Validity of Data

Our Quality Indicators allow us to reference data for improvement and standardization of practices that result in the superior quality of care and customer service we give each patient. We strive to report accurate and honest information about the quality of care we provide at Methodist Le Bonheur Healthcare. We have 6.5 FTEs that abstract information for 5 hospitals. Our abstractors attend abstraction clinics so they will be up to date on the most current abstraction rules. Our abstracted information is entered into a computerized system that checks the information for completeness and accuracy. Each missed opportunity is reviewed by our Clinical Decision Support department and all corrections are made before the data is submitted to CMS or DNV-GL.

The Centers for Medicare and Medicaid (CMS) perform an independent check of our data validity. Each quarter an independent audit is performed on information that has been submitted to CMS. These audits are performed by people that are not associated with Methodist Le Bonheur Healthcare. They review several hundred different data elements to see how many times our answers match theirs. CMS considers a passing grade to be anything over 80%.

QuarterValidation Score
3rd Quarter 2009 100%
4th Quarter 2009 CMS revised the process and performed no audits in 4Q2009.
1st Quarter 2010 97%
2nd Quarter 2010 99%
3rd Quarter 2010 100%
4th Quarter 2010 96%
1st Quarter 2011 100%
2nd Quarter 2011 99%
3rd Quarter 2011 100%