224 hospital benchmarks | 2018

Ayla Ellison and Jessica Kim Cohen - Print  | 

Hospitals across the nation compete in a number of ways, including on quality of care and price, and many use benchmarking to determine the top priorities for improvement. The continuous benchmarking process allows hospital executives to see how their organizations stack up against regional competitors as well as national leaders.

For the seventh year, Becker's Hospital Review has collected benchmarks related to some of the most important day-to-day areas hospital executives oversee: quality, patient satisfaction, staffing, utilization, finance, affiliations, compensation and health IT.

Quality and process of care

Source: Hospital Compare, HHS, Complications and Deaths-National Averages, May 2018, and Timely and Effective Care-National Averages, May 2018, the latest available data for these measures.

Hospital-acquired conditions

The following represent the average percentage of patients in the U.S. who experienced the conditions.

1. Collapsed lung due to medical treatment: 0.4 percent

2. A wound that splits open on the abdomen or pelvis after surgery: 2.26 percent

3. Accidental cuts and tears from medical treatment: 0.88 percent

4. Serious blood clots after surgery: 4.35 percent

5. Serious complications: 1 percent

6. Bloodstream infection after surgery: 5.94 percent

7. Developed a blood clot while in the hospital and did not get treatment that could have prevented it: 2 percent

Heart attack patients

8. Median time to fibrinolysis: 28 minutes

9. Median time to transfer to another facility for acute coronary intervention: 57 minutes

Outpatients with chest pain or possible heart attack

10. Who received aspirin within 24 hours of arrival or before transferring from the emergency department: 95 percent

11. Who received drugs to break up blood clots within 30 minutes of arrival: 59 percent

12. Median time before patient received an ECG: 7 minutes

Lower extremity joint replacement patients

13. Rate of complications for hip/knee replacement patients: 2.8 percent

Colonoscopy patients

14. Who received appropriate recommendation for follow-up colonoscopy: 85 percent

15. Percentage of patients with history of polyps who received follow-up colonoscopy in the appropriate time frame: 90 percent

Flu vaccination

16. Preventive care patients assessed and given flu vaccination: 93 percent

17. Healthcare workers who received flu vaccination: 88 percent

Pregnancy and delivery care

18. Mothers whose deliveries were scheduled one to two weeks early when a scheduled delivery was not medically necessary: 2 percent

Emergency department care

19. Average time spent in the ED before patient is admitted to the hospital as an inpatient: 281 minutes

20. Average time patient spent in ED after the physician decided to admit as an inpatient but before leaving the ED for the inpatient room: 102 minutes

21. Average time patient spent in the ED before being sent home: 140 minutes

22. Average time patient spent in the ED before being seen by a healthcare professional: 20 minutes

23. Average time patient who came to the ED with broken bones had to wait before receiving pain medication: 49 minutes

24. Percentage of patients who came to the ED with stroke symptoms who received brain scan results within 45 minutes of arrival: 72 percent

25. Percentage of patients who left the ED before being seen: 2 percent

Patient satisfaction

Source: Hospital Compare, HHS, HCAHPS National Survey Results, May 2018, the latest available data for these measures.

Overall hospital rating

26. Patients who gave the hospital a rating of nine or 10: 73 percent

27. Patients who gave the hospital a rating of seven or eight: 20 percent

28. Patients who gave the hospital a rating of six or lower: 7 percent

Patient recommendation

29. Patients who said yes, they would definitely recommend the hospital to friends and family: 72 percent

30. Patients who said yes, they would probably recommend the hospital to friends and family: 23 percent

31. Patients who said no, they probably or definitely would not recommend the hospital to friends and family: 5 percent

Cleanliness

32. Patients who said their room and bathroom were "always" clean: 75 percent

33. Patients who said their room and bathroom were "usually" clean: 17 percent

34. Patients who said their room and bathroom were "sometimes" or "never" clean: 8 percent

Noise

35. Patients who said the area around their room was "always" quiet at night: 62 percent

36. Patients who said the area around their room was "usually" quiet at night: 29 percent

37. Patients who said the area around their room was "sometimes" or "never" quiet at night: 9 percent

Physician communication

38. Patients who said their physicians "always" communicated well: 82 percent

39. Patients who said their physicians "usually" communicated well: 14 percent

40. Patients who said their physicians "sometimes" or "never" communicated well: 4 percent

Nurse communication

41. Patients who said their nurses "always" communicated well: 80 percent

42. Patients who said their nurses "usually" communicated well: 16 percent

43. Patients who said their nurses "sometimes" or "never" communicated well: 4 percent

Explanation of medicines

44. Patients who said staff "always" explained medicines before administering: 66 percent

45. Patients who said staff "usually" explained medicines before administering: 17 percent

46. Patients who said staff "sometimes" or "never" explained medicines before administering: 17 percent

Assistance from hospital staff

47. Patients who said they "always" received help as soon as they wanted: 69 percent

48. Patients who said they "usually" received help as soon as they wanted: 23 percent

49. Patients who said they "sometimes" or "never" received help as soon as they wanted: 8 percent

Recovery plan

50. Patients who said staff provided information about what to do during their recovery at home: 87 percent

51. Patients who said staff did not provide information about what to do during their recovery at home: 13 percent

Care plan at discharge

52. Patients who strongly agreed they understood their care when they left the hospital: 53 percent

53. Patients who agreed they understood their care when they left the hospital: 42 percent

54. Patients who disagreed or strongly disagreed they understood their care when they left the hospital: 5 percent

Staffing

Source: American Hospital Association "Hospital Statistics" report, 2018 Edition.

Average full-time staff

55. Hospitals with six to 24 beds: 101

56. Hospitals with 25 to 49 beds: 182

57. Hospitals with 50 to 99 beds: 296

58. Hospitals with 100 to 199 beds: 672

59. Hospitals with 200 to 299 beds: 1,232

60. Hospitals with 300 to 399 beds: 1,777

61. Hospitals with 400 to 499 beds: 2,596

62. Hospitals with 500 or more beds: 5,225

Average part-time staff

63. Hospitals with six to 24 beds: 50

64. Hospitals with 25 to 49 beds: 83

65. Hospitals with 50 to 99 beds: 139

66. Hospitals with 100 to 199 beds: 276

67. Hospitals with 200 to 299 beds: 468

68. Hospitals with 300 to 399 beds: 600

69. Hospitals with 400 to 499 beds: 954

70. Hospitals with 500 or more beds: 1,420

Utilization

Source: American Hospital Association "Hospital Statistics" report, 2018 Edition.

Average admissions per year

71. Hospitals with six to 24 beds: 379

72. Hospitals with 25 to 49 beds: 917

73. Hospitals with 50 to 99 beds: 2,084

74. Hospitals with 100 to 199 beds: 5,838

75. Hospitals with 200 to 299 beds: 11,035

76. Hospitals with 300 to 399 beds: 16,407

77. Hospitals with 400 to 499 beds: 20,541

78. Hospitals with 500 or more beds: 34,693

Average length of stay

79. Hospitals with six to 24 beds: 4.8 days

80. Hospitals with 25 to 49 beds: 5.4 days

81. Hospitals with 50 to 99 beds: 6.8 days

82. Hospitals with 100 to 199 beds: 5.3 days

83. Hospitals with 200 to 299 beds: 5 days

84. Hospitals with 300 to 399 beds: 5.1 days

85. Hospitals with 400 to 499 beds: 5.4 days

86. Hospitals with 500 or more beds: 5.8 days

Average inpatient surgeries per year

Averages include both hospital and nursing home units.

87. Hospitals with six to 24 beds: 86

88. Hospitals with 25 to 49 beds: 205

89. Hospitals with 50 to 99 beds: 486

90. Hospitals with 100 to 199 beds: 1,425

91. Hospitals with 200 to 299 beds: 2,896

92. Hospitals with 300 to 399 beds: 4,193

93. Hospitals with 400 to 499 beds: 5,784

94, Hospitals with 500 or more beds: 10,454

Average outpatient visits per year

Averages include both hospital and nursing home units.

95. Hospitals with six to 24 beds: 24,839

96. Hospitals with 25 to 49 beds: 47,656

97. Hospitals with 50 to 99 beds: 66,003

98. Hospitals with 100 to 199 beds: 141,842

99. Hospitals with 200 to 299 beds: 220,826

100. Hospitals with 300 to 399 beds: 266,285

101. Hospitals with 400 to 499 beds: 434,213

102. Hospitals with 500 or more beds: 714,425

Average outpatient surgeries per year

Averages include both hospital and nursing home units.

103. Hospitals with six to 24 beds: 649

104. Hospitals with 25 to 49 beds: 1,124

105. Hospitals with 50 to 99 beds: 1,761

106. Hospitals with 100 to 199 beds: 3,518

107. Hospitals with 200 to 299 beds: 5,698

108. Hospitals with 300 to 399 beds: 7,076

109. Hospitals with 400 to 499 beds: 9,785

110. Hospitals with 500 or more beds: 16,160

Finance

Average adjusted expenses per inpatient day

Source: Kaiser State Health Facts, accessed in 2018 and based on 2015 data. 

Adjusted expenses per inpatient day include all operating and nonoperating expenses for registered U.S. community hospitals, defined as public, nonfederal, short-term general and other hospitals. The figures are an estimate of the expenses incurred in a day of inpatient care and have been adjusted higher to reflect an estimate of the volume of outpatient services.

111. Nonprofit hospitals: $2,413

112. For-profit hospitals: $1,831

113. State/local government hospitals: $2,013

Key ratios

Source: Moody's Investors Service, "U.S. Not-for-Profit Hospital 2016 Medians" report, August 2017.

The medians are based on an analysis of audited 2016 financial statements for 323 freestanding hospitals, single-state health systems and multistate health systems, representing 81 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.

114. Maintained bed occupancy: 65.4 percent

115. Operating margin: 2.7 percent

116. Excess margin: 5.6 percent

117. Operating cash flow margin: 9.3 percent

118. Return on assets: 4.1 percent

119. Three-year operating revenue CAGR: 6.5 percent

120. Three-year operating expense CAGR: 6.2 percent

121. Days cash on hand: 204.7

122. Annual operating revenue growth rate: 6 percent

123. Annual operating expense growth rate: 7.2 percent

124. Total debt-to-capitalization: 34.9 percent

125. Total debt-to-total operating revenue: 34.6 percent

126. Current ratio: 2.0x

127. Cushion ratio: 20.9x

128. Annual debt service coverage: 5.1x

129. Maximum annual debt service coverage: 4.6x

130. Debt-to-cash flow: 2.8x

131. Capital spending ratio: 1.2x

132. Accounts receivable: 47.8 days

133. Average payment period: 62.8 days

134. Average age of plant: 11.2 years

Hospital margins by credit rating group

Source: S&P Global Ratings "U.S. Not-For-Profit Health Care System Median Financial Ratios — 2016 vs. 2015" report, August 2017.

AA+ rating

135. Operating margin: 4 percent

136. Operating EBIDA margin: 11.6 percent

137. Excess margin: 6.5 percent

138. EBIDA margin: 13.3 percent

AA rating

139. Operating margin: 4.8 percent

140. Operating EBIDA margin: 11 percent

141. Excess margin: 6.6 percent

142. EBIDA margin: 12.7 percent

AA- rating

143. Operating margin: 3.3 percent

144. Operating EBIDA margin: 9.6 percent

145. Excess margin: 4.4 percent

146. EBIDA margin: 10.8 percent

A+ rating

147. Operating margin: 2.3 percent

148. Operating EBIDA margin: 9 percent

149. Excess margin: 3.7 percent

150. EBIDA margin: 10 percent

A rating

151. Operating margin: 2 percent

152. Operating EBIDA margin: 7.8 percent

153. Excess margin: 2.9 percent

154. EBIDA margin: 8.8 percent

A- rating

155. Operating margin: 2.3 percent

156. Operating EBIDA margin: 9.4 percent

157. Excess margin: 2.9 percent

158. EBIDA margin: 9.5 percent

BBB+ rating

159. Operating margin: 0 percent

160. Operating EBIDA margin: 5.7 percent

161. Excess margin: 1 percent

162. EBIDA margin: 7.2 percent

Days cash on hand and days in accounts receivable by credit rating group

Source: S&P Global Ratings "U.S. Not-For-Profit Health Care System Median Financial Ratios — 2016 vs. 2015" report, August 2017.

AA+ rating

163. Days cash on hand: 398.8

164. Days in accounts receivable: 49.7

AA rating

165. Days cash on hand: 316.1

166. Days in accounts receivable: 51

AA- rating

167. Days cash on hand: 220.4

168. Days in accounts receivable: 47.7

A+ rating

169. Days cash on hand: 183.7

170. Days in accounts receivable: 47.9

A rating

171. Days cash on hand: 174.2

172. Days in accounts receivable: 48.5

A- rating

173. Days cash on hand: 148.5

174. Days in accounts receivable: 44.3

BBB+ rating

175. Days cash on hand: 155.9

176. Days in accounts receivable: 43.9

Health IT

HIMSS Analytics EMR Adoption Model, which runs from Stage 0 to Stage 7

Source: HIMSS Analytics, EMR Adoption Model, fourth quarter of 2017, the latest available data for these measures.

177. Stage 7 providers: 6.4 percent

178. Stage 6 providers: 33.8 percent

179. Stage 5 providers: 32.9 percent

180. Stage 4 providers: 10.2 percent

181. Stage 3 providers: 12 percent

182. Stage 2 providers: 1.8 percent

183. Stage 1 providers: 1.5 percent

184. Stage 0 providers: 1.4 percent

Affiliations 

Source: American Hospital Association "Hospital Statistics" report, 2018 Edition. 

Part of a group purchasing organization

185. Hospitals with six to 24 beds: 68 percent

186. Hospitals with 25 to 49 beds: 68 percent 

187. Hospitals with 50 to 99 beds: 66 percent 

188. Hospitals with 100 to 199 beds: 70 percent

189. Hospitals with 200 to 299 beds: 77 percent 

190. Hospitals with 300 to 399 beds: 79 percent 

191. Hospitals with 400 to 499 beds: 88 percent 

192. Hospitals with 500 or more beds: 92 percent

Part of a health system

193. Hospitals with six to 24 beds: 46 percent

194. Hospitals with 25 to 49 beds: 57 percent  

195. Hospitals with 50 to 99 beds: 68 percent  

196. Hospitals with 100 to 199 beds: 75 percent 

197. Hospitals with 200 to 299 beds: 76 percent  

198. Hospitals with 300 to 399 beds: 77 percent  

199. Hospitals with 400 to 499 beds: 75 percent

200. Hospitals with 500 or more beds: 78 percent

Compensation

Source: Integrated Healthcare Strategies 2017 National Healthcare Leadership Compensation Survey.

Average base salary for independent hospital executives

201. CEO: $527,800

202. CFO: $307,800

203. COO: $335,900

Average total cash compensation for independent hospital executives

204. CEO: $609,400

205. CFO: $343,800

206. COO: $373,600

Average base salary for subsidiary hospital executives

207. CEO: $384,900

208. CFO: $248,200

209. COO: $285,300

Average total cash compensation for subsidiary hospital executives

210. CEO: $464,200

211 .CFO: $280,200

212. COO: $325,200

Average base salary for independent health system executives

213. CEO: $906,900

214. CFO: $501,100

215. COO: $560,300

Average total cash compensation for independent health system executives

216. CEO: $1.15 million

217. CFO: $607,400

218. COO: $698,100

Average base salary for subsidiary health system executives

219. CEO: $611,700

220. CFO: $379,600

221. COO: $407,900

Average total cash compensation for subsidiary health system executives

222. CEO: $709,300

223. CFO: $423,200

224. COO: $463,200

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