by James C. Sherlock
UVa Hospital
The Centers for Medicare & Medicaid Services (CMS) on Wednesday released its latest annual hospital quality rankings .
Only 10.4% of the rated hospitals in the country were awarded the top ranking of five stars. Of Virginia’s 74 rated hospitals, 13 received that top ranking. Almost 18%.
Nationally, 28% received one of the top two rankings. In Virginia, 58%.
As a whole, Virginians are exceptionally well served.
By Hospital. I have taken Virginia’s hospitals from the new national list and sorted them descending by star-ranking, 5 stars though 1 star. The results are here.
The footnote dictionary is here. For the column header dictionary, see here.
By Hospital System. Categorized by system and with computed system hospital averages, the system ranking is here, sorted, like the individual hospitals, descending from best to worst.
By Region. See here. Northern Virginia, with all of its hospitals 5- and 4-Star rated, may be the only region of its size in the country that can make that claim.
Regional wealth or poverty, and the attractiveness of the location to staff and management still matter. Especially management.
The new rankings show significant changes. We’ll take a look.
Individual Hospitals.
UVa Medical Center and Inova Fairfax, each enormous, and handling a large percentage of very tough cases. Both landed 5-star quality ratings.
So did the Salem Veterans Administration Medical Center and Critical Access Hospitals in Giles and Shenandoah counties, run by Carilion and Valley Health respectively.
Three Inova hospitals and two Sentara facilities are on the 5-Star list.
It’s nice to see HCA’s John Randolph Medical Center in Hopewell on the 4-star list. Well done in a tough location to which to recruit talent. It gives the beleaguered citizens of Petersburg, with 1-star Bon Secours Southside Medical Center in their city, a nearby quality option if they know how much better it is and can get to it eight miles away.
The 2-star hospitals of some big name systems need to step up their games.
The three hospitals in the Fredericksburg/Spotsylvania region are not up to standards.
The other 1-star is Ballad’s Russel County Hospital in Lebanon.
Race, poverty, location and management. It doesn’t go unnoticed that hospitals in two of the Blackest cities in the state, Franklin and Petersburg, both now Bon Secours facilities, are poor and bad respectively. They were bad when Bon Secours took them over.
The half White/half-Black populations of Danville and Martinsville are poorly served. But Hopewell, with the same demographic split as those two cities, has an excellent hospital courtesy of HCA.
And the Ballad hospital in nearly all-White Russell County is terrible. Richmond and Roanoke have both excellent and poor hospitals.
So it’s somewhat of a wash on race.
Rather than the color of the patients, discrepancies in hospital quality appear to be about money and location.
- Some are in Northern Virginia;
- Some are in urban areas outside of Northern Virginia with a mix of rich, middle class and poor patients;
- Others are in areas where the patients are poor and recruiting staff is tough.
In all three cases, management counts. Some do well and some don’t in each environment.
Hospital Systems. Inova has been the best hospital system in Virginia and one of the very best in the country as long as I have been studying these things. I’ve looked closely at Inova’s boards, management and operations. It is astonishingly well-run.
Its hospitals are also in inner Northern Virginia, greatly easing recruiting and with a wealthy overall population.
Centra has done extremely well. Congratulations to them and the cities of Lynchburg, Bedford and Prince Edward they serve. Those are much harder places in which to excel than Inova’s perch in some of the richest jurisdictions in America.
Valley Health has stepped it its game, as has VCU Health and Novant. Independent Augusta Health is always excellent. Arlington County can be justifiably proud of its county-owned Virginia Hospital Center.
Sentara has done very well, better than in earlier years, marred only by 2-star Sentara Halifax in South Boston.
As a retired military officer, I am proud of the VA Hospitals in Salem and Hampton. They have come a long way.
The overall performance of HCA’s system in Virginia is not what we, or they, are used to seeing. Expect changes at their Pulaski and Spotsylvania campuses.
Bon Secours, Ballad, LifePoint and Mary Washington have a lot of work to do.
SOVAH’s facilities in Danville and Martinsville, combined for rating purposes as SOVAH Danville, remain dreadful.
Bottom line. There are some improvements and some sliding backwards in the new rankings. But overall what we expect to see every year, we see in this one.
Running a high quality hospital is hard. The management teams of Virginia’s hospitals do it better than most.
It’s harder if the hospitals are located in places where physicians and nurses are less likely to want to live and work and the patients are poor. Unlike sports, poor teams do not get high draft choices.
But some facilities in less attractive locations pull it off. The rest, and perhaps the state, can take lessons from those who do.
But overall, great job.
Updated Jul 28 at 9:55 to add regional view.
