Virginia Hospitals’ Quality Ratings – Which Need Improvement?

Carilion Medical Center Roanoke

by James C. Sherlock

Medicare star ratings for Virginia hospitals constitute a high stakes game in every respect.

It’s the best information a consumer can get. Careers in hospital management rise and fall on the results.

All Virginians should pay attention.

I’ll list our best hospitals in another article, but we’ll look today at those that Medicare quality standards indicate need to improve.

Eighteen out of Virginia’s 82 total acute care and critical access hospitals are rated two stars (below average) or one star (poor). Together, those ratings (22% of Virginia hospitals one or two stars) are better than the national averages (29%).

The Virginia systems and regional groupings that Medicare data show have work to do include:

  • Carilion – 4 out of 6 hospitals.
  • Lifepoint Health – 3 of 6 hospitals
  • Bon Secours – 4 of 11 hospitals.
  • Both Fredericksburg hospitals

Eight of the 18 hospitals are parts of regional monopolies. Three are rural critical access hospitals. Four are proprietary.

Medicare Star Rating. The Medicare Care Compare website is a consumer tool that provides quality measure information.

The overall rating, between 1 and 5 stars, is a result of crunching about half of those measures in algorithms. The inputs are a variety of measures across 5 areas of quality. The 5 measure groups include:

  • Mortality
  • Safety of care
  • Readmission
  • Patient experience
  • Timely and effective care

The overall star rating assigned is a weighted measure of those factors.

Patient Survey Rating. Patient experience of care is measured by a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay. This is also referred to as HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems).

2-star.  The two-star Virginia hospitals are:

  • Russell County Hospital –  Lebanon:
  • Bon Secours Memorial Regional Medical Center – Mechanicsville
  • Bon Secours Rappahannock General Hospital – Kilmarnock
  • Bon Secours Southampton Memorial Hospital – Franklin
  • Bon Secours Southside Regional Medical Center – Petersburg
  • Carilion Franklin Memorial Hospital – Rocky Mount
  • Carilion Medical Center – Roanoke
  • Carilion Stonewall Jackson Hospital – Lexington
  • Mary Washington Hospital – Fredericksburg
  • Spotsylvania Regional Medical Center – Fredericksburg
  • Fauquier Hospital – Warrenton
  • Twin County Regional Hospital – Galax
  • Novant Health UVA Health System Haymarket Medical Center – Haymarket
  • Riverside Regional Medical Center – Newport News
  • Sentara Virginia Beach General Hospital – Virginia Beach

One star.

 The two one-star hospitals here in Virginia are:

  • Carilion Tazewell in Tazewell; and
  • Valley Health Page Memorial in Luray.

That ranking puts those two in the bottom 6% of hospitals in the country.

Bottom line. Good overall ratings statewide compared to the rest of the nation, but I did not expect Carilion to perform so poorly.

Both its regional medical center in Roanoke and three of that hospital’s five satellite hospitals are on this list.

Here is a spreadsheet that shows all 18 alongside both their Medicare and Patient Survey ratings.


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Comments

11 responses to “Virginia Hospitals’ Quality Ratings – Which Need Improvement?”

  1. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    I am surprised that the Bon Secours facility in Mechanicsville has such a low rating. Unlike the other Bon Secours hospitals on this list, the Mechanicsville facility is not an older one that Bon Secours took over, but is a fairly new one that it built.

    Like so much in medical care, these ratings may be of limited value to the consumer. In rural areas, which is the case with most of the ones on this list, there is only one hospital available. Therefore, the consumer/patient has no choice. Even in urban areas that have several hospitals, the choices are limited. If it is an elective procedure, the patient is limited to the hospitals at which his/her doctor has privileges. In emergency situations, the patient may not be able to articulate which hospital he prefers; besides, ambulance drivers have instructions to take a patient to the nearest hospital.

    1. James C. Sherlock Avatar
      James C. Sherlock

      This is designed for elective procedures.

      But it can also be used for voluntary transfer decisions. The Medicare data have the singular advantage of being up-to-date. It is the only patient source that is. vhi.org has in-depth data as well, but it is old – 2019.

      Medicare ratings are the best a patient can do when choosing a hospital.

      Even in an emergency admission, once stabilized, the patient can ask to he transferred to another hospital. The hospital will do that automatically if the patient needs more care than can be provided, say a remote area.

      As example, Carilion’s network offers limited services outside of Roanoke. The regional medical center in Roanoke will take the cases one of their satellite facilities can’t handle.

      We have a different case here in Virginia Beach.

      We have access to some excellent hospitals. Virginia Beach General is not currently one of them, but it offers nearly everything but labor and delivery. Sentara is not going to transfer a patient from there if the hospital offers the service required. A patient who can safely be transported can request a transfer.

    2. James C. Sherlock Avatar
      James C. Sherlock

      In my experience, the physical facility is not a predictor of the quality of care.

    3. James C. Sherlock Avatar
      James C. Sherlock

      I was involved in hospital improvement professionally in a couple of large projects after the Navy.

      If your doctor has privileges only in a poor hospital and there is a highly rated one available, it is very worth considering another doctor. Once in the hospital, the patient is under the care of the staff, including hospitalists. The quality ratings really don’t lie.

      1. Dick Hall-Sizemore Avatar
        Dick Hall-Sizemore

        I appreciate your experience and comments.

        Again, the consumer/patient is at a disadvantage. Switching PCP’s is not always simple. My wife’s PCP is retiring. We have found that a lot of PCPs are not accepting new patients and, for those that are, one often has to wait several months to get an appointment.

        1. LarrytheG Avatar

          same thing in the Fredericksburg area – people lose their doctor and finding a new one is a long slog.

          Worse than that, IMO, doctors do not readily share patient data which means if one has multiple providers, specialists , new doctors, sharing of the data is problematical. But that’s a different issue I admit but in my mind just as important or more so than the doctor no matter their “rating”.

  2. LarrytheG Avatar

    Just want to point out, again, that this is the Government rating not the private sector or “market” nor social media.

    How much would we really know about most of this without the govt deciding what criteria and data to collect and then to provide it to the folks that paid for it – taxpayers.

    The “free market” would not likely being doing this or if they did, no doubt the data would be “curated” to make the hospitals look good.

    And from this data, consumers can make decisions and in doing so, hold the hospitals accountable and without it, not so much.

    1. Nancy Naive Avatar
      Nancy Naive

      You mean the same government that isn’t the solution but the problem?

      Doctors bury their mistakes.

      1. LarrytheG Avatar

        And so probably would those “wonderful” private sector facilities that COPN doesn’t allow.

  3. Teddy007 Avatar

    What can be interesting is rural hospitals can have lower quality scores but higher Press-Ganey scores because the patient experience is better for many of the patients.

  4. Does the ranking adjust for the acuity of the patient population admitted to each hospital?

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