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Evansville State Hospital
Calculation of Revenue Per Patient Day
Twelve Months Ending June 30, 2005
| Actual $ SF YTD June 2005 | $ Per Patient Day | |
|---|---|---|
| Patient Specific Revenues: | ||
| Medicare Part A | - | |
| Medicare Part B | 87,595 | |
| Inpatient Psychiatric Medicaid, Federal Share | 2,126,617 | |
| Inpatient Psychiatric Medicaid, State Share | 1,378,720 | |
| ICF/MR Medicaid, Federal Share | 3,119,471 | |
| ICF/MR Medicaid, State Share | 1,876,093 | |
| Social Security | 517,766 | |
| Other TPL (Third Party Liability) Collections | - | |
| Self-Pay | 194,715 | |
| Subtotal Patient | 9,300,978 | 156.91 |
| Non-Patient Specific Revenues | ||
| DSH - Federal Share | 7,220,366 | |
| DSH - State Share | 3,719,583 | |
| Federal Grant Receipts | - | |
| Sale of Meals to Employees/Guests | 18,099 | |
| Medical Records Copy Income | - | |
| Unrestricted Donations | - | |
| Miscellaneous Revenues | - | |
| Subtotal Non-Patient | 10,958,048 | 184.87 |
| Total Cash Revenue* | 20,259,026 | 341.78 |
| State General Funds | 10,666,894 | 179.96 |
| Total Revenue | 30,925,920 | 521.74 |