Others titles
- Medicare Skilled Nursing Facility Utilization and Payment Data 2016
- Skilled Nursing Facility Payment Amounts 2016
Keywords
- Skilled Nursing Facility
- SNF Payment
- SNF Charges
- Skilled Nursing Facility Data 2016
- Nursing Utilization and Payment Data
- Skilled Nursing Facility PUF
Skilled Nursing Facility Utilization and Payment Data 2016
This dataset provides information on services provided to Medicare beneficiaries residing in skilled nursing facilities. The Skilled Nursing Facility Public Use File contains information on utilization, payment (allowed amount, Medicare payment and standard payment), submitted charges, and beneficiary demographic and chronic condition indicators organized by Centers for Medicare and Medicaid Services (CMS) Certification Number, Resource Utilization Group (RUG), and state of service.
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Description
This dataset is created annually and contains dozens of variables that describe the characteristics of institutional Medicare providers. The primary data source for theis dataset is CMS’s Chronic Conditions Data Warehouse (CCW). The CCW Part A and Part B data files contain 100 percent of Medicare final action claims for beneficiaries who are enrolled in the Fee-For-Service (FFS) program. The CCW Part A institutional claims and revenue center files, restricted to claims where the claim type code was “20” or “30” indicating that the claim was a Skilled Nursing Facility claim, were used to create the Skilled Nursing Facility Public Use File (PUF). The Skilled Nursing Facility PUF also includes information on the amount of therapy provided to patients who are categorized into two specific Resource Utilization Group (RUG), the RV (Very-high Rehab) and RU (Ultra-high Rehab) categories.
The data source for this data is the 2015 Long-Term Care Minimum Data Set 3.0 (MDS). The MDS is a standardized, primary screening and assessment tool of health status which forms the foundation of the comprehensive assessment for all residents (regardless of payer) of long-term care facilities certified to participate in Medicare or Medicaid. The MDS contains items that measure physical, clinical, psychological, psychosocial functioning, and life care wishes. Provider demographics are also incorporated into the Skilled Nursing Facility PUF including name and complete address from the CMS Provider of Services (POS) file.
About this Dataset
Data Info
Date Created | 2018-10-10 |
---|---|
Last Modified | 2019-05-02 |
Version | 2019-05-02 |
Update Frequency |
Annual |
Temporal Coverage |
2016 |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicare and Medicaid Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | Skilled Nursing Facility, SNF Payment, SNF Charges, Skilled Nursing Facility Data 2016, Nursing Utilization and Payment Data, Skilled Nursing Facility PUF |
Other Titles | Medicare Skilled Nursing Facility Utilization and Payment Data 2016, Skilled Nursing Facility Payment Amounts 2016 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Provider_ID | The 6-digit identification number for the SNF on the claim. | integer | level : Nominal |
Facility_Name | The SNF name, as reported in the POS file. | string | - |
Street | Address of SNF provider | string | - |
City | The city where the SNF is located, as reported in the POS file | string | - |
State_Abbreviation | The state where the SNF is located, as reported in POS file. The fifty U.S. states and the District of Columbia are reported by the state postal abbreviation. | string | - |
Zip_Code | The SNF’s zip code, as reported in the POS file. | integer | level : Nominal |
Total_Stays | Total count of stays provided by an SNF in the calendar year. | integer | level : Ratio |
Distinct_Beneficiaries_Per_Provider | Number of distinct Medicare beneficiaries with a least one SNF stay or SNF day in the calendar year. Beneficiaries may have more than one SNF stay or day per year but are only counted once in this field per row, however they may be double-counted across providers or RUGs. Therefore, this column will not sum to a total count of unique beneficiaries. | integer | level : Ratio |
Average_Length_of_Stay_Days | Average length of stay, in days. | number | level : Ratio |
Total_SNF_Charge_Amount | Total charges that the SNF submitted for stays. | number | - |
Total_SNF_Medicare_Allowed_Amount | Total of the Medicare allowed amount for stays; this figure is the sum of the amount Medicare pays, the deductible and coinsurance amount that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying. | number | - |
Total_SNF_Medicare_Payment_Amount | Total amount that Medicare paid for the SNF stays after deductible and coinsurance amounts have been deducted. | number | - |
Total_SNF_Medicare_Standard_Payment_Amount | Total amount that Medicare paid for SNF stays adjusted for geographic differences in payment rates. | number | - |
Average_Age | Average age of beneficiaries. Beneficiary age is calculated at the end of the calendar year or at the time of death | integer | level : Ratio |
Male_Beneficiaries | Number of male beneficiaries. | integer | level : Ratio |
Female_Beneficiaries | Number of female beneficiaries | integer | level : Ratio |
Nondual_Beneficiaries | Number of Medicare beneficiaries qualified to receive Medicare only benefits. Beneficiaries are classified as Medicare only entitlement if they received zero months of any Medicaid benefits (full or partial) in the given calendar year. | integer | level : Ratio |
Dual_Beneficiaries | Number of Medicare beneficiaries qualified to receive Medicare and Medicaid benefits. Beneficiaries are classified as Medicare and Medicaid entitlement if in any month in the given calendar year they were receiving full or partial Medicaid benefits | integer | level : Ratio |
White_Beneficiaries | Number of non-Hispanic white beneficiaries | integer | level : Ratio |
Black_Beneficiaries | Number of non-Hispanic black or African American beneficiaries. | integer | level : Ratio |
Asian_Pacific_Islander_Beneficiaries | Number of Asian Pacific Islander beneficiaries. | integer | level : Ratio |
Hispanic_Beneficiaries | Number of Hispanic beneficiaries | integer | level : Ratio |
American_Indian_Or_Alaska_Native_Beneficiaries | Number of American Indian or Alaska Native beneficiaries | integer | level : Ratio |
Other_Or_Unknown_Beneficiaries | Number of beneficiaries with race not elsewhere classified. | integer | level : Ratio |
Average_HCC_Score | Average Hierarchical Condition Category (HCC) risk score of beneficiaries. | number | level : Ratio |
Percent_of_Beneficiaries_With_Atrial_Fibrillation | Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation. | number | level : Ratio |
Percent_of_Beneficiaries_With_Alzheimers | Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia. | number | level : Ratio |
Percent_of_Beneficiaries_With_Asthma | Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma. | number | level : Ratio |
Percent_of_Beneficiaries_With_Cancer | Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer. | number | level : Ratio |
Percent_of_Beneficiaries_With_CHF | Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure. | number | level : Ratio |
Percent_of_Beneficiaries_With_Chronic_Kidney_Disease | Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease. | number | level : Ratio |
Percent_of_Beneficiaries_With_COPD | Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease. | number | level : Ratio |
Percent_of_Beneficiaries_With_Depression | Percent of beneficiaries meeting the CCW chronic condition algorithm for depression. | number | level : Ratio |
Percent_of_Beneficiaries_With_Diabetes | Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes. | number | level : Ratio |
Percent_of_Beneficiaries_With_Hyperlipidemia | Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia. | number | level : Ratio |
Percent_of_Beneficiaries_With_Hypertension | Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension. | number | level : Ratio |
Percent_of_Beneficiaries_With_IHD | Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease. | number | level : Ratio |
Percent_of_Beneficiaries_With_Osteoporosis | Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis. | number | level : Ratio |
Percent_of_Beneficiaries_with_Rheumatiod_Arthritis_Oseoarthritis | Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis. | number | level : Ratio |
Percent_of_Beneficiaries_With_Schizophrenia | Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders. | number | level : Ratio |
Percent_of_Beneficiaries_With_Stroke | Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke. | number | level : Ratio |
Data Preview
Provider ID | Facility Name | Street | City | State Abbreviation | Zip Code | Total Stays | Distinct Beneficiaries Per Provider | Average Length of Stay Days | Total SNF Charge Amount | Total SNF Medicare Allowed Amount | Total SNF Medicare Payment Amount | Total SNF Medicare Standard Payment Amount | Average Age | Male Beneficiaries | Female Beneficiaries | Nondual Beneficiaries | Dual Beneficiaries | White Beneficiaries | Black Beneficiaries | Asian Pacific Islander Beneficiaries | Hispanic Beneficiaries | American Indian Or Alaska Native Beneficiaries | Other Or Unknown Beneficiaries | Average HCC Score | Percent of Beneficiaries With Atrial Fibrillation | Percent of Beneficiaries With Alzheimers | Percent of Beneficiaries With Asthma | Percent of Beneficiaries With Cancer | Percent of Beneficiaries With CHF | Percent of Beneficiaries With Chronic Kidney Disease | Percent of Beneficiaries With COPD | Percent of Beneficiaries With Depression | Percent of Beneficiaries With Diabetes | Percent of Beneficiaries With Hyperlipidemia | Percent of Beneficiaries With Hypertension | Percent of Beneficiaries With IHD | Percent of Beneficiaries With Osteoporosis | Percent of Beneficiaries with Rheumatiod Arthritis Oseoarthritis | Percent of Beneficiaries With Schizophrenia | Percent of Beneficiaries With Stroke |
10022 | CHEROKEE MEDICAL CENTER | 400 NORTHWOOD DR | CENTRE | AL | 35960 | 96 | 83 | 12.6 | 3359238 | 449462 | 431913 | 543864 | 79 | 28 | 55 | 62 | 21 | 82 | 2.06 | 0.25 | 39 | 49 | 0.14 | 63 | 69 | 46 | 39 | 58 | 69 | 0.1 | 4.0 | 0.14 | ||||||||
10034 | COMMUNITY HOSPITAL INC | 805 FRIENDSHIP ROAD | TALLASSEE | AL | 36078 | 93 | 83 | 11.9 | 1347294 | 426985 | 422477 | 521619 | 80 | 29 | 54 | 67 | 16 | 64 | 18.0 | 2.28 | 0.29 | 34 | 54 | 0.13 | 63 | 72 | 58 | 30 | 54 | 69 | 0.23 | 64.0 | 4.0 | 0.28 | ||||||
10044 | MARION REGIONAL MEDICAL CENTER | 1256 MILITARY STREET SOUTH | HAMILTON | AL | 35570 | 164 | 150 | 12.5 | 4931053 | 818240 | 808419 | 1006516 | 78 | 57 | 93 | 108 | 42 | 144 | 1.74 | 0.18 | 39 | 41 | 0.13 | 47 | 54 | 39 | 38 | 45 | 48 | 0.21 | 63.0 | 5.0 | 0.13 | |||||||
10045 | FAYETTE MEDICAL CENTER | 1653 TEMPLE AVENUE NORTH | FAYETTE | AL | 35555 | 126 | 121 | 15.9 | 2887631 | 863293 | 852513 | 1061525 | 79 | 48 | 73 | 90 | 31 | 104 | 16.0 | 1.98 | 0.23 | 37 | 52 | 0.14 | 55 | 63 | 49 | 36 | 42 | 60.0 | 60 | 0.18 | 6.0 | 0.19 | ||||||
10058 | BIBB MEDICAL CENTER | 208 PIERSON AVE | CENTREVILLE | AL | 35042 | 86 | 70 | 18.6 | 1581118 | 662824 | 578957 | 688834 | 77 | 24 | 46 | 46 | 24 | 59 | 2.1 | 0.23 | 49 | 36 | 0.09 | 51 | 57 | 34 | 43 | 60 | 73.0 | 47 | 0.16 | 64.0 | 7.0 | 0.09 | ||||||
10059 | LAWRENCE MEDICAL CENTER | 202 HOSPITAL STREET | MOULTON | AL | 35650 | 61 | 55 | 11.8 | 864921 | 208267 | 206979 | 261067 | 76 | 14 | 41 | 38 | 17 | 52 | 1.48 | 0.2 | 33 | 35 | 0.11 | 56 | 60 | 36 | 56 | 47 | 75.0 | 67 | 0.11 | 0.16 | ||||||||
10069 | MEDICAL CENTER BARBOUR | 820 W WASHINGTON ST | EUFAULA | AL | 36027 | 63 | 60 | 16.0 | 1080517 | 298569 | 285528 | 362639 | 81 | 22 | 38 | 44 | 16 | 50 | 1.79 | 0.25 | 33 | 30 | 0.13 | 40 | 65 | 32 | 45 | 50 | 50 | 0.25 | 67.0 | 5.0 | 0.25 | |||||||
10073 | CLAY COUNTY HOSPITAL | 83825 HIGHWAY 9 P O BOX 1270 | ASHLAND | AL | 36251 | 68 | 64 | 10.3 | 964332 | 191101 | 176289 | 227430 | 79 | 25 | 39 | 43 | 21 | 60 | 1.76 | 0.23 | 34 | 45 | 0.16 | 58 | 56 | 45 | 45 | 55 | 63 | 0.09 | 56.0 | 5.0 | 0.16 | |||||||
10086 | NORTHWEST MEDICAL CENTER | 1530 U S HIGHWAY 43 | WINFIELD | AL | 35594 | 82 | 76 | 10.4 | 3152751 | 278673 | 271589 | 342751 | 78 | 29 | 47 | 53 | 23 | 73 | 2.29 | 0.32 | 22 | 45 | 0.08 | 62 | 72 | 43 | 36 | 53 | 64.0 | 57 | 0.12 | 51.0 | 4.0 | 0.07 | ||||||
10095 | HALE COUNTY HOSPITAL | 508 GREEN STREET | GREENSBORO | AL | 36744 | 84 | 76 | 15.7 | 763387 | 533183 | 519981 | 648532 | 76 | 27 | 49 | 38 | 38 | 22 | 54.0 | 1.95 | 0.14 | 36 | 41 | 0.17 | 53 | 74 | 41 | 26 | 55 | 63.0 | 50 | 0.03 | 13.0 | 0.14 |