{"text_format":"3","workbook":"xlsx","n_sheets":4,"sheets":["Cover Page","HRSA 100-2-A DISCH BY PAYOR,ZIP","HRSA 100-2-B DISCH BY CHRON DI","HRSA 100-2-C HOSP LVL PAT SAFTY"],"not_rendered":{"macros":1,"external_links":1,"defined_names":7},"read":"whole","date_system":"1900"}

{"sheet":"Cover Page","index":0,"n_rows":24,"n_cols":7,"rows_kept":24,"merged":[[3,1,13,8],[20,1,22,8],[23,1,36,8]]}
["Department of Health and Human Services",{"$nulls":5},"OMB No. 0915-0313"]
["Health Resources and Services Administration",{"$nulls":5},"Expiration Date:  11/30/2013"]
[]
[null,"\n\n\nCHILDREN’S HOSPITALS GRADUATE MEDICAL EDUCATION PAYMENT PROGRAM\n\nANNUAL REPORT FORM HRSA 100-2\n"]
{"$rows_empty":16}
[null,"Public Burden Statement"]
[]
[]
[null,"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0915-0313.  Public reporting burden for the applicant for this collection of information is estimated to average 39.4 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14 33, Rockville, Maryland, 20857."]

{"sheet":"HRSA 100-2-A DISCH BY PAYOR,ZIP","index":1,"n_rows":26,"n_cols":6,"rows_kept":26,"merged":[[0,0,0,1],[1,0,1,1],[3,0,3,5],[4,1,4,5],[5,1,5,5],[6,1,6,5],[8,0,8,5],[18,0,19,3],[20,0,20,5],[21,4,24,5],[25,0,25,2]]}
["Department of Health and Human Services",{"$nulls":4},"OMB No.  0915-0313"]
["Health Resources and Services Administration",{"$nulls":4},"Expiration Date:  11/30/2013"]
["Children's Hospitals Graduate Medical Education Payment Program"]
["HRSA 100-2-A:   Discharge Data by Payor and Zip Code"]
["Hospital Name:"]
["Medicare Provider Number:"]
["Date of Report:","2012-12-31"]
["1.  DISCHARGES BY PAYOR"]
["Provide the number of discharges for the academic year most recently completed  (July 1, 2011 - June 30, 2012) for each of the following payment groups.  Include all Medicaid payments including Medicaid managed care and any other Medicaid payments under the Medicaid and/or CHIP category. Self-pay refers to patients who have made out-of-pocket payments for services.  Uncompensated care means care for which the hospital receives no payment.  Do not include lab services under Outpatient Visits.  See detailed guidance for complete instructions."]
[]
["Payor","Inpatient Discharges","Outpatient Visits","Emergency Department Visits"]
["Private Insurance"]
["Medicaid and/or CHIP"]
["Medicare"]
["Other Public (TRICARE, Indian Health Service) "]
["Self-pay"]
["Uncompensated Care"]
["Total"]
["2.  DISCHARGES BY ZIP CODE"]
[]
["Please enter the number of discharges for the academic year most recently completed  (July 1, 2011 - June 30, 2012) by zip code in the highlighted cell of the mock table provided as an example below. Also, include a separate CD that provides the number of inpatient discharges for the most recent academic year (July 1, 2011 - June 30, 2012) by city, state and zip code. The total number of inpatient discharges must equal total number of inpatient discharges documented in section one above.  Please include the name and Medicare Provider Number of your hospital at the top of the listing and on the outside of the CD."]
["Zip Code (up to 9 digits, if possible)","City","State","No. of Inpatient Discharges"]
["Zip Code 1","Roanoke","VA",12]
["Zip Code 2","Las Vegas","NV",40]
["Zip Code 3","Springfield","IL",32]
["Total"]

{"sheet":"HRSA 100-2-B DISCH BY CHRON DI","index":2,"n_rows":41,"n_cols":6,"rows_kept":41,"merged":[[0,0,0,1],[1,0,1,1],[3,0,3,4],[4,0,4,4],[5,1,5,4],[6,1,6,4],[7,1,7,4],[8,0,9,4],[34,0,38,4],[39,0,39,4]]}
["Department of Health and Human Services",{"$nulls":3},"OMB No. 0915-0313"]
["Health Resources and Services Administration",{"$nulls":3},"Expiration Date:  11/30/2013"]
["Children's Hospitals Graduate Medical Education Payment Program"]
["HRSA 100-2-B:  Discharge Data Aggregated by Selected Chronic"]
["Diseases "]
["Hospital Name:",{"$f":"'HRSA 100-2-A DISCH BY PAYOR,ZIP'!B5:F5","v":0}]
["Medicare Provider Number:",{"$f":"'HRSA 100-2-A DISCH BY PAYOR,ZIP'!B6:F6","v":{"v":0,"d":"00-0000"}}]
["Date of Report:",{"$f":"'HRSA 100-2-A DISCH BY PAYOR,ZIP'!B7:F7","v":"2012-12-31"}]
["Please list the number of unique inpatient discharges, outpatient visits, and ER visits, by the ICD-9 codes provided in the table below.  Primary and all secondary diagnoses should be included when preparing the table. Please note that at-risk neonates are identified using V codes for low birth weight.  Do not include lab services under Outpatient Visits.  See detailed guidance for complete instructions."]
[]
["Chronic Disease","ICD-9 Codes","Inpatient Discharges","Outpatient Visits","Emergency Department Visits"," "]
[" AIDS (incl HIV positive) "," 042, V08, 0795"]
["Arthropathies (excl infectious, joint pain) "," 710, 712-718, 720-723, 725-728,731-39, V49"]
[" Asthma ",493]
[" Cardiac disease "," 392-454, 456-458"]
[" Cerebral palsy and other paralyses ","342-344"]
[" CNS disorders (excl epilepsy, paralyses) ","324-341, 347-349, V48"]
[" Congenital anomalies (excl spina bifida) ","740, 742-59, 771"]
[" Cystic fibrosis and other ",277]
[" Diabetes Mellitus ",250]
[" Endocrine, other than diabetes ","252-259"]
[" Epilepsy ","345; 780.39"]
[" Gastroenteritis, colitis & malabsorption "," 555-7, 579,V44"]
[" Hematologic (sickle cell, excl, anemia) "," 281-289; excluding 285.9"]
[" Mental Retardation","317-319"]
[" Metabolic/immune disorders "," 270-275, 279"]
[" Neoplasms "," 140-215, 217-239, V10"]
[" Neuromuscular disorders (incl polio) ","350-359, 045-049,138"]
[" Dental diseases ","520-522, 524-526"]
[" Renal failure "," 582-589"]
[" Spina bifida ",741]
[" Thyroid disease "," 240-246"]
["Neonatal","V21.30-V21.35"]
["Psychiatric/mental health","295-316"]
[]
[]
[]
[]
[]
[]
["   "]

{"sheet":"HRSA 100-2-C HOSP LVL PAT SAFTY","index":3,"n_rows":30,"n_cols":5,"rows_kept":30,"merged":[[0,0,0,1],[1,0,1,1],[1,3,1,4],[3,0,3,4],[4,1,4,4],[5,1,5,4],[6,1,6,4],[7,0,7,4],[8,0,8,4]]}
["Department of Health and Human Services",{"$nulls":3},"OMB No. 0915-0313"]
["Health Resources and Services Administration",null,null,"Expiration Date:  11/30/2013"]
["Children's Hospitals Graduate Medical Education Payment Program"]
["HRSA 100-2-C:  Patient Safety Initiatives "]
["Hospital Name:",{"$f":"'HRSA 100-2-A DISCH BY PAYOR,ZIP'!B5:F5","v":0}]
["Medicare provider number:",{"$f":"'HRSA 100-2-A DISCH BY PAYOR,ZIP'!B6:F6","v":{"v":0,"d":"00-0000"}}]
["Date of report:",{"$f":"'HRSA 100-2-A DISCH BY PAYOR,ZIP'!B7:F7","v":"2012-12-31"}]
["For each of the following patient safety initiatives, indicate whether your children’s hospital had any of the listed initiatives in place in the most recently completed academic year (2011-2012) and if any changes in the initiatives have occurred since the previous academic year (2010-2011). "]
["Please indicate the rationale for any changes in the initiative (i.e., newly introduced, eliminated, enhanced) and list the benefits of the changes, including, for example, but not limited to, increases in medical knowledge; improvements in clinical competence;  increased awareness of psychosocial and behavioral aspects of health and illness; increased awareness of the availability of community resources.  See detailed guidance for complete instructions."]
[]
[null,"Part of the Hospital's Patient Safety Program  in Most Recent Academic Year (2011-2012) \nü=YES  \nBlank=NO    "," Hospital has Made Changes in Initiative since the previous academic year (2010-2011)    ü=YES  \nBlank=NO  ","Reasons for Change","Benefits of Initiative"]
["Root cause or error analysis"]
["Chart audits"]
["Rapid response team (RRT)"]
["Voluntary and confidential error reporting system"]
["Required error reporting system"]
["Mandatory error disclosure"]
["Standardization of drug dosing"]
["Computerized  physician order entry"]
["Logic-based forcing functions in computerized physician order entry (e.g., screen for inaccurate data entry, drug interactions, etc.)"]
["Automatic drug dispensing linked to computerized physician order entry"]
["Elimination of look-alike and sound-alike meds"]
["Electronic medical records"]
["Institution of protocols/guidelines"]
["Reducing hand-offs"]
["Availability of translators"]
["Formalized support mechanisms for residents that err and harm or kill a patient"]
["Logs and literature reviews regarding analysis of errors to be included in each resident's portfolio."]
["Resident participation in quality assurance committees"]
["Other (specify):"]