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Health Resources and Services Administration
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Academic Year: 2024-2025
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Bureau of Health Workforce
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OMB Number: 0906-0086
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Annual Performance Report
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OMB Expiration Date: 03/31/2027
CHD-1: CHGME Hospital Data - Hospital Discharge Data
CHD-1 - Hospital Discharge Data By Payor SetupWarning
If you have used the CHD-1 form before, this answer is pre-selected ‘Yes’ for you. You do not need to answer this question again. Please move ahead to the CHD-1 form by using the form list located on the left side of your screen. | Did any of your residency programs have at least one resident spending > 75% under Children’s Hospital Supervision? | Yes (complete table below) No (Click Save and Validate to proceed to the next form) |
Figure 1. CHD-1 - Hospital Discharge Data By Payor Setup
To begin providing hospital-level data for institutions that received a CHGME funding during the current reporting period, or to provide updates for hospitals previously reported on CHD-1, click ‘Yes’ to the initial setup question. Did any of your residency programs have at least one resident spending > 75% under Children’s Hospital Supervision?: Note
Clicking ‘Yes’ will indicate that your site is a reporting program and activate the remaining forms that will allow you to begin data entry. |
CHD-1 - Entering Hospital Discharge Data By Payor Figure 2. CHD-1 - Entering Hospital Discharge Data By Payor
For each Payment Group, follow the instructions below to enter the required information: Payor: Enter # of Inpatient Charges: In Column 2, enter the number of inpatient discharges.Enter # of Outpatient Visits: In Column 3, enter the number of outpatient visits.Enter # of Emergency Department Visits: In Column 4, enter the number of emergency department visits. Warning
A number must be entered in each cell. If there were no inpatient discharges billed to a particular payment group, enter a zero (0) in that cell. Note
Report all Medicaid payments, including Medicaid managed care and any other Medicaid payments under the Medicaid and/or CHIP category. Note
Self-pay refers to patients who have made out-of-pocket payments for services. Note
Uncompensated care means care for which the hospital receives no payment. To Complete the Form: Click on the “Save and Validate” button located on the bottom right corner of your screen. If no errors are found, the BPMH system will automatically route you to the next required subform. |
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