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Overview

Address
1300 W 7TH ST, SAN PEDRO, CA 90732
Phone
(310) 832-3311
Hospital Type
Acute Care
Ownership
Non-Profit
Emergency Services
No
4 /5
CMS Overall Rating
p63
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 4 of 7 measures reported
4
Better No different Worse
30-day death rates for heart attack, heart failure, pneumonia, COPD, stroke, CABG, and kidney disease.
Safety of Care 3 of 8 measures reported
1
2
Better No different Worse
Healthcare-associated infections and patient safety indicators (PSI-90 composite).
Readmission 6 of 11 measures reported
6
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 8 of 12 measures reported
8 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)
— Not reported
Heart Failure 100 discharges
0.9736 p32
Pneumonia 118 discharges
0.9588 p24
COPD
1.0026 p55
Hip/Knee Replacement
— Not reported
CABG Surgery
— Not reported
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 above the national median, suggesting a positive payment adjustment.

41.8 p83
Total Performance Score
National median: 29.5
Clinical Outcomes 25% weight
7.5 p67
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
18.3 p90
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
8.5 p47
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
7.5 p67
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: 1.0026
Value-Based Purchasing
41.8 TPS
Above national median
HAC Reduction
No Reduction
HAC Score: -0.4798

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 Number of Cases Too Small
Hybrid_HWM 4.30 No Different Than the National Rate 385
MORT_30_AMI Number of Cases Too Small
MORT_30_CABG
MORT_30_COPD 9.60 No Different Than the National Rate 32
MORT_30_HF 9.10 No Different Than the National Rate 82
MORT_30_PN 14.10 No Different Than the National Rate 115
MORT_30_STK 12.20 No Different Than the National Rate 28
PSI_03 0.35 No Different Than the National Rate 1,620
PSI_04 Number of Cases Too Small
PSI_06 0.26 No Different Than the National Rate 1,991
PSI_08 0.26 No Different Than the National Rate 1,930
PSI_09 2.60 No Different Than the National Rate 181
PSI_10 1.66 No Different Than the National Rate 51
PSI_11 8.82 No Different Than the National Rate 51
PSI_12 3.21 No Different Than the National Rate 195
PSI_13 5.05 No Different Than the National Rate 47
PSI_14 1.75 No Different Than the National Rate 53
PSI_15 1.01 No Different Than the National Rate 260
PSI_90 0.89 No Different 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 78%
H_COMP_1_SN_P: Nurses "sometimes" or "never" communicated well 4%
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 84%
H_NURSE_RESPECT_SN_P: Nurses "sometimes" or "never" treated them with courtesy and respect 2%
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 4%
H_NURSE_LISTEN_U_P: Nurses "usually" listened carefully 22%
H_NURSE_EXPLAIN_A_P: Nurses "always" explained things so they could understand 75%
H_NURSE_EXPLAIN_SN_P: Nurses "sometimes" or "never" explained things so they could understand 5%
H_NURSE_EXPLAIN_U_P: Nurses "usually" explained things so they could understand 20%
H_COMP_2_A_P: Doctors "always" communicated well 81%
H_COMP_2_SN_P: Doctors "sometimes" or "never" communicated well 4%
H_COMP_2_U_P: Doctors "usually" communicated well 15%
H_COMP_2_LINEAR_SCORE: Doctor communication - linear mean score
H_COMP_2_STAR_RATING: Doctor communication - star rating 4
H_DOCTOR_RESPECT_A_P: Doctors "always" treated them with courtesy and respect 85%
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 11%
H_DOCTOR_LISTEN_A_P: Doctors "always" listened carefully 79%
H_DOCTOR_LISTEN_SN_P: Doctors "sometimes" or "never" listened carefully 4%
H_DOCTOR_LISTEN_U_P: Doctors "usually" listened carefully 17%
H_DOCTOR_EXPLAIN_A_P: Doctors "always" explained things so they could understand 77%
H_DOCTOR_EXPLAIN_SN_P: Doctors "sometimes" or "never" explained things so they could understand 4%
H_DOCTOR_EXPLAIN_U_P: Doctors "usually" explained things so they could understand 19%
H_COMP_5_A_P: Staff "always" explained 60%
H_COMP_5_SN_P: Staff "sometimes" or "never" explained 19%
H_COMP_5_U_P: Staff "usually" explained 21%
H_COMP_5_LINEAR_SCORE: Communication about medicines - linear mean score
H_COMP_5_STAR_RATING: Communication about medicines - star rating 3
H_MED_FOR_A_P: Staff "always" explained new medications 77%
H_MED_FOR_SN_P: Staff "sometimes" or "never" explained new medications 8%
H_MED_FOR_U_P: Staff "usually" explained new medications 15%
H_SIDE_EFFECTS_A_P: Staff "always" explained possible side effects 44%
H_SIDE_EFFECTS_SN_P: Staff "sometimes" or "never" explained possible side effects 31%
H_SIDE_EFFECTS_U_P: Staff "usually" explained possible side effects 25%
H_COMP_6_N_P: No, staff "did not" give patients this information 14%
H_COMP_6_Y_P: Yes, staff "did" give patients this information 86%
H_COMP_6_LINEAR_SCORE: Discharge information - linear mean score
H_COMP_6_STAR_RATING: Discharge information - star rating 3
H_DISCH_HELP_N_P: No, staff "did not" give patients information about help after discharge 13%
H_DISCH_HELP_Y_P: Yes, staff "did" give patients information about help after discharge 87%
H_SYMPTOMS_N_P: No, staff "did not" give patients information about possible symptoms 15%
H_SYMPTOMS_Y_P: Yes, staff "did" give patients information about possible symptoms 85%
H_CLEAN_HSP_A_P: Room was "always" clean 78%
H_CLEAN_HSP_SN_P: Room was "sometimes" or "never" clean 6%
H_CLEAN_HSP_U_P: Room was "usually" clean 16%
H_CLEAN_LINEAR_SCORE: Cleanliness - linear mean score
H_CLEAN_STAR_RATING: Cleanliness - star rating 4
H_QUIET_HSP_A_P: "Always" quiet at night 47%
H_QUIET_HSP_SN_P: "Sometimes" or "never" quiet at night 17%
H_QUIET_HSP_U_P: "Usually" quiet at night 36%
H_QUIET_LINEAR_SCORE: Quietness - linear mean score
H_QUIET_STAR_RATING: Quietness - star rating 2
H_HSP_RATING_0_6: Patients who gave a rating of "6" or lower (low) 7%
H_HSP_RATING_7_8: Patients who gave a rating of "7" or "8" (medium) 16%
H_HSP_RATING_9_10: Patients who gave a rating of "9" or "10" (high) 77%
H_HSP_RATING_LINEAR_SCORE: Overall hospital rating - linear mean score
H_HSP_RATING_STAR_RATING: Overall hospital rating - star rating 4
H_RECMND_DN: "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it) 7%
H_RECMND_DY: "YES", patients would definitely recommend the hospital 74%
H_RECMND_PY: "YES", patients would probably recommend the hospital 19%
H_RECMND_LINEAR_SCORE: Recommend hospital - linear mean score
H_RECMND_STAR_RATING: Recommend hospital - star rating 4
H_STAR_RATING: Summary star rating 3

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
HAI_1_CIUPPER
HAI_1_DOPC 921.000
HAI_1_ELIGCASES 0.756
HAI_1_NUMERATOR 0.000
HAI_1_SIR
HAI_2_CILOWER 0.277 No Different than National Benchmark
HAI_2_CIUPPER 5.461 No Different than National Benchmark
HAI_2_DOPC 1407.000 No Different than National Benchmark
HAI_2_ELIGCASES 1.210 No Different than National Benchmark
HAI_2_NUMERATOR 2.000 No Different than National Benchmark
HAI_2_SIR 1.653 No Different than National Benchmark
HAI_3_CILOWER
HAI_3_CIUPPER
HAI_3_DOPC 13.000
HAI_3_ELIGCASES 0.282
HAI_3_NUMERATOR 0.000
HAI_3_SIR
HAI_4_CILOWER
HAI_4_CIUPPER
HAI_4_DOPC 28.000
HAI_4_ELIGCASES 0.273
HAI_4_NUMERATOR 0.000
HAI_4_SIR
HAI_5_CILOWER
HAI_5_CIUPPER
HAI_5_DOPC 18381.000
HAI_5_ELIGCASES 0.758
HAI_5_NUMERATOR 0.000
HAI_5_SIR
HAI_6_CILOWER 0.047 Better than the National Benchmark
HAI_6_CIUPPER 0.929 Better than the National Benchmark
HAI_6_DOPC 18381.000 Better than the National Benchmark
HAI_6_ELIGCASES 7.112 Better than the National Benchmark
HAI_6_NUMERATOR 2.000 Better than the National Benchmark
HAI_6_SIR 0.281 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 Electronic Clinical Quality Measure
HH_ORAE Electronic Clinical Quality Measure
IMM_3 61.0 Healthcare Personnel Vaccination
OP_18a 164.0 Emergency Department
OP_18b 161.0 Emergency Department
OP_18c 247.0 Emergency Department
OP_18d Emergency Department
OP_22 1.0 Emergency Department
OP_23 73.0 Emergency Department
OP_29 92.0 Colonoscopy care
OP_31 Cataract surgery outcome
OP_40 Electronic Clinical Quality Measure
SAFE_USE_OF_OPIOIDS 15.0 Electronic Clinical Quality Measure
SEP_1 71.0 Sepsis Care
SEP_SH_3HR 76.0 Sepsis Care
SEP_SH_6HR 92.0 Sepsis Care
SEV_SEP_3HR 87.0 Sepsis Care
SEV_SEP_6HR 95.0 Sepsis Care
STK_02 95.0 Electronic Clinical Quality Measure
STK_03 Electronic Clinical Quality Measure
STK_05 97.0 Electronic Clinical Quality Measure
VTE_1 Electronic Clinical Quality Measure
VTE_2 98.0 Electronic Clinical Quality Measure

Unplanned Hospital Visits

Readmission and ED return rates within 30 days of discharge.

Measure Score vs. National
EDAC_30_AMI Number of Cases Too Small
EDAC_30_HF 0.00 Average Days per 100 Discharges
EDAC_30_PN -0.20 Average Days per 100 Discharges
Hybrid_HWR 15.30 No Different Than the National Rate
OP_32 12.80 No Different Than the National Rate
OP_35_ADM
OP_35_ED
OP_36 1.00 No Different than expected
READM_30_AMI Number of Cases Too Small
READM_30_CABG
READM_30_COPD 18.20 No Different Than the National Rate
READM_30_HF 19.30 No Different Than the National Rate
READM_30_HIP_KNEE Number of Cases Too Small
READM_30_PN 15.30 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
0.98

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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Source Metric Value National Median Pctl. Raw key
Cost Report Cost per Discharge ($) $851,576 metrics.cost_per_discharge
Cost Report Cost-to-Charge Ratio 0.23 metrics.cost_to_charge_ratio
Cost Report Current Ratio 2.21 metrics.current_ratio
Cost Report Employees per Bed 6.17 metrics.employees_per_bed
Cost Report fiscal_year 2,023 fiscal_year
Cost Report Fund Balance ($) $105,299,813 metrics.fund_balance
Cost Report Net Income ($) $-37,662,983 metrics.net_income
Cost Report Net Patient Revenue ($) $217,420,072 metrics.net_patient_revenue
Cost Report Occupancy Rate (%) 2.8% metrics.occupancy_rate
Cost Report Operating Margin (%) -19.3% metrics.operating_margin
Cost Report Total Assets ($) $170,827,410 metrics.total_assets
Cost Report Total Costs ($) $221,409,740 metrics.total_costs
Cost Report Total Liabilities ($) $65,527,597 metrics.total_liabilities
Cost Report Total Margin (%) -17.0% metrics.total_margin
Cost Report Uncompensated Care (%) 1.8% metrics.uncompensated_care_pct
General Information Address 1300 W 7TH ST Address
General Information City/Town SAN PEDRO City/Town
General Information Count of Facility MORT Measures 4 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 6 Count of Facility READM Measures
General Information Count of Facility Safety Measures 3 Count of Facility Safety Measures
General Information Count of Facility TE Measures 8 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 4 Count of MORT Measures No Different
General Information Count of MORT Measures Worse 0 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 6 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 2 Count of Safety Measures No Different
General Information Count of Safety Measures Worse 0 Count of Safety Measures Worse
General Information County/Parish LOS ANGELES County/Parish
General Information Emergency Services No Emergency Services
General Information Facility ID 050078 Facility ID
General Information Facility Name PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO Facility Name
General Information Hospital overall rating 4 Hospital overall rating
General Information Hospital overall rating footnote Hospital overall rating footnote
General Information Hospital Ownership Voluntary non-profit - Private Hospital Ownership
General Information Hospital Type Acute Care Hospitals Hospital Type
General Information Meets criteria for birthing friendly designation 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 CA State
General Information TE Group Footnote TE Group Footnote
General Information TE Group Measure Count 12 TE Group Measure Count
General Information Telephone Number (310) 832-3311 Telephone Number
General Information ZIP Code 90732 ZIP Code
HAC Reduction Program fiscal_year 2,026 fiscal_year
HAC Reduction Program measures — cauti — sir 0.77 measures.cauti.sir
HAC Reduction Program measures — cdi — sir 0.21 measures.cdi.sir
HAC Reduction Program measures — clabsi — sir 0 measures.clabsi.sir
HAC Reduction Program measures — mrsa — sir 0.57 measures.mrsa.sir
HAC Reduction Program measures — ssi — sir 0.58 measures.ssi.sir
HAC Reduction Program payment_reduction No payment_reduction
HAC Reduction Program total_hac_score -0.48 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 0.98 Value
Readmissions (HRRP) COPD — Excess readmission ratio 1.00 0.9969 p55 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 — Predicted readmission rate 19.4% READM-30-COPD-HRRP.predicted_readmission_rate
Readmissions (HRRP) Heart Failure — Excess readmission ratio 0.97 0.9983 p32 READM-30-HF-HRRP.excess_readmission_ratio
Readmissions (HRRP) Heart Failure — Expected readmission rate 19.4% READM-30-HF-HRRP.expected_readmission_rate
Readmissions (HRRP) Heart Failure — Number of discharges 100 READM-30-HF-HRRP.num_discharges
Readmissions (HRRP) Heart Failure — Number of readmissions 17 READM-30-HF-HRRP.num_readmissions
Readmissions (HRRP) Heart Failure — Predicted readmission rate 18.9% READM-30-HF-HRRP.predicted_readmission_rate
Readmissions (HRRP) Pneumonia — Excess readmission ratio 0.96 0.9955 p24 READM-30-PN-HRRP.excess_readmission_ratio
Readmissions (HRRP) Pneumonia — Expected readmission rate 15.8% READM-30-PN-HRRP.expected_readmission_rate
Readmissions (HRRP) Pneumonia — Number of discharges 118 READM-30-PN-HRRP.num_discharges
Readmissions (HRRP) Pneumonia — Number of readmissions 15 READM-30-PN-HRRP.num_readmissions
Readmissions (HRRP) Pneumonia — Predicted readmission rate 15.1% READM-30-PN-HRRP.predicted_readmission_rate
Value-Based Purchasing Clinical Outcomes 7.50 5.00 p67 clinical_outcomes_score
Value-Based Purchasing Efficiency & Cost Reduction 7.50 2.50 p67 efficiency_score
Value-Based Purchasing Person & Community Engagement 8.50 8.75 p47 person_community_score
Value-Based Purchasing Safety 18.33 10.00 p90 safety_score
Value-Based Purchasing Total Performance Score 41.83 29.50 p83 total_performance_score
Methodology

Full methodology →