Barnes Jewish Hospital-St Louis (pdf) - Illinois Department of ...

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Barnes Jewish Hospital St Louis, MO Qualifying Rate Level 4: Illinois hospital located outside H.S.A. 6, with a DPU psychiatric care per diem rate less than the statewide $0.00 psychiatric DPU average default rate, with a MIUR > 19%, total beds < 275, psychiatric care days 50, and a psychiatric occupancy rate > 60% Your hospital’s total Psychiatric Adjustment Payment amount: $0.00 (Assigned rate x total qualified hospital days) PLEASE NOTE: Your actual final payment amount may vary due to rounding. PAP Attach Page 4
Barnes Jewish Hospital St Louis, MO Rural Adjustment Payments For the Period of July 1, 2011 through June 30, 2012 Hospital Is Excluded By Rule. Factors used to determine qualification and rate: Inpatient Component A) Your hospital's total inpatient days during the Rural Adjustment Payment base year: B) Your hospital's total inpatient payments during the Rural Adjustment Payment base year: C) Your hospital's inpatient quarterly payments during the Rural Adjustment Payment base year: D) Your hospital's total inpatient reimbursement per day during the Rural Adjustment Payment base year: (B+C) / A E) Your hospital's total inpatient charges during the Rural Adjustment Payment base year: N/A N/A N/A N/A N/A F) Your hospital's cost to charge ratio: N/A (HFY 2008 Medicaid Cost Report) G) Your hospital's total inpatient cost during the Rural Adjustment Payment base year: (F * E) N/A H) Your hospital's total inpatient cost per day during the Rural Adjustment Payment base year: (G / A) N/A I) Your hospital's inpatient cost coverage deficit per day during the Rural Adjustment Payment base year: (H - D) N/A J) Rural Adjustment Payment base year inpatient total cost coverage deficit: (A * I) N/A K) Aggregate Rural Adjustment Payment base year inpatient cost coverage deficit: $7,775,488 (Sum of all qualifying hospitals inpatient total cost coverage deficits) Outpatient Component: L) Your hospital's total outpatient service units during the Rural Adjustment Payment base year: M) Your hospital's total outpatient payments during the Rural Adjustment Payment base year: (Including applicable outpatient quarterly payments) N/A N/A RAP Attach Page 5
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Barnes Jewish Hospital-St Louis (pdf) - Illinois Department of ...

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