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Madison State Hospital
Calculation of Revenue Per Patient Day
Year Ending June 30, 2005
| Actual $ SF YTD Jun 05 | $ Per Patient Day | |
|---|---|---|
| Revenue: | ||
| Patient Specific | ||
| Medicare Part A | 244,452.52 | |
| Medicare Part B | 23,966.17 | |
| Inpatient Psychiatric Medicaid, Federal Share | 884,857.94 | |
| Inpatient Psychiatric Medicate, State Share | 532,284.18 | |
| ICF/MR Medicaid, Federal Share | 2,737,765.43 | |
| ICF/MR Medicaid, State Share | 1,645,179.98 | |
| Social Security | 453,098.59 | |
| Other TPL (Third Party Liability) Collections | 150,023.97 | |
| Self Pay | 207,859.39 | |
| Total Patient Specific | 6,879,488.17 | $138.93 |
| Non-Patient Specific | ||
| DSH - Federal Share | 8,072,725.32 | |
| DSH - State Share | 4,158,676.68 | |
| Federal Grant Receipts | - | |
| Sale of Meals to Employees/Guests | 4,578.00 | |
| Medical Records Copy Income | 33.00 | |
| Lease Income | - | |
| Miscellaneous Revenues | 12,754.00 | |
| Total Non-Patient Specific | 12,267,480.30 | 247.75 |
| Total Cash Revenue * | 19,146,968.47 | 386.68 |
| State General Funds | 8,383,472.09 | 169.31 |
| Total Revenue | 27,530,440.56 | 555.99 |