Skip to content
2023 Grace Award Application
SECTION I: DEMOGRAPHIC INFORMATION
Applicant demographic information.
OK
*
1.
Demographic information of person completing application.
(Required.)
First and Last Name
Title
Organization
Location (City and State)
2.
Type of organization (select all that apply).
Rehabilitation
Ambulatory (free standing, surgery, or clinic)
Physician Office
Post-Acute Care Setting
Hospital
Rural Hospital
Critical Access Hospital
Multi-hospital Setting
Long Term Care
Home health
Payer/Insurance
Other (please specify E.g. QIO, ACO, HIE)
3.
Size of Organization
Beds
Licensed Beds (Rehab Center or Hospital)
Annual Visits (Surgery Center or Clinic)
Annual Inpatient Discharges (Hospital)
Annual Outpatient Visits (Hospital)
(For non-traditional settings) Number of patient lives served
4.
Organizational Staffing - Employees
1-250
251-500
501-1,000
1,001-5,000
5,001-10,000
10,000+
5.
Organizational Staffing - HIM Professionals
1-5
6-10
11-25
26-50
51-100
100+
6.
Organizational Staffing - AHIMA Credentialed HIM Professionals
1-5
6-10
11-25
26-50
51-100
100+
7.
Please list all job titles and credentials for the HIM professionals who are employed within your organization.
Current Progress,
0 of 18 answered
