Cardiac Rehab Phase I Utilization Question Title * 1. What setting is your facility located? Rural City Question Title * 2. Number of beds in your hospital Question Title * 3. Do you offer Phase 1? Yes No Question Title * 4. Do you Charge for Phase I? Yes No Question Title * 5. If yes, what charge code do you use? Question Title * 6. Where do you generate most of your Phase II referrals? Inpatient Internal referral from MD office Outside referral from MD office Other (please specify) Question Title * 7. Who handles inpatient education pre/post intervention? Cardiac Rehab Staff PT Staff Floor RNs Other (please specify) Question Title * 8. Who provides inpatient mobility after intervention? Cardiac Rehab Staff PT staff Floor RNs Other (please specify) Done