Module 8 lecture, part 4 Flashcards
Where is ALOS highest?
Federal hospitals
What are the ways in which hospitals can be classified (not mutually exclusive)?
Ownership
Public access
Multiunit affiliation
Type of service
Length of stay
Location
Size
Other
Types of hospital ownership
Public
Private
Nonprofit
Private for-profit
Types of public access hospitals
Community
Non-community
What percentage of US hospitals were multiunit affiliation in 2014?
65%
Categories of length of stay in hospitals
Short stay
Long stay
LTC
Location categories of hospitals
Urban
Rural (swing bed, critical access)
Beyond what bed size are costs significantly higher?
150
What types of hospitals are in the “other” category?
Teaching hospitals
Church affiliated hospitals
Osteopathic hospitals
What percentage of the hospitals in 2014 were private non-profit or voluntary?
Over 50%
What are different types hospitals based on service?
General hospital
Specialty hospital
Psychiatric hospital
Rehab hospital
Children’s hospital
What type of hospital are most US hospitals?
General
What is the ownership of specialty hospitals?
Mostly physician-owned
Svcs for specialty hospital
Narrow range for specific conditions of pt types
What is the purpose of a psychiatric hospital?
Provide psychiatric, psychological, and social work svcs
Who treat ppl with severe and persistent mental illness?
State mental hospitals
What is the Meidcare rule for a rehab hospital?
75% of inpts must require intensive rehab (at least 3 hrs of therapy per day)
Purpose of a rehab hospital
Therapeutic svcs to restore maximum function in pts
Composition of rehab hospitals
80% are hospital-based units rather than freestanding
What do children’s hospitals specialize in?
Complex, severe, or chronic illnesses among children
What are children’s hospitals in most communities?
General hospitals
Which hospitals tend to serve a lower share of Medicaid pts?
Physician-owned specialty hospitals
Other tendencies of physician-owned specialty hospitals
Admit less severe, more profitable cases
Draw pts from community hospitals
Severity adjusted costs are not lower and provider-induced demand may be occurring
Key issues in non-profit hospitals
Competing head on with for-profit hospitals (institutional theory)
Mixed performance on charity care
-Tax exemption is controversial
-IRS now requires documentation on community benefit expenditures
Some debate over what constitutes a community benefit
Details about tax-exempt status in non-profit hospitals
Must provide some defined public good (svc, education, welfare- charity care)
No distribution of profits to any individual
Executive pay may not be deemed unreasonably high
Rules about nonprofit institutions under the ACA
Establish written financial assistance and emergency care policies
Limit charges for those eligible for assistance under hospital’s financial assistance policy
Limit billing and collection actions against those within the guidelines of financial assistance
Conduct a community health needs assessment
