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 sixth 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-National Averages December 2016 and Timely and Effective Care Measures-National Averages December 2016, 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: 0.41 percent
2. A wound that splits open on the abdomen or pelvis after surgery: 2.32 percent
3. Accidental cuts and tears from medical treatment: 1.43 percent
4. Serious blood clots after surgery: 5.31 percent
5. Serious complications: 0.9 percent
6. Bloodstream infection after surgery: 10.21 percent
7. Infections from a large venous catheter: 0.17 percent
8. Developed a blood clot while in the hospital and did not get treatment that could have prevented it: 2 percent
Heart attack patients
9. Median time to fibrinolysis: 28 minutes
10. Median time to transfer to another facility for acute coronary intervention: 58 minutes
Outpatients with chest pain or possible heart attack
11. Who received aspirin within 24 hours of arrival or before transferring from the emergency department: 96 percent
12. Who received drugs to break up blood clots within 30 minutes of arrival: 59 percent
13. Median time before patient received an ECG: 7 minutes
Lower extremity joint replacement patients
14. Rate of complications for hip/knee replacement patients: 3 percent
Stroke patients
15. Who received fibrinolysis within three hours after symptoms started: 87 percent
Blood clot patients
16. Who were discharged on a blood thinner medicine and received written instructions about that medicine: 93 percent
Colonoscopy patients
17. Who received appropriate recommendation for follow-up colonoscopy: 80 percent
18. Percentage of patients with history of polyps who received follow-up colonoscopy in the appropriate timeframe: 87 percent
Flu vaccination
19. Preventive care patients assessed and given flu vaccination: 94 percent
20. Healthcare workers who received flu vaccination: 86 percent
Pregnancy and delivery care
21. Mothers whose deliveries were scheduled one to two weeks early, when a scheduled delivery was not medically necessary: 2 percent
Emergency department care
22. Average time spent in the ED before patient is admitted to the hospital as an inpatient: 279 minutes
23. Average time patient spent in ED after the physician decided to admit as an inpatient but before leaving the ED for the inpatient room: 99 minutes
24. Average time patient spent in the ED before sent home: 140 minutes
25. Average time patient spent in the ED before seen by a healthcare professional: 22 minutes
26. Average time patient who came to the ED with broken bones had to wait before receiving pain medication: 52 minutes
27. Percentage of patients who came to the ED with stroke symptoms who received brain scan results within 45 minutes of arrival: 69 percent
28. Percentage of patients who left the ED before being seen: 2 percent
Patient satisfaction
Source: Hospital Compare, HHS, HCAHPS National Survey Results December 2016, the latest available data for these measures.
Overall hospital rating
29. Patients who gave the hospital a rating of nine or 10: 72 percent
30. Patients who gave the hospital a rating of seven or eight: 21 percent
31. Patients who gave the hospital a rating of six or lower: 7 percent
Patient recommendation
32.Patients who said, yes, they would definitely recommend the hospital to friends and family: 72 percent
33. Patients who said, yes, they would probably recommend the hospital to friends and family: 23 percent
34. Patients who said, no, they probably or definitely would not recommend the hospital to friends and family: 5 percent
Cleanliness
35. Patients who said their room and bathroom was "always" clean: 74 percent
36. Patients who said their room and bathroom was "usually" clean: 18 percent
37. Patients who said their room and bathroom was "sometimes" or "never" clean: 8 percent
Noise
38. Patients who said the area around their room was "always" quiet at night: 62 percent
39. Patients who said the area around their room was "usually" quiet at night: 29 percent
40. Patients who said the area around their room was "sometimes" or "never" quiet at night: 9 percent
Physician communication
41. Patients who said their physicians "always" communicated well: 82 percent
42. Patients who said their physicians "usually" communicated well: 14 percent
43. Patients who said their physicians "sometimes" or "never" communicated well: 4 percent
Nurse communication
44. Patients who said their nurses "always" communicated well: 80 percent
45. Patients who said their nurses "usually" communicated well: 16 percent
46. Patients who said their nurses "sometimes" or "never" communicated well: 4 percent
Pain control
47. Patients who said their pain was "always" well controlled: 71 percent
48. Patients who said their pain was "usually" well controlled: 22 percent
49. Patients who said their pain was "sometimes" or "never" well controlled: 7 percent
Explanation of medicines
50. Patients who said staff "always" explained medicines before administering: 65 percent
51. Patients who said staff "usually" explained medicines before administering: 18 percent
52. Patients who said staff "sometimes" or "never" explained medicines before administering: 17 percent
Assistance from hospital staff
53. Patients who said they "always" received help as soon as they wanted: 69 percent
54. Patients who said they "usually" received help as soon as they wanted: 23 percent
55. Patients who said they "sometimes" or "never" received help as soon as they wanted: 8 percent
Recovery plan
56. Patients who said staff provided information about what to do during their recovery at home: 87 percent
57. Patients who said staff did not provide information about what to do during their recovery at home: 13 percent
Care plan at discharge
58. Patients who strongly agreed they understood their care when they left the hospital: 52 percent
59. Patients who agreed they understood their care when they left the hospital: 43 percent
60. 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, 2017 Edition.
Full- and part-time staff averages are for the hospital unit only and do not include separate nursing home units.
Average full-time staff
61. Hospitals with six to 24 beds: 99
62. Hospitals with 25 to 49 beds: 176
63. Hospitals with 50 to 99 beds: 286
64. Hospitals with 100 to 199 beds: 646
65. Hospitals with 200 to 299 beds: 1,192
66. Hospitals with 300 to 399 beds: 1,727
67. Hospitals with 400 to 499 beds: 2,562
68. Hospitals with 500 or more beds: 5,005
Average part-time staff
69. Hospitals with six to 24 beds: 50
70. Hospitals with 25 to 49 beds: 81
71. Hospitals with 50 to 99 beds: 132
72. Hospitals with 100 to 199 beds: 263
73. Hospitals with 200 to 299 beds: 453
74. Hospitals with 300 to 399 beds: 567
75. Hospitals with 400 to 499 beds: 835
76. Hospitals with 500 or more beds: 1,341
Utilization
Source: American Hospital Association "Hospital Statistics" report, 2017 Edition.
Average admissions per year
77. Hospitals with six to 24 beds: 394
78. Hospitals with 25 to 49 beds: 922
79. Hospitals with 50 to 99 beds: 2,098
80. Hospitals with 100 to 199 beds: 5,779
81. Hospitals with 200 to 299 beds: 11,011
82. Hospitals with 300 to 399 beds: 16,133
83. Hospitals with 400 to 499 beds: 20,410
84. Hospitals with 500 or more beds: 33,623
Average length of stay
85. Hospitals with six to 24 beds: 4.5 days
86. Hospitals with 25 to 49 beds: 5.1 days
87. Hospitals with 50 to 99 beds: 5.5 days
88. Hospitals with 100 to 199 beds: 4.6 days
89. Hospitals with 200 to 299 beds: 4.7 days
90. Hospitals with 300 to 399 beds: 4.9 days
91. Hospitals with 400 to 499 beds: 5.1 days
92. Hospitals with 500 or more beds: 5.5 days
Average inpatient surgeries per year
Averages include both hospital and nursing home units.
93. Hospitals with six to 24 beds: 90
94. Hospitals with 25 to 49 beds: 200
95. Hospitals with 50 to 99 beds: 480
96. Hospitals with 100 to 199 beds: 1,419
97. Hospitals with 200 to 299 beds: 2,893
98. Hospitals with 300 to 399 beds: 4,182
99. Hospitals with 400 to 499 beds: 5,710
100. Hospitals with 500 or more beds: 10,236
Average outpatient visits per year
Averages include both hospital and nursing home units.
101. Hospitals with six to 24 beds: 23,780
102. Hospitals with 25 to 49 beds: 45,249
103. Hospitals with 50 to 99 beds: 66,154
104. Hospitals with 100 to 199 beds: 135,975
105. Hospitals with 200 to 299 beds: 212,085
106. Hospitals with 300 to 399 beds: 271,538
107. Hospitals with 400 to 499 beds: 415,662
108. Hospitals with 500 or more beds: 667,839
Average outpatient surgeries per year
Averages include both hospital and nursing home units.
109. Hospitals with six to 24 beds: 663
110. Hospitals with 25 to 49 beds: 1,040
111. Hospitals with 50 to 99 beds: 1,708
112. Hospitals with 100 to 199 beds: 3,417
113. Hospitals with 200 to 299 beds: 5,528
114. Hospitals with 300 to 399 beds: 6,934
115. Hospitals with 400 to 499 beds: 9,364
116. Hospitals with 500 or more beds: 15,124
Finance
Average adjusted expenses per inpatient day
Source: Kaiser State Health Facts, accessed in 2017 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.
117. Nonprofit hospitals: $2,413
118. For-profit hospitals: $1,831
119. State/local government hospitals: $2,013
Key ratios
Source: Moody's Investors Service, "U.S. Not-for-Profit Hospital 2015 Medians" report, September 2016.
The medians are based on an analysis of audited 2015 financial statements for 340 freestanding hospitals, single-state health systems and multi-state 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.
120. Maintained bed occupancy: 64.3 percent
121. Operating margin: 3.4 percent
122. Excess margin: 6.1 percent
123. Operating cash flow margin: 10.3 percent
124. Return on assets: 4.8 percent
125. Three-year operating revenue CAGR: 5.8 percent
126. Three-year operating expense CAGR: 5.5 percent
127. Days cash on hand: 211.8 days
128. Annual operating revenue growth rate: 7.5 percent
129. Annual operating expense growth rate: 6.6 percent
130. Total debt-to-capitalization: 33.7 percent
131. Total debt-to-total operating revenue: 34.5 percent
132. Current ratio: 2.0x
133. Cushion ratio: 20.6x
134. Annual debt service coverage: 5.2x
135. Maximum annual debt service coverage: 4.8x
136. Debt-to-cash flow: 2.7x
137. Capital spending ratio: 1.1x
138. Accounts receivable: 48.4 days
139. Average payment period: 64.3 days
140. Average age of plant: 11 years
Hospital margins by credit rating group
Source: S&P Global Ratings "U.S. Not-For-Profit Health Care System Median Financial Ratios — 2015 vs. 2014" report, September 2016.
AA+ rating
141. Operating margin: 6.2 percent
142. Operating EBIDA margin: 13.1 percent
143. Excess margin: 8.4 percent
144. EBIDA margin: 14.8 percent
AA rating
145. Operating margin: 4.9 percent
146. Operating EBIDA margin: 10.6 percent
147. Excess margin: 7.2 percent
148. EBIDA margin: 13.3 percent
AA- rating
149. Operating margin: 3.5 percent
150. Operating EBIDA margin: 10.4 percent
151. Excess margin: 6.4 percent
152. EBIDA margin: 12.7 percent
A+ rating
153. Operating margin: 4.1 percent
154. Operating EBIDA margin: 10.3 percent
155. Excess margin: 5.6 percent
156. EBIDA margin: 12.3 percent
A rating
157. Operating margin: 3.6 percent
158. Operating EBIDA margin: 10.6 percent
159. Excess margin: 5.2 percent
160. EBIDA margin: 11.1 percent
A- rating
161. Operating margin: 2.9 percent
162. Operating EBIDA margin: 9.5 percent
163. Excess margin: 3.9 percent
164. EBIDA margin: 10.8 percent
BBB+ rating
165. Operating margin: 0.8 percent
166. Operating EBIDA margin: 6.8 percent
167. Excess margin: 3.4 percent
168. EBIDA margin: 8.7 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 — 2015 vs. 2014" report, September 2016.
AA+ rating
169. Days cash on hand: 426.2
170. Days in accounts receivable: 45.8
AA rating
171. Days cash on hand: 292.9
172. Days in accounts receivable: 49.9
AA- rating
173. Days cash on hand: 258.2
174. Days in accounts receivable: 48.8
A+ rating
175. Days cash on hand: 200.3
176. Days in accounts receivable: 46.2
A rating
177. Days cash on hand: 182.5
178. Days in accounts receivable: 49.1
A- rating
179. Days cash on hand: 156.6
180. Days in accounts receivable: 46.2
BBB+ rating
181. Days cash on hand: 148.7
182. Days in accounts receivable: 47.6
Health IT
HIMSS Analytics EMR Adoption Model, which runs from Stage 0 to Stage 7
Source: HIMSS Analytics, EMR Adoption Model, fourth quarter of 2016, the latest available data for these measures.
183. Stage 7 providers: 4.8 percent
184. Stage 6 providers: 30.5 percent
185. Stage 5 providers: 34.9 percent
186. Stage 4 providers: 10.2 percent
187. Stage 3 providers: 13.9 percent
188. Stage 2 providers: 2.3 percent
189. Stage 1 providers: 1.4 percent
190. Stage 0 providers: 1.9 percent
Affiliations
Source: American Hospital Association "Hospital Statistics" report, 2017 Edition.
Part of a group purchasing organization
191. Hospitals with six to 24 beds: 67 percent
192. Hospitals with 25 to 49 beds: 69 percent
193. Hospitals with 50 to 99 beds: 66 percent
194. Hospitals with 100 to 199 beds: 72 percent
195. Hospitals with 200 to 299 beds: 77 percent
196. Hospitals with 300 to 399 beds: 82 percent
197. Hospitals with 400 to 499 beds: 86 percent
198. Hospitals with 500 or more beds: 93 percent
Part of a health system
199. Hospitals with six to 24 beds: 46 percent
200. Hospitals with 25 to 49 beds: 55 percent
201. Hospitals with 50 to 99 beds: 67 percent
202. Hospitals with 100 to 199 beds: 75 percent
203. Hospitals with 200 to 299 beds: 74 percent
204. Hospitals with 300 to 399 beds: 77 percent
205. Hospitals with 400 to 499 beds: 75 percent
206. Hospitals with 500 or more beds: 75 percent
Compensation
Source: Integrated Healthcare Strategies 2016 National Healthcare Leadership Compensation Survey.
Average base salary for independent hospital executives
207. CEO: $487,000
208. CFO: $227,900
209. COO: $323,000
Average total cash compensation for independent hospital executives
210. CEO: $553,400
211. CFO: $305,000
212. COO: $357,800
Average base salary for subsidiary hospital executives
213. CEO: $387,500
214. CFO: $276,000
215. COO: $304,700
Average total cash compensation for subsidiary hospital executives
216. CEO: $462,000
217. CFO: $309,300
218. COO: $349,200
Average base salary for independent health system executives
219. CEO: $826,500
220. CFO: $453,300
221. COO: $503,100
Average total cash compensation for independent health system executives
222. CEO: $1.04 million
223. CFO: $538,400
224. COO: $606,300
Average base salary for subsidiary health system executives
225. CEO: $699,500
226. CFO: $406,800
227. COO: $376,800
Average total cash compensation for subsidiary health system executives
228. CEO: $866,300
229. CFO: $478,400
230. COO: $430,300