200 hospital benchmarks

Hospitals across the nation are competing in a number of areas, including quality and price, and many use benchmarking as a way to determine the areas most in need of improvement. The continuous process of benchmarking allows hospital executives to see how their organizations stack up against competitors as well as national leaders.

For the fourth year, Becker's Hospital Review has collected 200 benchmarks related to some of the most important day-to-day areas executives oversee: quality, patient satisfaction, operations, utilization and finance.

Quality and process of care
Source: Hospital Compare, HHS, Timely and Effective Care Measures-National Averages September 2014, the latest available data for these measures.

Hospital-acquired conditions
The following represent the average percentage of patients who experienced the conditions.

Collapsed lung due to medical treatment: 0.41 percent
A wound that splits open on the abdomen or pelvis after surgery: 1.91 percent
Accidental cuts and tears from medical treatment: 1.96 percent
Serious blood clots after surgery: 4.67 percent
Serious complications: 0.88 percent

Heart attack patients
Who were given fibrinolytic medication within 30 minutes of arrival: 60 percent
Who were given primary percutaneous coronary intervention within 90 minutes of arrival: 96 percent
Who were given aspirin at discharge: 99 percent
Who were given a prescription for a statin at discharge: 99 percent

Heart failure patients
Who were given discharge instructions: 94 percent
Who were given an evaluation of left ventricular systolic function: 99 percent
Who were given ACE inhibitor or ARB for left ventricular systolic dysfunction: 97 percent

Pneumonia patients
Who were given the most appropriate initial antibiotics(s): 96 percent

Surgery patients
Who were given an antibiotic within one hour before surgery to help prevent infection: 99 percent
Whose preventive antibiotics were stopped within 24 hours after surgery: 98 percent
Who were taking beta blockers before coming to the hospital and who were kept on the beta blockers: 98 percent
Who were given the appropriate kind of antibiotic to help prevent infection: 99 percent
Whose urinary catheters were removed on the first or second day after surgery: 98 percent
Who were actively warmed in the operating room or whose body temperature was near normal by the end of the surgery: 100 percent

Stroke patients
Who were evaluated for rehabilitation services: 98 percent
Who received a prescription for medicine known to prevent complications caused by blood clots before discharge: 99 percent
Who were given a prescription for a blood thinner at discharge: 96 percent
Who got treatment to keep blood clots from forming anywhere in the body within two days of arriving at the hospital: 96 percent
Who received written educational materials about stroke care and prevention during the hospital stay: 93 percent

Preventive care patients
Who were assessed and given flu vaccination: 93 percent

Children's asthma patients
Who received reliever medication while hospitalized for asthma: 100 percent
Who received systemic corticosteriod medication that reduces inflammation and controls symptoms while hospitalized for asthma: 100 percent

Emergency Department Care
Source: Hospital Compare, HHS, Timely and Effective Care Measures-National Averages September 2014, the latest available data for these measures.

Average time spent in the ED before patients were admitted to the hospital as an inpatient: 273 minutes
Average time patients spent in the ED after the physician decided to admit them as an inpatient but before leaving the ED for their inpatient room: 96 minutes
Average time patients spent in the ED before being sent home: 138 minutes
Average time patients spent in the ED before they were seen by a healthcare professional: 24 minutes
Average time patients who came to the ED with broken bones had to wait before receiving pain medication: 54 minutes
Percentage of patients who came to the ED with stroke symptoms who received brain scan results within 45 minutes of arrival: 64 percent

Patient Satisfaction
Source: Hospital Compare, HHS, HCAHPS survey results September 2014, the latest available data for these measures.

Overall hospital rating
Patients who gave the hospital a rating of nine or 10: 71 percent
Patients who gave the hospital a rating of seven or eight: 21 percent
Patients who gave the hospital a rating of six or lower: 8 percent

Patient recommendation
Patients who said, yes, they would definitely recommend the hospital to friends and family: 71 percent
Patients who said, yes, they would probably recommend the hospital to friends and family: 24 percent
Patients who said, no, they probably or definitely would not recommend the hospital to friends and family: 5 percent

Cleanliness
Patients who said their room and bathroom was "always" clean: 74 percent
Patients who said their room and bathroom was "usually" clean: 18 percent
Patients who said their room and bathroom was "sometimes" or "never" clean: 8 percent

Noise
Patients who said the area around their room was "always" quiet at night: 62 percent
Patients who said the area around their room was "usually" quiet at night: 29 percent
Patients who said the area around their room was "sometimes" or "never" quiet at night: 9 percent

Physician communication
Patients who said their physicians "always" communicated well: 82 percent
Patients who said their physicians "usually" communicated well: 14 percent
Patients who said their physicians "sometimes" or "never" communicated well: 4 percent

Nurse communication
Patients who said their nurses "always" communicated well: 79 percent
Patients who said their nurses "usually" communicated well: 17 percent
Patients who said their nurses "sometimes" or "never" communicated well: 4 percent

Pain control
Patients who said their pain was "always" well controlled: 71 percent
Patients who said their pain was "usually" well controlled: 22 percent
Patients who said their pain was "sometimes" or "never" well controlled: 7 percent

Staff explanations
Patients who said staff "always" explained medicines before administering: 65 percent
Patients who said staff "usually" explained medicines before administering: 17 percent
Patients who said staff "sometimes" or "never" explained medicines before administering: 18 percent

Staff help
Patients who said they "always" received help as soon as they wanted: 68 percent
Patients who said they "usually" received help as soon as they wanted: 23 percent
Patients who said they "sometimes" or "never" received help as soon as they wanted: 9 percent

Recovery information
Patients who said staff provided information about what to do during their recovery at home: 86 percent
Patients who said staff did not provide information about what to do during their recovery at home: 14 percent

Staffing
Source: American Hospital Association "Hospital Statistics" report, 2015 Edition.

Average full-time staff
Hospitals with 6 to 24 beds: 98
Hospitals with 25 to 49 beds: 169
Hospitals with 50 to 99 beds: 280
Hospitals with 100 to 199 beds: 622
Hospitals with 200 to 299 beds: 1,134
Hospitals with 300 to 399 beds: 1,717
Hospitals with 400 to 499 beds: 2,406
Hospitals with 500 or more beds: 4,810

Average part-time staff
Hospitals with 6 to 24 beds: 47
Hospitals with 25 to 49 beds: 74
Hospitals with 50 to 99 beds: 130
Hospitals with 100 to 199 beds: 263
Hospitals with 200 to 299 beds: 445
Hospitals with 300 to 399 beds: 571
Hospitals with 400 to 499 beds: 835
Hospitals with 500 or more beds: 1,296

Inpatient volume
Source: American Hospital Association "Hospital Statistics" report, 2015 Edition.

Average admissions per year
Hospitals with 6 to 24 beds: 404
Hospitals with 25 to 49 beds: 917
Hospitals with 50 to 99 beds: 2,108
Hospitals with 100 to 199 beds: 5,783
Hospitals with 200 to 299 beds: 10,782
Hospitals with 300 to 399 beds: 15,999
Hospitals with 400 to 499 beds: 20,493
Hospitals with 500 or more beds: 33,598

Average inpatient surgeries per year
Hospitals with 6 to 24 beds: 83
Hospitals with 25 to 49 beds: 191
Hospitals with 50 to 99 beds: 484
Hospitals with 100 to 199 beds: 1,480
Hospitals with 200 to 299 beds: 2,843
Hospitals with 300 to 399 beds: 4,257
Hospitals with 400 to 499 beds: 5,673
Hospitals with 500 or more beds: 10,329

Outpatient volume
Source: American Hospital Association "Hospital Statistics" report, 2015 Edition.

Average outpatient surgeries per year
Hospitals with 6 to 24 beds: 605
Hospitals with 25 to 49 beds: 971
Hospitals with 50 to 99 beds: 1,608
Hospitals with 100 to 199 beds: 3,437
Hospitals with 200 to 299 beds: 5,252
Hospitals with 300 to 399 beds: 6,938
Hospitals with 400 to 499 beds: 8,785
Hospitals with 500 or more beds: 14,796

Average emergency outpatient visits per year
Hospitals with 6 to 24 beds: 4,170
Hospitals with 25 to 49 beds: 7,238
Hospitals with 50 to 99 beds: 12,301
Hospitals with 100 to 199 beds: 27,338
Hospitals with 200 to 299 beds: 43,740
Hospitals with 300 to 399 beds: 56,681
Hospitals with 400 to 499 beds: 67,135
Hospitals with 500 or more beds: 100,649

Average total outpatient visits per year
Hospitals with 6 to 24 beds: 23,216
Hospitals with 25 to 49 beds: 40,011
Hospitals with 50 to 99 beds: 60,608
Hospitals with 100 to 199 beds: 124,183
Hospitals with 200 to 299 beds: 197,761
Hospitals with 300 to 399 beds: 268,704
Hospitals with 400 to 499 beds: 389,940
Hospitals with 500 or more beds: 591,687

Finance

Hospital adjusted expenses per inpatient day
Source: Kaiser State Health Facts, accessed in 2015 and based on 2013 data.

Adjusted expenses per inpatient day included expenses incurred for both inpatient and outpatient care; inpatient days are adjusted higher to reflect an estimate of the volume of outpatient services.

Nonprofit hospitals: $2,289
State/local government hospitals: $1,878
For-profit hospitals: $1,791

Key ratios
Source: Moody's Investors Service, "U.S. Not-for-Profit Hospital 2014 Medians" report, September 2015.

The medians are based on an analysis of audited 2014 statements for 366 freestanding hospitals, single-state health systems and multi-state health systems, representing 86 percent of all Moody's rated healthcare entities. Children's hospitals, hospitals for which five years of data are not available and certain specialty hospitals were not eligible for inclusion in the medians.

Maintained bed occupancy: 63.3 percent
Operating margin: 2.6 percent
Excess margin: 5.7 percent
Operating cash flow margin: 9.6 percent
Return on assets: 4.5 percent
Cash-to-direct debt ratio: 151.2 percent
Cash-to-comprehensive debt ratio: 108.3 percent
Debt-to-capitalization ratio: 33.7 percent
Debt-to-total operating revenue: 36.7 percent
Three-year operating revenue CAGR: 5.1 percent
Three-year operating expense CAGR: 5.2 percent
Annual operating revenue growth rate: 5.2 percent
Annual operating expense growth rate: 4.6 percent

Current ratio: 2.0x
Cushion ratio: 19.3x
Annual debt service coverage: 5.0x
Maximum annual debt service coverage: 4.6x
Debt-to-cash flow: 3.1x
Capital spending ratio: 1.1x

Cash on hand: 205.8 days
Accounts receivable: 49.5 days
Average payment period: 64.6 days
Average age of plant: 10.8 years

Financial medians related to healthcare reform
Reimbursement methods (% of net patient revenue)

DRG: 40 percent
Percent of charges: 18.1 percent
Fee schedule: 26 percent
Per diem: 3.9 percent
Risk-based: 3 percent
Traditional capitation: 1.8 percent
Other: 4 percent

Sources of revenue
Inpatient revenue: 49.8 percent
Outpatient revenue: 50.1 percent

Number of covered lives
Medicare: 25,063
Medicaid: 32,797
Commercial: 22,143

Hospital utilization data
Unique patients: 149,612
Total case mix index: 1.4
Number of employed physicians: 136
Active medical staff (independent and employed): 542

Patient revenue sources by gross revenue
Medicare: 45 percent
Medicaid: 13.7 percent
Commercial: 32.4 percent
Self-pay and other: 6.9 percent

Hospital margins by credit rating group
Source: Fitch Ratings, "2014 Median Ratios for Nonprofit Hospitals and Healthcare System" report, August 2015.

"AA" rating
Operating margin: 4.9 percent
Operating EBITDA margin: 11.5 percent
Excess margin: 7.6 percent
EBITDA margin: 14.7 percent

"A" rating
Operating margin: 3.6 percent
Operating EBITDA margin: 10.3 percent
Excess margin: 5.4 percent
EBITDA margin: 12.4 percent

"BBB" rating
Operating margin: 0.6 percent
Operating EBITDA margin: 7.7 percent
Excess margin: 2.4 percent
EBITDA margin: 9.5 percent

Below "BBB" rating
Operating margin: 0.3 percent
Operating EBITDA margin: 8.1 percent
Excess margin: 0.4 percent
EBITDA margin: 8.9 percent

Charity care
Source: American Hospital Association, "Schedule H Project Benchmark" report, August 2015. The report is based on the most recent data available from more than 1,100 tax-exempt hospitals for tax year 2012.

Charity care includes total unreimbursed means-tested government programs and other benefits.

Total charity care as an average percent of total expenses
Small hospitals (less than $100 million in total expenses): 8.6 percent
Medium hospitals ($100 million to $299 million in total expenses): 8 percent
Large hospitals ($300 million or more in total expenses): 9.6 percent
Systems (more than one licensed hospital): 9.1 percent

General medical/surgical hospital: 8.5 percent
Teaching hospital: 9.4 percent
Critical access hospital: 9.6 percent
Children's hospital: 12.7 percent

Urban/suburban hospital: 8.7 percent
Rural hospital: 8.6 percent

Total benefit to the community as an average percent of total expenses
Small hospitals: 11.8 percent
Medium hospitals: 12.8 percent
Large hospitals: 12.3 percent
Systems: 12.4 percent

General medical/surgical hospital: 12.3 percent
Teaching hospital: 11.5 percent
Critical access hospital: 11.3 percent
Children's hospital: 14.4 percent

Urban/suburban hospital: 12.7 percent
Rural hospital: 11.3 percent

 

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