APPENDICES
APPENDIX A
Agency Response
Appendix B
Profile Summary of Acute Care Hospitals
The following contains a snapshot summary of each of Connecticut's acute care hospitals. The information and calculations were compiled from a variety of hospital data sources. Below is a description and data source for each summary component.
Graph
• The graph contains three years of hospital operating margins as reported by the Office of Healthcare Access (OHCA).
• The location and primary service area were listed in OHCA's 2004 annual report on the financial status of acute care hospitals.
Top Table
• The number of discharges, average length of stay (ALOS), and per diem payments for each program population group were determined with FY 05 data from each hospital's reporting schedule forms 200 and UCT, filed with OHCA.
• The FY 05 payment to cost ratios were provided to program review staff by OHCA. (The Medicaid payment to cost ratio includes Medicaid Managed Care, Medicaid Fee-for-Service, and SAGA.)
• Per diem and payment to cost ratio for the uninsured population is not available.
Middle Table
• The total number of emergency room visits, full-time equivalents (FTEs), and staffed beds with corresponding occupancy rates were compiled using data from OHCA schedule 500.
Bottom Table
• Net revenue refers to net revenue as defined by OHCA after reconciliation from each hospital's audited financial statements which is reported on schedule UCT.
• The cost of uncompensated care (UC) as a percentage of total operating expense was calculated from OHCA schedule UCT and S10, and reflects just uncompensated care and not the cost of medical assistance underpayments.
• The total disproportionate share (DSH) payments each hospital received for FYs 04 and 05 were obtained from the Department of Social Services.
Appendix C. Base Medicaid Target Rates Per Discharge FY 06 and Current Year | ||
HOSPITAL |
RATE FYE 9/30/06 |
RATE Eff. 10/01/06 |
Backus Hospital |
$3,750.00 |
$4,000.00 |
Bradley Memorial Hospital |
$6,896.04 |
$6,896.04 |
Bridgeport Hospital |
$5,350.00 |
$5,350.00 |
Bristol Hospital |
$3,750.00 |
$4,000.00 |
Danbury Hospital |
$3,750.00 |
$4,000.00 |
Day Kimball Hospital |
$3,750.00 |
$4,000.00 |
UCONN Health Center/John Dempsey |
$7,797.36 |
$7,797.36 |
Greenwich Hospital Association |
$4,527.33 |
$4,527.33 |
Griffin Hospital |
$3,860.24 |
$4,000.00 |
Hartford Hospital |
$4,216.46* |
$5,350.00 |
Charlotte Hungerford Hospital |
$3,750.00 |
$4,000.00 |
Johnson Memorial Hospital |
$3,750.00 |
$4,000.00 |
Lawrence & Memorial Hospital |
$3,906.48 |
$4,000.00 |
Manchester Memorial Hospital |
$4,490.96 |
$4,490.96 |
Midstate Med Center |
$3,750.00 |
$4,000.00 |
Middlesex Memorial Hospital |
$3,750.00 |
$4,000.00 |
Milford Hospital |
$3,750.00 |
$4,000.00 |
New Britain General Hospital |
$4,000.00 |
$4,000.00 |
New Milford Hospital |
$4,146.23 |
$4,146.23 |
Norwalk Hospital |
$4,750.00 |
$5,100.00 |
Rockville General Hospital |
$3,750.00 |
$4,000.00 |
St. Francis Hospital |
$3,438.12 |
$4,000.00 |
St. Mary's Hospital |
$4,690.00 |
$4,690.00 |
St. Raphael |
$3,784.35 |
$4,000.00 |
St. Vincent's Medical Center |
$3,904.57 |
$4,000.00 |
Sharon Hospital |
$3,750.00 |
$4,000.00 |
Stamford Hospital |
$3,750.00 |
$4,000.00 |
Waterbury Hospital |
$4,900.00 |
$4,900.00 |
Windham Community Memorial |
$4,600.00 |
$4,600.00 |
Yale-New Haven Hospital |
$5,151.04 |
$5,151.04 |
Source: Department of Social Services *The current rate of $5,350 was retroactive to 10/1/05 per exception request | ||
APPENDIX D. Comparison of Medicaid Payments Under Current Inpatient Reimbursement System and New Reimbursement System. | ||||||||
HOSPITAL |
Proposed Reimbursement System |
2005 Medicaid Discharges |
New Payments= (New Weighted Rate * Discharges) |
Current Medical Assistance Inpatient Payments |
Difference b/w New Payments and Current Payments | |||
06 Current Medicare Base Rate |
New Rate = Current Base Rate + ($ IME * % of Inpatient Medicaid) |
Medicaid Case Mix Index |
New Weighted Rate = (New Rate * Medicaid Case Mix Index) | |||||
Backus |
$5,301 |
5301.00 |
0.88 |
4,664.88 |
1682 |
$7,846,328 |
$5,587,224 |
$2,259,104 |
Bradley |
$5,301 |
5301.00 |
1.05 |
5,566.05 |
66 |
$367,359 |
$203,094 |
$164,265 |
Bridgeport |
$5,785 |
6003.97 |
0.92 |
5,523.65 |
4767 |
$26,331,256 |
$19,862,511 |
$6,468,745 |
Bristol |
$5,301 |
5301.00 |
0.78 |
4,134.78 |
1181 |
$4,883,175 |
$3,589,427 |
$1,293,748 |
CCMC |
$5,301 |
5757.65 |
1.24 |
7,139.48 |
2368 |
$16,906,297 |
$25,187,188 |
-($8,280,891) |
Danbury |
$5,785 |
5860.15 |
0.75 |
4,395.11 |
2378 |
$10,451,571 |
$9,016,193 |
$1,435,378 |
Day Kimball |
$5,301 |
5301.00 |
0.64 |
3,392.64 |
1102 |
$3,738,689 |
$3,893,196 |
-($154,507) |
Greenwich |
$5,785 |
5793.57 |
1.00 |
5,793.57 |
276 |
$1,599,024 |
$1,933,185 |
-($334,161) |
Griffin |
$5,635 |
5715.18 |
0.67 |
3,829.17 |
1094 |
$4,189,116 |
$3,642,437 |
$546,679 |
Hartford |
$5,301 |
5474.52 |
1.05 |
5,748.25 |
6540 |
$37,593,543 |
$36,524,518 |
$1,069,025 |
Hungerford |
$5,301 |
5301.00 |
0.74 |
3,922.74 |
995 |
$3,903,126 |
$1,876,762 |
$2,026,364 |
John Dempsey |
$5,692 |
6151.65 |
1.24 |
7,628.05 |
1466 |
$11,182,716 |
$20,613,055 |
-($9,430,339) |
Johnson Memorial |
$5,301 |
5301.00 |
0.73 |
3,869.73 |
462 |
$1,787,815 |
$2,190,496 |
-($402,681) |
Lawrence Memorial |
$5,301 |
5303.02 |
0.80 |
4,242.41 |
2329 |
$9,880,578 |
$7,996,976 |
$1,883,602 |
Manchester |
$5,301 |
5301.00 |
0.75 |
3,975.75 |
1122 |
$4,460,792 |
$3,544,238 |
$916,554 |
Middlesex |
$5,325 |
5360.12 |
0.80 |
4,288.10 |
1309 |
$5,613,117 |
$4,632,485 |
$980,632 |
MidState |
$5,635 |
5635.00 |
0.82 |
4,620.70 |
1476 |
$6,820,153 |
$4,971,477 |
$1,848,676 |
Milford |
$5,635 |
5635.00 |
0.76 |
4,282.60 |
337 |
$1,443,236 |
$1,230,090 |
$213,146 |
New Britain |
$5,301 |
5391.45 |
0.79 |
4,259.24 |
3433 |
$14,621,977 |
$11,452,067 |
$3,169,910 |
New Milford |
$5,785 |
5785.00 |
0.81 |
4,685.85 |
232 |
$1,087,117 |
$727,621 |
$359,496 |
Norwalk |
$5,785 |
5838.76 |
0.81 |
4,729.40 |
1398 |
$6,611,695 |
$10,227,178 |
-($3,615,483) |
Rockville |
$5,301 |
5301.00 |
0.69 |
3,657.69 |
590 |
$2,158,037 |
$1,828,516 |
$329,521 |
Sharon |
$5,301 |
5301.00 |
0.85 |
4,505.85 |
293 |
$1,320,214 |
$1,075,495 |
$244,719 |
St. Francis |
$5,301 |
5459.44 |
0.93 |
5,077.28 |
6410 |
$32,545,381 |
$26,292,191 |
$6,253,190 |
St. Mary's |
$5,635 |
5763.75 |
0.83 |
4,783.91 |
2524 |
$12,074,599 |
$6,842,636 |
$5,231,963 |
St. Raphael |
$5,635 |
5748.71 |
1.01 |
5,806.20 |
3062 |
$17,778,587 |
$17,622,266 |
$156,321 |
St. Vincent's |
$5,785 |
5867.49 |
0.93 |
5,456.77 |
2816 |
$15,366,252 |
$12,651,702 |
$2,714,550 |
Stamford |
$5,785 |
5878.75 |
0.80 |
4,703.00 |
2805 |
$13,191,919 |
$10,179,648 |
$3,012,271 |
Waterbury |
$5,635 |
5749.00 |
0.79 |
4,541.71 |
3108 |
$14,115,623 |
$11,060,318 |
$3,055,305 |
Windham |
$5,301 |
5301.00 |
0.88 |
4,664.88 |
851 |
$3,969,813 |
$3,536,556 |
$433,257 |
Yale-New Haven |
$5,635 |
6241.96 |
1.00 |
6,241.96 |
11,669 |
$72,837,431 |
$65,837,444 |
$6,999,987 |
TOTAL |
$366,676,538 |
$335,828,190 |
$30,848,348 | |||||
Source: LPR&IC Staff Analysis | ||||||||
APPENDIX E. DSS Calculation of 2006 Medicaid DSH Adjustment. | |||
Hospital |
Total Inpatient Medicaid Days (Fee for Service + Medicaid Managed Care) |
Total Days |
Utilization Rate |
Backus |
5,799 |
46,215 |
12.5479 |
Bradley |
226 |
10,591 |
2.1339 |
Bridgeport |
21,638 |
107,649 |
*20.1005 |
Bristol |
3,473 |
36,280 |
9.5728 |
Danbury |
7,282 |
78,729 |
9.2495 |
Day Kimball |
3,301 |
22,709 |
14.5361 |
Dempsey |
12,476 |
57,940 |
*21.5326 |
Essent/Sharon |
306 |
12,671 |
2.4150 |
Greenwich |
929 |
47,534 |
1.9544 |
Griffin |
4,406 |
32,304 |
13.6392 |
Hartford |
33,544 |
219,452 |
15.2853 |
Hungerford |
3,436 |
28,350 |
12.1199 |
Johnson Memorial |
2,113 |
19,052 |
11.0907 |
Lawrence Memorial |
7,001 |
68,083 |
10.2830 |
Manchester |
3,950 |
40,812 |
9.6785 |
Mid State |
4,468 |
41,260 |
10.8289 |
Middlesex |
4,599 |
49,709 |
9.2518 |
Milford |
1,205 |
22,611 |
5.3293 |
New Britain General |
10,992 |
68,122 |
16.1358 |
New Milford |
733 |
14,352 |
5.1073 |
Norwalk |
7,370 |
81,123 |
9.0850 |
Rockville |
1,928 |
16,097 |
11.9774 |
St. Francis |
27,739 |
163,640 |
16.9512 |
St. Mary's |
8,846 |
54,510 |
16.2282 |
St. Raphael |
19,083 |
142,069 |
13.4322 |
St. Vincent's |
12,153 |
99,386 |
12.2281 |
Stamford |
8,428 |
77,981 |
10.8078 |
Waterbury |
10,832 |
68,955 |
15.7088 |
Windham |
3,315 |
21,127 |
15.6908 |
Yale-New Haven |
54,304 |
219,217 |
*24.7718 |
Standard Deviation |
5.4216 | ||
(Average) Mean |
11.9891 | ||
Qualifying Level |
*17.4107 | ||
Source: Department of Social Services | |||
APPENDIX F. Total Uncompensated Care (FYs 03-05) | ||||
|
HOSPITAL |
FY 03 Uncompensated Care |
FY 04 Uncompensated Care |
FY 05 Uncompensated Care |
% Change FYs 03-05 |
CCMC |
$3,644,349 |
$2,171,171 |
$2,445,934 |
(33) |
Dempsey |
$4,272,895 |
$4,185,950 |
$3,476,379 |
(19) |
Windham |
$5,432,116 |
$5,155,032 |
$4,990,522 |
(8) |
Lawrence Memorial |
$13,347,968 |
$12,874,803 |
$13,395,464 |
0 |
St. Raphael |
$18,083,726 |
$17,663,866 |
$18,199,402 |
1 |
Hungerford |
$1,894,826 |
$2,278,201 |
$1,947,497 |
3 |
Essent/Sharon |
$2,295,048 |
$2,410,228 |
$2,419,280 |
5 |
Manchester |
$5,152,707 |
$5,413,279 |
$5,451,532 |
6 |
Yale-New Haven |
$32,253,433 |
$33,664,340 |
$36,964,963 |
15 |
Milford |
$2,801,121 |
$3,683,683 |
$3,241,441 |
16 |
St. Vincent's |
$17,156,028 |
$19,059,573 |
$19,866,424 |
16 |
Backus |
$8,239,313 |
$10,977,791 |
$10,011,674 |
22 |
Bristol |
$6,233,713 |
$7,122,372 |
$7,584,934 |
22 |
Mid State |
$6,520,245 |
$6,807,303 |
$7,998,165 |
23 |
Johnson Memorial |
$3,866,601 |
$4,704,822 |
$4,848,034 |
25 |
Day Kimball |
$3,477,747 |
$3,132,414 |
$4,423,014 |
27 |
Middlesex |
$9,903,749 |
$14,498,715 |
$12,614,782 |
27 |
Hartford |
$31,856,407 |
$36,657,229 |
$41,985,236 |
32 |
Waterbury |
$10,473,974 |
$14,339,518 |
$14,068,249 |
34 |
Greenwich |
$12,306,998 |
$16,053,277 |
$16,553,803 |
35 |
Danbury |
$14,271,520 |
$17,237,050 |
$19,468,850 |
36 |
Stamford |
$24,624,041 |
$30,032,611 |
$35,442,287 |
44 |
Norwalk |
$10,907,959 |
$14,885,278 |
$15,763,727 |
45 |
Rockville |
$2,084,207 |
$2,453,416 |
$3,014,577 |
45 |
St. Mary's |
$6,454,340 |
$8,135,112 |
$9,845,637 |
53 |
St. Francis |
$12,736,606 |
$18,084,399 |
$19,654,497 |
54 |
Bridgeport |
$17,570,047 |
$21,719,413 |
$27,409,489 |
56 |
Griffin |
$4,525,854 |
$8,449,356 |
$8,509,881 |
88 |
New Britain General |
$6,217,635 |
$10,136,906 |
$12,362,379 |
99 |
New Milford |
$1,490,032 |
$1,852,956 |
$3,269,087 |
119 |
Bradley |
$338,127 |
$1,713,647 |
$910,635 |
169 |
TOTAL |
$300,433,332 |
$357,553,711 |
$388,137,775 |
29% |
Source of Data: OHCA Schedule 202 | ||||
APPENDIX G. Total Free Care (FYs 03-05) | ||||
|
HOSPITAL |
FY 03 Free Care |
FY 04 Free Care |
FY 05 Free Care |
% Change FYs 03-05 |
Bristol |
$732,469 |
$816,487 |
$688,672 |
(6) |
St. Mary's |
$1,050,982 |
$890,352 |
$1,175,197 |
12 |
Lawrence Memorial |
$1,552,625 |
$1,188,480 |
$1,898,766 |
22 |
St. Raphael |
$3,024,726 |
$4,363,864 |
$3,901,407 |
29 |
Greenwich |
$8,307,388 |
$12,463,363 |
$11,932,073 |
44 |
Waterbury |
$1,097,262 |
$1,377,666 |
$1,620,443 |
48 |
Johnson Memorial |
$273,603 |
$183,885 |
$431,525 |
58 |
Stamford |
$4,110,096 |
$5,691,530 |
$6,566,676 |
60 |
Yale-New Haven |
$7,780,683 |
$11,977,918 |
$12,560,367 |
61 |
Windham |
$923,778 |
$1,525,814 |
$1,625,369 |
76 |
Hartford |
$9,633,009 |
$13,804,234 |
$17,123,304 |
78 |
Bradley |
$16,864 |
$15,593 |
$32,174 |
91 |
Norwalk |
$2,674,891 |
$3,743,284 |
$5,122,306 |
91 |
Mid State |
$472,777 |
$573,899 |
$917,479 |
94 |
Danbury |
$4,078,391 |
$6,205,087 |
$8,121,149 |
99 |
CCMC |
$202,553 |
$248,655 |
$420,544 |
108 |
St. Vincent's |
$2,066,171 |
$3,029,728 |
$5,231,883 |
153 |
Middlesex |
$884,788 |
$1,294,206 |
$2,253,481 |
155 |
Manchester |
$458,636 |
$1,495,089 |
$1,281,564 |
179 |
Day Kimball |
$268,687 |
$313,884 |
$759,601 |
183 |
Hungerford |
$197,281 |
$461,199 |
$566,431 |
187 |
Bridgeport |
$3,079,342 |
$5,637,217 |
$8,920,434 |
190 |
Essent/Sharon |
$190,132 |
$314,346 |
$600,122 |
216 |
Rockville |
$193,609 |
$705,733 |
$715,770 |
270 |
Backus |
$621,678 |
$1,703,843 |
$2,535,009 |
308 |
Milford |
$63,667 |
$115,089 |
$371,489 |
483 |
St. Francis |
$1,087,791 |
$4,490,813 |
$7,030,166 |
546 |
Dempsey |
$103,943 |
$806,223 |
$752,944 |
624 |
Griffin |
$170,529 |
$439,853 |
$2,094,321 |
1128 |
New Britain General |
$25,846 |
$0 |
$327,997 |
1169 |
New Milford |
$70,521 |
$419,455 |
$1,173,949 |
1565 |
TOTAL |
$55,414,718 |
$86,296,789 |
$108,752,612 |
96% |
Source of Data: OHCA Schedule 202 | ||||