD J168 - Pneumonia due to other specified infectious organisms | $24,653,771 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD J168 - Pneumonia due to other specified infectious organisms | $1,741 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD J168 - Pneumonia due to other specified infectious organisms | $14,417 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $139,647,967 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $81,665 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 12.75 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 19.18 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 31.99 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 834: ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 147,017 | ||||
| Total Hospitalizations with ICD J168 - Pneumonia due to other specified infectious organisms | 378 | ||||
| DRG Share of Total Hospitalizations | 0.45 | ||||
| % of Total ICD J168 - Pneumonia due to other specified infectious organisms in DRG | 3.64 | ||||
| Avg LOS at DRG | 3.12 | ||||
| Avg LOS with ICD J168 - Pneumonia due to other specified infectious organisms | 3.5 | ||||
| Readmission Rate at DRG | 11.06 | ||||
| Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 11.73 | ||||
| Unplanned Readmission Rate at DRG | 7.05 | ||||
| Unplanned Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 6.42 | ||||
| Total Medicare payments at DRG | $662,922,575 | ||||
| Total Medicare payments with ICD J168 - Pneumonia due to other specified infectious organisms | $2,075,639 | ||||
| Total Medicare payment per Day at DRG | $1,445 | ||||
| Total Medicare payment per Day with ICD J168 - Pneumonia due to other specified infectious organisms | $1,569 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,509 | ||||
| Total Medicare payment per Hospitalization with ICD J168 - Pneumonia due to other specified infectious organisms | $5,491 | ||||
| Total Medicare Charges at DRG | $2,893,146,238 | ||||
| Total Medicare Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $6,334,747 | ||||
| Avg Charges at DRG | $19,679 | ||||
| Avg Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $16,759 | ||||
| Mortality Rate at DRG | 0.67 | ||||
| Mortality Rate with ICD J168 - Pneumonia due to other specified infectious organisms | NA | ||||
| SNF Discharge Rate at DRG | 13.03 | ||||
| SNF Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 11.64 | ||||
| Home Discharge Rate at DRG | 62.41 | ||||
| Home Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 58.73 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 870: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 808: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 231,410 | ||||
| Total Hospitalizations with ICD J168 - Pneumonia due to other specified infectious organisms | 203 | ||||
| DRG Share of Total Hospitalizations | 0.7 | ||||
| % of Total ICD J168 - Pneumonia due to other specified infectious organisms in DRG | 1.96 | ||||
| Avg LOS at DRG | 7.29 | ||||
| Avg LOS with ICD J168 - Pneumonia due to other specified infectious organisms | 10.82 | ||||
| Readmission Rate at DRG | 25.54 | ||||
| Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 33.33 | ||||
| Unplanned Readmission Rate at DRG | 18.36 | ||||
| Unplanned Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 22.22 | ||||
| Total Medicare payments at DRG | $2,801,759,007 | ||||
| Total Medicare payments with ICD J168 - Pneumonia due to other specified infectious organisms | $3,587,197 | ||||
| Total Medicare payment per Day at DRG | $1,661 | ||||
| Total Medicare payment per Day with ICD J168 - Pneumonia due to other specified infectious organisms | $1,633 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,107 | ||||
| Total Medicare payment per Hospitalization with ICD J168 - Pneumonia due to other specified infectious organisms | $17,671 | ||||
| Total Medicare Charges at DRG | $13,366,030,360 | ||||
| Total Medicare Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $18,212,531 | ||||
| Avg Charges at DRG | $57,759 | ||||
| Avg Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $89,717 | ||||
| Mortality Rate at DRG | 7.21 | ||||
| Mortality Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 6.9 | ||||
| SNF Discharge Rate at DRG | 32.47 | ||||
| SNF Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 21.67 | ||||
| Home Discharge Rate at DRG | 20.84 | ||||
| Home Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 28.08 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 004: TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURE | DRG 867: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 837: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SDX OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 003: ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 36,636 | ||||
| Total Hospitalizations with ICD J168 - Pneumonia due to other specified infectious organisms | 117 | ||||
| DRG Share of Total Hospitalizations | 0.11 | ||||
| % of Total ICD J168 - Pneumonia due to other specified infectious organisms in DRG | 1.13 | ||||
| Avg LOS at DRG | 5.73 | ||||
| Avg LOS with ICD J168 - Pneumonia due to other specified infectious organisms | 8.19 | ||||
| Readmission Rate at DRG | 21.72 | ||||
| Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 30.28 | ||||
| Unplanned Readmission Rate at DRG | 14.08 | ||||
| Unplanned Readmission Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 17.43 | ||||
| Total Medicare payments at DRG | $448,734,039 | ||||
| Total Medicare payments with ICD J168 - Pneumonia due to other specified infectious organisms | $2,174,362 | ||||
| Total Medicare payment per Day at DRG | $2,137 | ||||
| Total Medicare payment per Day with ICD J168 - Pneumonia due to other specified infectious organisms | $2,270 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,248 | ||||
| Total Medicare payment per Hospitalization with ICD J168 - Pneumonia due to other specified infectious organisms | $18,584 | ||||
| Total Medicare Charges at DRG | $2,388,208,589 | ||||
| Total Medicare Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $9,676,482 | ||||
| Avg Charges at DRG | $65,187 | ||||
| Avg Charges with ICD J168 - Pneumonia due to other specified infectious organisms | $82,705 | ||||
| Mortality Rate at DRG | 0.77 | ||||
| Mortality Rate with ICD J168 - Pneumonia due to other specified infectious organisms | NA | ||||
| SNF Discharge Rate at DRG | 10.73 | ||||
| SNF Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | NA | ||||
| Home Discharge Rate at DRG | 59.85 | ||||
| Home Discharge Rate with ICD J168 - Pneumonia due to other specified infectious organisms | 75.21 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER | 1515 HOLCOMBE BLVD | HOUSTON | TX | 77030 | 458 |
| KING'S DAUGHTERS MEDICAL CENTER | 2201 LEXINGTON AVE | ASHLAND | KY | 41101 | 126 |
| CHEROKEE REGIONAL MEDICAL CENTER | 300 SIOUX VALLEY DR | CHEROKEE | IA | 51012 | 103 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. VIVEKANANDA VARMA DATLA | 2201 LEXINGTON AVE | ASHLAND | KY | 41101 | 17 |
| Dr. NAVAL GUSTAD DAVER | 1515 HOLCOMBE BLVD | HOUSTON | TX | 77030 | 15 |
| Dr. YESID ALVARADO VALERO | 1515 HOLCOMBE BLVD | HOUSTON | TX | 77030 | 15 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MARK ETHAN VANNORDEN | 200 E 8TH ST | LARNED | KS | 67550 | 41 |
| Dr. CHRISTOPHER J. VANDELUNE | 300 SIOUX VALLEY DR | CHEROKEE | IA | 51012 | 40 |
| Dr. TIMOTHY G. RICE | 300 SIOUX VALLEY DR | CHEROKEE | IA | 51012 | 24 |
| No | ICD Diagnosis Code | Description |
|---|---|---|
| 1 | Z79899 | Other long term (current) drug therapy |
| 2 | J449 | Chronic obstructive pulmonary disease, unspecified |
| 3 | R0902 | Hypoxemia |
| 4 | I10 | Essential (primary) hypertension |
| 5 | E876 | Hypokalemia |