Bottom quartile Middle Top quartile Percentile badges compare this hospital to all 5,426 hospitals nationally.

Overview

Address
1007 GOODYEAR AVENUE, GADSDEN, AL 35903
Phone
(256) 494-4000
Hospital Type
Acute Care
Ownership
For-Profit
Emergency Services
Yes
Birthing Friendly
Yes
1 /5
CMS Overall Rating
p0
Acute Care — General medical and surgical hospital participating in Medicare IPPS. Subject to CMS quality reporting and payment adjustment programs (VBP, HRRP, HAC).

CMS Star Rating — Quality Domain Breakdown

CMS computes the overall star rating from five quality domains. Each domain compares this hospital's measures against national benchmarks.

Mortality 7 of 7 measures reported
6
1
Better No different Worse
30-day death rates for heart attack, heart failure, pneumonia, COPD, stroke, CABG, and kidney disease.
Safety of Care 7 of 8 measures reported
1
5
1
Better No different Worse
Healthcare-associated infections and patient safety indicators (PSI-90 composite).
Readmission 9 of 11 measures reported
9
Better No different Worse
30-day unplanned readmission rates for heart attack, heart failure, pneumonia, COPD, hip/knee replacement, and CABG.
Patient Experience 8 of 8 measures reported
8 measures reported (comparative data not available for this domain)
HCAHPS survey scores — patient-reported experience with communication, responsiveness, cleanliness, and discharge planning.
Timely & Effective Care 10 of 12 measures reported
10 measures reported (comparative data not available for this domain)
Process-of-care measures including flu immunization, blood clot prevention, and appropriate use of imaging.

Readmissions — Hospital Readmissions Reduction Program

The Excess Readmission Ratio (ERR) compares this hospital's 30-day readmission rate to expected, adjusting for patient mix. An ERR of 1.0 means readmissions are as expected; > 1.0 triggers a Medicare payment penalty (up to 3%).

This hospital has excess readmissions in at least one condition and is subject to HRRP payment reduction.
Acute Myocardial Infarction (Heart Attack)
0.9772 p34
Heart Failure 229 discharges
0.9563 p22
Pneumonia 248 discharges
1.0159 p62
COPD 89 discharges
0.9967 p49
Hip/Knee Replacement
1.1146 p79
CABG Surgery 47 discharges
1.1728 p95
Expected (1.0) National median

Value-Based Purchasing

The Hospital VBP Program adjusts Medicare payments based on clinical quality. The Total Performance Score (TPS) is a weighted composite of four domains, each worth 25%. This hospital's TPS is below the national median, suggesting a negative payment adjustment.

24.7 p33
Total Performance Score
National median: 29.5
Clinical Outcomes 25% weight
5.8 p55
Nat'l median: 5.0
Measures mortality rates for conditions like heart attack, heart failure, pneumonia, and COPD. Based on 30-day risk-standardized mortality.
Safety 25% weight
12.1 p62
Nat'l median: 10.0
Patient safety measures including healthcare-associated infections (CLABSI, CAUTI, SSI, MRSA, C. diff) and perioperative complications.
Person & Community Engagement 25% weight
6.8 p33
Nat'l median: 8.8
Based on HCAHPS patient experience survey results — communication with nurses and doctors, hospital cleanliness, pain management, discharge information.
Efficiency & Cost Reduction 25% weight
0.0 p0
Nat'l median: 2.5
Based on Medicare Spending Per Beneficiary (MSPB). Measures episode-of-care costs from 3 days before admission through 30 days after discharge.

CMS Payment Programs

Three Medicare programs adjust hospital payments based on quality performance. Hospitals can be penalized under multiple programs simultaneously.

Readmissions (HRRP)
Penalized
Worst ERR: 1.1728
Value-Based Purchasing
24.7 TPS
Below national median
HAC Reduction
Payment Reduced
HAC Score: 0.6323

Complications & Deaths

30-day mortality rates, patient safety indicators, and complication rates. "Better" means statistically significantly better than the national rate.

Measure Score vs. National Denominator
COMP_HIP_KNEE 4.20 No Different Than the National Rate 50
Hybrid_HWM 4.90 No Different Than the National Rate 763
MORT_30_AMI 11.10 No Different Than the National Rate 88
MORT_30_CABG 2.40 No Different Than the National Rate 48
MORT_30_COPD 9.30 No Different Than the National Rate 80
MORT_30_HF 10.80 No Different Than the National Rate 201
MORT_30_PN 20.10 Worse Than the National Rate 233
MORT_30_STK 12.90 No Different Than the National Rate 112
PSI_03 1.88 Worse Than the National Rate 2,702
PSI_04 182.27 No Different Than the National Rate 44
PSI_06 0.24 No Different Than the National Rate 3,153
PSI_08 0.28 No Different Than the National Rate 3,346
PSI_09 1.97 No Different Than the National Rate 597
PSI_10 1.57 No Different Than the National Rate 245
PSI_11 15.12 No Different Than the National Rate 244
PSI_12 3.23 No Different Than the National Rate 633
PSI_13 7.72 No Different Than the National Rate 219
PSI_14 1.70 No Different Than the National Rate 160
PSI_15 1.17 No Different Than the National Rate 555
PSI_90 1.58 Worse Than the National Value

Patient Experience (HCAHPS)

Hospital Consumer Assessment of Healthcare Providers and Systems — standardized patient survey measuring satisfaction with care.

Measure Score Star Rating
H_COMP_1_A_P: Nurses "always" communicated well 76%
H_COMP_1_SN_P: Nurses "sometimes" or "never" communicated well 6%
H_COMP_1_U_P: Nurses "usually" communicated well 18%
H_COMP_1_LINEAR_SCORE: Nurse communication - linear mean score
H_COMP_1_STAR_RATING: Nurse communication - star rating 3
H_NURSE_RESPECT_A_P: Nurses "always" treated them with courtesy and respect 82%
H_NURSE_RESPECT_SN_P: Nurses "sometimes" or "never" treated them with courtesy and respect 4%
H_NURSE_RESPECT_U_P: Nurses "usually" treated them with courtesy and respect 14%
H_NURSE_LISTEN_A_P: Nurses "always" listened carefully 74%
H_NURSE_LISTEN_SN_P: Nurses "sometimes" or "never" listened carefully 6%
H_NURSE_LISTEN_U_P: Nurses "usually" listened carefully 20%
H_NURSE_EXPLAIN_A_P: Nurses "always" explained things so they could understand 71%
H_NURSE_EXPLAIN_SN_P: Nurses "sometimes" or "never" explained things so they could understand 8%
H_NURSE_EXPLAIN_U_P: Nurses "usually" explained things so they could understand 21%
H_COMP_2_A_P: Doctors "always" communicated well 75%
H_COMP_2_SN_P: Doctors "sometimes" or "never" communicated well 6%
H_COMP_2_U_P: Doctors "usually" communicated well 19%
H_COMP_2_LINEAR_SCORE: Doctor communication - linear mean score
H_COMP_2_STAR_RATING: Doctor communication - star rating 2
H_DOCTOR_RESPECT_A_P: Doctors "always" treated them with courtesy and respect 82%
H_DOCTOR_RESPECT_SN_P: Doctors "sometimes" or "never" treated them with courtesy and respect 4%
H_DOCTOR_RESPECT_U_P: Doctors "usually" treated them with courtesy and respect 14%
H_DOCTOR_LISTEN_A_P: Doctors "always" listened carefully 73%
H_DOCTOR_LISTEN_SN_P: Doctors "sometimes" or "never" listened carefully 7%
H_DOCTOR_LISTEN_U_P: Doctors "usually" listened carefully 20%
H_DOCTOR_EXPLAIN_A_P: Doctors "always" explained things so they could understand 71%
H_DOCTOR_EXPLAIN_SN_P: Doctors "sometimes" or "never" explained things so they could understand 7%
H_DOCTOR_EXPLAIN_U_P: Doctors "usually" explained things so they could understand 22%
H_COMP_5_A_P: Staff "always" explained 57%
H_COMP_5_SN_P: Staff "sometimes" or "never" explained 27%
H_COMP_5_U_P: Staff "usually" explained 16%
H_COMP_5_LINEAR_SCORE: Communication about medicines - linear mean score
H_COMP_5_STAR_RATING: Communication about medicines - star rating 2
H_MED_FOR_A_P: Staff "always" explained new medications 68%
H_MED_FOR_SN_P: Staff "sometimes" or "never" explained new medications 15%
H_MED_FOR_U_P: Staff "usually" explained new medications 17%
H_SIDE_EFFECTS_A_P: Staff "always" explained possible side effects 45%
H_SIDE_EFFECTS_SN_P: Staff "sometimes" or "never" explained possible side effects 39%
H_SIDE_EFFECTS_U_P: Staff "usually" explained possible side effects 16%
H_COMP_6_N_P: No, staff "did not" give patients this information 17%
H_COMP_6_Y_P: Yes, staff "did" give patients this information 83%
H_COMP_6_LINEAR_SCORE: Discharge information - linear mean score
H_COMP_6_STAR_RATING: Discharge information - star rating 2
H_DISCH_HELP_N_P: No, staff "did not" give patients information about help after discharge 19%
H_DISCH_HELP_Y_P: Yes, staff "did" give patients information about help after discharge 81%
H_SYMPTOMS_N_P: No, staff "did not" give patients information about possible symptoms 16%
H_SYMPTOMS_Y_P: Yes, staff "did" give patients information about possible symptoms 84%
H_CLEAN_HSP_A_P: Room was "always" clean 63%
H_CLEAN_HSP_SN_P: Room was "sometimes" or "never" clean 14%
H_CLEAN_HSP_U_P: Room was "usually" clean 23%
H_CLEAN_LINEAR_SCORE: Cleanliness - linear mean score
H_CLEAN_STAR_RATING: Cleanliness - star rating 2
H_QUIET_HSP_A_P: "Always" quiet at night 61%
H_QUIET_HSP_SN_P: "Sometimes" or "never" quiet at night 10%
H_QUIET_HSP_U_P: "Usually" quiet at night 29%
H_QUIET_LINEAR_SCORE: Quietness - linear mean score
H_QUIET_STAR_RATING: Quietness - star rating 3
H_HSP_RATING_0_6: Patients who gave a rating of "6" or lower (low) 16%
H_HSP_RATING_7_8: Patients who gave a rating of "7" or "8" (medium) 26%
H_HSP_RATING_9_10: Patients who gave a rating of "9" or "10" (high) 58%
H_HSP_RATING_LINEAR_SCORE: Overall hospital rating - linear mean score
H_HSP_RATING_STAR_RATING: Overall hospital rating - star rating 2
H_RECMND_DN: "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it) 12%
H_RECMND_DY: "YES", patients would definitely recommend the hospital 58%
H_RECMND_PY: "YES", patients would probably recommend the hospital 30%
H_RECMND_LINEAR_SCORE: Recommend hospital - linear mean score
H_RECMND_STAR_RATING: Recommend hospital - star rating 2
H_STAR_RATING: Summary star rating 2

Healthcare Associated Infections

Standardized Infection Ratios (SIR). A SIR < 1.0 means fewer infections than predicted based on national baseline data.

Measure Score (SIR) vs. National
HAI_1_CILOWER 0.014 No Different than National Benchmark
HAI_1_CIUPPER 1.429 No Different than National Benchmark
HAI_1_DOPC 4119.000 No Different than National Benchmark
HAI_1_ELIGCASES 3.452 No Different than National Benchmark
HAI_1_NUMERATOR 1.000 No Different than National Benchmark
HAI_1_SIR 0.290 No Different than National Benchmark
HAI_2_CILOWER 0.055 No Different than National Benchmark
HAI_2_CIUPPER 1.082 No Different than National Benchmark
HAI_2_DOPC 6812.000 No Different than National Benchmark
HAI_2_ELIGCASES 6.105 No Different than National Benchmark
HAI_2_NUMERATOR 2.000 No Different than National Benchmark
HAI_2_SIR 0.328 No Different than National Benchmark
HAI_3_CILOWER N/A Better than the National Benchmark
HAI_3_CIUPPER 0.937 Better than the National Benchmark
HAI_3_DOPC 113.000 Better than the National Benchmark
HAI_3_ELIGCASES 3.196 Better than the National Benchmark
HAI_3_NUMERATOR 0.000 Better than the National Benchmark
HAI_3_SIR 0.000 Better than the National Benchmark
HAI_4_CILOWER N/A No Different than National Benchmark
HAI_4_CIUPPER 2.957 No Different than National Benchmark
HAI_4_DOPC 102.000 No Different than National Benchmark
HAI_4_ELIGCASES 1.013 No Different than National Benchmark
HAI_4_NUMERATOR 0.000 No Different than National Benchmark
HAI_4_SIR 0.000 No Different than National Benchmark
HAI_5_CILOWER 0.410 No Different than National Benchmark
HAI_5_CIUPPER 3.110 No Different than National Benchmark
HAI_5_DOPC 46896.000 No Different than National Benchmark
HAI_5_ELIGCASES 3.102 No Different than National Benchmark
HAI_5_NUMERATOR 4.000 No Different than National Benchmark
HAI_5_SIR 1.289 No Different than National Benchmark
HAI_6_CILOWER N/A Better than the National Benchmark
HAI_6_CIUPPER 0.162 Better than the National Benchmark
HAI_6_DOPC 45659.000 Better than the National Benchmark
HAI_6_ELIGCASES 18.544 Better than the National Benchmark
HAI_6_NUMERATOR 0.000 Better than the National Benchmark
HAI_6_SIR 0.000 Better than the National Benchmark

Timely & Effective Care

Process-of-care measures including ED wait times, treatment timeliness, and preventive care.

Measure Score Condition
EDV medium Emergency Department
GMCS Electronic Clinical Quality Measure
GMCS_Malnutrition_Diagnosis_Documented Electronic Clinical Quality Measure
GMCS_Malnutrition_Screening Electronic Clinical Quality Measure
GMCS_Nutrition_Assessment Electronic Clinical Quality Measure
GMCS_Nutritional_Care_Plan Electronic Clinical Quality Measure
HH_HYPER Electronic Clinical Quality Measure
HH_HYPO 3.0 Electronic Clinical Quality Measure
HH_ORAE Electronic Clinical Quality Measure
IMM_3 19.0 Healthcare Personnel Vaccination
OP_18a 214.0 Emergency Department
OP_18b 203.0 Emergency Department
OP_18c 458.0 Emergency Department
OP_18d Emergency Department
OP_22 2.0 Emergency Department
OP_23 Emergency Department
OP_29 Colonoscopy care
OP_31 Cataract surgery outcome
OP_40 Electronic Clinical Quality Measure
SAFE_USE_OF_OPIOIDS 16.0 Electronic Clinical Quality Measure
SEP_1 41.0 Sepsis Care
SEP_SH_3HR 33.0 Sepsis Care
SEP_SH_6HR 73.0 Sepsis Care
SEV_SEP_3HR 69.0 Sepsis Care
SEV_SEP_6HR 76.0 Sepsis Care
STK_02 94.0 Electronic Clinical Quality Measure
STK_03 Electronic Clinical Quality Measure
STK_05 86.0 Electronic Clinical Quality Measure
VTE_1 Electronic Clinical Quality Measure
VTE_2 Electronic Clinical Quality Measure

Unplanned Hospital Visits

Readmission and ED return rates within 30 days of discharge.

Measure Score vs. National
EDAC_30_AMI -12.30 Average Days per 100 Discharges
EDAC_30_HF 20.00 More Days Than Average per 100 Discharges
EDAC_30_PN 8.00 Average Days per 100 Discharges
Hybrid_HWR 15.90 No Different Than the National Rate
OP_32 13.10 No Different Than the National Rate
OP_35_ADM Number of Cases Too Small
OP_35_ED Number of Cases Too Small
OP_36 1.00 No Different than expected
READM_30_AMI 13.30 No Different Than the National Rate
READM_30_CABG 12.40 No Different Than the National Rate
READM_30_COPD 18.10 No Different Than the National Rate
READM_30_HF 19.10 No Different Than the National Rate
READM_30_HIP_KNEE 5.40 No Different Than the National Rate
READM_30_PN 16.20 No Different Than the National Rate

Medicare Spending Per Beneficiary

MSPB ratio: values > 1.0 mean this hospital's episode spending is higher than the national median hospital.

Value
1.07

Financial Health (Cost Report — FY 2023)

All Data

Every labeled metric surfaced for this hospital, with national medians and percentiles where a benchmark is available.

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Show 94 rows
Source Metric Value National Median Pctl. Raw key
Cost Report Cost-to-Charge Ratio 0.05 metrics.cost_to_charge_ratio
Cost Report Current Ratio 3.23 metrics.current_ratio
Cost Report Employees per Bed 4.59 metrics.employees_per_bed
Cost Report fiscal_year 2,023 fiscal_year
Cost Report Fund Balance ($) $113,325,305 metrics.fund_balance
Cost Report Net Income ($) $9,982,263 metrics.net_income
Cost Report Net Patient Revenue ($) $165,166,279 metrics.net_patient_revenue
Cost Report Operating Margin (%) 3.2% metrics.operating_margin
Cost Report Total Assets ($) $126,571,550 metrics.total_assets
Cost Report Total Costs ($) $154,146,580 metrics.total_costs
Cost Report Total Liabilities ($) $13,246,245 metrics.total_liabilities
Cost Report Total Margin (%) 5.9% metrics.total_margin
Cost Report Uncompensated Care (%) 6.3% metrics.uncompensated_care_pct
General Information Address 1007 GOODYEAR AVENUE Address
General Information City/Town GADSDEN City/Town
General Information Count of Facility MORT Measures 7 Count of Facility MORT Measures
General Information Count of Facility Pt Exp Measures 8 Count of Facility Pt Exp Measures
General Information Count of Facility READM Measures 9 Count of Facility READM Measures
General Information Count of Facility Safety Measures 7 Count of Facility Safety Measures
General Information Count of Facility TE Measures 10 Count of Facility TE Measures
General Information Count of MORT Measures Better 0 Count of MORT Measures Better
General Information Count of MORT Measures No Different 6 Count of MORT Measures No Different
General Information Count of MORT Measures Worse 1 Count of MORT Measures Worse
General Information Count of READM Measures Better 0 Count of READM Measures Better
General Information Count of READM Measures No Different 9 Count of READM Measures No Different
General Information Count of READM Measures Worse 0 Count of READM Measures Worse
General Information Count of Safety Measures Better 1 Count of Safety Measures Better
General Information Count of Safety Measures No Different 5 Count of Safety Measures No Different
General Information Count of Safety Measures Worse 1 Count of Safety Measures Worse
General Information County/Parish ETOWAH County/Parish
General Information Emergency Services Yes Emergency Services
General Information Facility ID 010040 Facility ID
General Information Facility Name GADSDEN REGIONAL MEDICAL CENTER Facility Name
General Information Hospital overall rating 1 Hospital overall rating
General Information Hospital overall rating footnote Hospital overall rating footnote
General Information Hospital Ownership Proprietary Hospital Ownership
General Information Hospital Type Acute Care Hospitals Hospital Type
General Information Meets criteria for birthing friendly designation Y Meets criteria for birthing friendly designation
General Information MORT Group Footnote MORT Group Footnote
General Information MORT Group Measure Count 7 MORT Group Measure Count
General Information Pt Exp Group Footnote Pt Exp Group Footnote
General Information Pt Exp Group Measure Count 8 Pt Exp Group Measure Count
General Information READM Group Footnote READM Group Footnote
General Information READM Group Measure Count 11 READM Group Measure Count
General Information Safety Group Footnote Safety Group Footnote
General Information Safety Group Measure Count 8 Safety Group Measure Count
General Information State AL State
General Information TE Group Footnote TE Group Footnote
General Information TE Group Measure Count 12 TE Group Measure Count
General Information Telephone Number (256) 494-4000 Telephone Number
General Information ZIP Code 35903 ZIP Code
HAC Reduction Program fiscal_year 2,026 fiscal_year
HAC Reduction Program measures — cauti — sir 0.35 measures.cauti.sir
HAC Reduction Program measures — cdi — sir 0.16 measures.cdi.sir
HAC Reduction Program measures — clabsi — sir 1.48 measures.clabsi.sir
HAC Reduction Program measures — mrsa — sir 1.57 measures.mrsa.sir
HAC Reduction Program measures — ssi — sir 0.13 measures.ssi.sir
HAC Reduction Program payment_reduction Yes payment_reduction
HAC Reduction Program total_hac_score 0.63 total_hac_score
Medicare Spending per Beneficiary End Date 12/31/2024 End Date
Medicare Spending per Beneficiary Measure ID MSPB-1 Measure ID
Medicare Spending per Beneficiary Start Date 01/01/2024 Start Date
Medicare Spending per Beneficiary Value 1.07 Value
Readmissions (HRRP) Acute Myocardial Infarction (Heart Attack) — Excess readmission ratio 0.98 0.9995 p34 READM-30-AMI-HRRP.excess_readmission_ratio
Readmissions (HRRP) Acute Myocardial Infarction (Heart Attack) — Expected readmission rate 12.8% READM-30-AMI-HRRP.expected_readmission_rate
Readmissions (HRRP) Acute Myocardial Infarction (Heart Attack) — Predicted readmission rate 12.5% READM-30-AMI-HRRP.predicted_readmission_rate
Readmissions (HRRP) CABG Surgery — Excess readmission ratio 1.17 1.0000 p95 READM-30-CABG-HRRP.excess_readmission_ratio
Readmissions (HRRP) CABG Surgery — Expected readmission rate 12.2% READM-30-CABG-HRRP.expected_readmission_rate
Readmissions (HRRP) CABG Surgery — Number of discharges 47 READM-30-CABG-HRRP.num_discharges
Readmissions (HRRP) CABG Surgery — Number of readmissions 11 READM-30-CABG-HRRP.num_readmissions
Readmissions (HRRP) CABG Surgery — Predicted readmission rate 14.3% READM-30-CABG-HRRP.predicted_readmission_rate
Readmissions (HRRP) COPD — Excess readmission ratio 1.00 0.9969 p49 READM-30-COPD-HRRP.excess_readmission_ratio
Readmissions (HRRP) COPD — Expected readmission rate 19.4% READM-30-COPD-HRRP.expected_readmission_rate
Readmissions (HRRP) COPD — Number of discharges 89 READM-30-COPD-HRRP.num_discharges
Readmissions (HRRP) COPD — Number of readmissions 17 READM-30-COPD-HRRP.num_readmissions
Readmissions (HRRP) COPD — Predicted readmission rate 19.4% READM-30-COPD-HRRP.predicted_readmission_rate
Readmissions (HRRP) Heart Failure — Excess readmission ratio 0.96 0.9983 p22 READM-30-HF-HRRP.excess_readmission_ratio
Readmissions (HRRP) Heart Failure — Expected readmission rate 22.1% READM-30-HF-HRRP.expected_readmission_rate
Readmissions (HRRP) Heart Failure — Number of discharges 229 READM-30-HF-HRRP.num_discharges
Readmissions (HRRP) Heart Failure — Number of readmissions 45 READM-30-HF-HRRP.num_readmissions
Readmissions (HRRP) Heart Failure — Predicted readmission rate 21.1% READM-30-HF-HRRP.predicted_readmission_rate
Readmissions (HRRP) Hip/Knee Replacement — Excess readmission ratio 1.11 0.9916 p79 READM-30-HIP-KNEE-HRRP.excess_readmission_ratio
Readmissions (HRRP) Hip/Knee Replacement — Expected readmission rate 5.4% READM-30-HIP-KNEE-HRRP.expected_readmission_rate
Readmissions (HRRP) Hip/Knee Replacement — Predicted readmission rate 6.0% READM-30-HIP-KNEE-HRRP.predicted_readmission_rate
Readmissions (HRRP) Pneumonia — Excess readmission ratio 1.02 0.9955 p62 READM-30-PN-HRRP.excess_readmission_ratio
Readmissions (HRRP) Pneumonia — Expected readmission rate 16.6% READM-30-PN-HRRP.expected_readmission_rate
Readmissions (HRRP) Pneumonia — Number of discharges 248 READM-30-PN-HRRP.num_discharges
Readmissions (HRRP) Pneumonia — Number of readmissions 43 READM-30-PN-HRRP.num_readmissions
Readmissions (HRRP) Pneumonia — Predicted readmission rate 16.9% READM-30-PN-HRRP.predicted_readmission_rate
Value-Based Purchasing Clinical Outcomes 5.83 5.00 p55 clinical_outcomes_score
Value-Based Purchasing Efficiency & Cost Reduction 0.00 2.50 p0 efficiency_score
Value-Based Purchasing Person & Community Engagement 6.75 8.75 p33 person_community_score
Value-Based Purchasing Safety 12.08 10.00 p62 safety_score
Value-Based Purchasing Total Performance Score 24.67 29.50 p33 total_performance_score
Methodology

Full methodology →