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 seventh 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 and Deaths-National Averages, May 2018, and Timely and Effective Care-National Averages, May 2018, 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: 0.4 percent
2. A wound that splits open on the abdomen or pelvis after surgery: 2.26 percent
3. Accidental cuts and tears from medical treatment: 0.88 percent
4. Serious blood clots after surgery: 4.35 percent
5. Serious complications: 1 percent
6. Bloodstream infection after surgery: 5.94 percent
7. Developed a blood clot while in the hospital and did not get treatment that could have prevented it: 2 percent
Heart attack patients
8. Median time to fibrinolysis: 28 minutes
9. Median time to transfer to another facility for acute coronary intervention: 57 minutes
Outpatients with chest pain or possible heart attack
10. Who received aspirin within 24 hours of arrival or before transferring from the emergency department: 95 percent
11. Who received drugs to break up blood clots within 30 minutes of arrival: 59 percent
12. Median time before patient received an ECG: 7 minutes
Lower extremity joint replacement patients
13. Rate of complications for hip/knee replacement patients: 2.8 percent
Colonoscopy patients
14. Who received appropriate recommendation for follow-up colonoscopy: 85 percent
15. Percentage of patients with history of polyps who received follow-up colonoscopy in the appropriate time frame: 90 percent
Flu vaccination
16. Preventive care patients assessed and given flu vaccination: 93 percent
17. Healthcare workers who received flu vaccination: 88 percent
Pregnancy and delivery care
18. Mothers whose deliveries were scheduled one to two weeks early when a scheduled delivery was not medically necessary: 2 percent
Emergency department care
19. Average time spent in the ED before patient is admitted to the hospital as an inpatient: 281 minutes
20. Average time patient spent in ED after the physician decided to admit as an inpatient but before leaving the ED for the inpatient room: 102 minutes
21. Average time patient spent in the ED before being sent home: 140 minutes
22. Average time patient spent in the ED before being seen by a healthcare professional: 20 minutes
23. Average time patient who came to the ED with broken bones had to wait before receiving pain medication: 49 minutes
24. Percentage of patients who came to the ED with stroke symptoms who received brain scan results within 45 minutes of arrival: 72 percent
25. Percentage of patients who left the ED before being seen: 2 percent
Patient satisfaction
Source: Hospital Compare, HHS, HCAHPS National Survey Results, May 2018, the latest available data for these measures.
Overall hospital rating
26. Patients who gave the hospital a rating of nine or 10: 73 percent
27. Patients who gave the hospital a rating of seven or eight: 20 percent
28. Patients who gave the hospital a rating of six or lower: 7 percent
Patient recommendation
29. Patients who said yes, they would definitely recommend the hospital to friends and family: 72 percent
30. Patients who said yes, they would probably recommend the hospital to friends and family: 23 percent
31. Patients who said no, they probably or definitely would not recommend the hospital to friends and family: 5 percent
Cleanliness
32. Patients who said their room and bathroom were "always" clean: 75 percent
33. Patients who said their room and bathroom were "usually" clean: 17 percent
34. Patients who said their room and bathroom were "sometimes" or "never" clean: 8 percent
Noise
35. Patients who said the area around their room was "always" quiet at night: 62 percent
36. Patients who said the area around their room was "usually" quiet at night: 29 percent
37. Patients who said the area around their room was "sometimes" or "never" quiet at night: 9 percent
Physician communication
38. Patients who said their physicians "always" communicated well: 82 percent
39. Patients who said their physicians "usually" communicated well: 14 percent
40. Patients who said their physicians "sometimes" or "never" communicated well: 4 percent
Nurse communication
41. Patients who said their nurses "always" communicated well: 80 percent
42. Patients who said their nurses "usually" communicated well: 16 percent
43. Patients who said their nurses "sometimes" or "never" communicated well: 4 percent
Explanation of medicines
44. Patients who said staff "always" explained medicines before administering: 66 percent
45. Patients who said staff "usually" explained medicines before administering: 17 percent
46. Patients who said staff "sometimes" or "never" explained medicines before administering: 17 percent
Assistance from hospital staff
47. Patients who said they "always" received help as soon as they wanted: 69 percent
48. Patients who said they "usually" received help as soon as they wanted: 23 percent
49. Patients who said they "sometimes" or "never" received help as soon as they wanted: 8 percent
Recovery plan
50. Patients who said staff provided information about what to do during their recovery at home: 87 percent
51. Patients who said staff did not provide information about what to do during their recovery at home: 13 percent
Care plan at discharge
52. Patients who strongly agreed they understood their care when they left the hospital: 53 percent
53. Patients who agreed they understood their care when they left the hospital: 42 percent
54. 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, 2018 Edition.
Average full-time staff
55. Hospitals with six to 24 beds: 101
56. Hospitals with 25 to 49 beds: 182
57. Hospitals with 50 to 99 beds: 296
58. Hospitals with 100 to 199 beds: 672
59. Hospitals with 200 to 299 beds: 1,232
60. Hospitals with 300 to 399 beds: 1,777
61. Hospitals with 400 to 499 beds: 2,596
62. Hospitals with 500 or more beds: 5,225
Average part-time staff
63. Hospitals with six to 24 beds: 50
64. Hospitals with 25 to 49 beds: 83
65. Hospitals with 50 to 99 beds: 139
66. Hospitals with 100 to 199 beds: 276
67. Hospitals with 200 to 299 beds: 468
68. Hospitals with 300 to 399 beds: 600
69. Hospitals with 400 to 499 beds: 954
70. Hospitals with 500 or more beds: 1,420
Utilization
Source: American Hospital Association "Hospital Statistics" report, 2018 Edition.
Average admissions per year
71. Hospitals with six to 24 beds: 379
72. Hospitals with 25 to 49 beds: 917
73. Hospitals with 50 to 99 beds: 2,084
74. Hospitals with 100 to 199 beds: 5,838
75. Hospitals with 200 to 299 beds: 11,035
76. Hospitals with 300 to 399 beds: 16,407
77. Hospitals with 400 to 499 beds: 20,541
78. Hospitals with 500 or more beds: 34,693
Average length of stay
79. Hospitals with six to 24 beds: 4.8 days
80. Hospitals with 25 to 49 beds: 5.4 days
81. Hospitals with 50 to 99 beds: 6.8 days
82. Hospitals with 100 to 199 beds: 5.3 days
83. Hospitals with 200 to 299 beds: 5 days
84. Hospitals with 300 to 399 beds: 5.1 days
85. Hospitals with 400 to 499 beds: 5.4 days
86. Hospitals with 500 or more beds: 5.8 days
Average inpatient surgeries per year
Averages include both hospital and nursing home units.
87. Hospitals with six to 24 beds: 86
88. Hospitals with 25 to 49 beds: 205
89. Hospitals with 50 to 99 beds: 486
90. Hospitals with 100 to 199 beds: 1,425
91. Hospitals with 200 to 299 beds: 2,896
92. Hospitals with 300 to 399 beds: 4,193
93. Hospitals with 400 to 499 beds: 5,784
94, Hospitals with 500 or more beds: 10,454
Average outpatient visits per year
Averages include both hospital and nursing home units.
95. Hospitals with six to 24 beds: 24,839
96. Hospitals with 25 to 49 beds: 47,656
97. Hospitals with 50 to 99 beds: 66,003
98. Hospitals with 100 to 199 beds: 141,842
99. Hospitals with 200 to 299 beds: 220,826
100. Hospitals with 300 to 399 beds: 266,285
101. Hospitals with 400 to 499 beds: 434,213
102. Hospitals with 500 or more beds: 714,425
Average outpatient surgeries per year
Averages include both hospital and nursing home units.
103. Hospitals with six to 24 beds: 649
104. Hospitals with 25 to 49 beds: 1,124
105. Hospitals with 50 to 99 beds: 1,761
106. Hospitals with 100 to 199 beds: 3,518
107. Hospitals with 200 to 299 beds: 5,698
108. Hospitals with 300 to 399 beds: 7,076
109. Hospitals with 400 to 499 beds: 9,785
110. Hospitals with 500 or more beds: 16,160
Finance
Average adjusted expenses per inpatient day
Source: Kaiser State Health Facts, accessed in 2018 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.
111. Nonprofit hospitals: $2,413
112. For-profit hospitals: $1,831
113. State/local government hospitals: $2,013
Key ratios
Source: Moody's Investors Service, "U.S. Not-for-Profit Hospital 2016 Medians" report, August 2017.
The medians are based on an analysis of audited 2016 financial statements for 323 freestanding hospitals, single-state health systems and multistate 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.
114. Maintained bed occupancy: 65.4 percent
115. Operating margin: 2.7 percent
116. Excess margin: 5.6 percent
117. Operating cash flow margin: 9.3 percent
118. Return on assets: 4.1 percent
119. Three-year operating revenue CAGR: 6.5 percent
120. Three-year operating expense CAGR: 6.2 percent
121. Days cash on hand: 204.7
122. Annual operating revenue growth rate: 6 percent
123. Annual operating expense growth rate: 7.2 percent
124. Total debt-to-capitalization: 34.9 percent
125. Total debt-to-total operating revenue: 34.6 percent
126. Current ratio: 2.0x
127. Cushion ratio: 20.9x
128. Annual debt service coverage: 5.1x
129. Maximum annual debt service coverage: 4.6x
130. Debt-to-cash flow: 2.8x
131. Capital spending ratio: 1.2x
132. Accounts receivable: 47.8 days
133. Average payment period: 62.8 days
134. Average age of plant: 11.2 years
Hospital margins by credit rating group
Source: S&P Global Ratings "U.S. Not-For-Profit Health Care System Median Financial Ratios — 2016 vs. 2015" report, August 2017.
AA+ rating
135. Operating margin: 4 percent
136. Operating EBIDA margin: 11.6 percent
137. Excess margin: 6.5 percent
138. EBIDA margin: 13.3 percent
AA rating
139. Operating margin: 4.8 percent
140. Operating EBIDA margin: 11 percent
141. Excess margin: 6.6 percent
142. EBIDA margin: 12.7 percent
AA- rating
143. Operating margin: 3.3 percent
144. Operating EBIDA margin: 9.6 percent
145. Excess margin: 4.4 percent
146. EBIDA margin: 10.8 percent
A+ rating
147. Operating margin: 2.3 percent
148. Operating EBIDA margin: 9 percent
149. Excess margin: 3.7 percent
150. EBIDA margin: 10 percent
A rating
151. Operating margin: 2 percent
152. Operating EBIDA margin: 7.8 percent
153. Excess margin: 2.9 percent
154. EBIDA margin: 8.8 percent
A- rating
155. Operating margin: 2.3 percent
156. Operating EBIDA margin: 9.4 percent
157. Excess margin: 2.9 percent
158. EBIDA margin: 9.5 percent
BBB+ rating
159. Operating margin: 0 percent
160. Operating EBIDA margin: 5.7 percent
161. Excess margin: 1 percent
162. EBIDA margin: 7.2 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 — 2016 vs. 2015" report, August 2017.
AA+ rating
163. Days cash on hand: 398.8
164. Days in accounts receivable: 49.7
AA rating
165. Days cash on hand: 316.1
166. Days in accounts receivable: 51
AA- rating
167. Days cash on hand: 220.4
168. Days in accounts receivable: 47.7
A+ rating
169. Days cash on hand: 183.7
170. Days in accounts receivable: 47.9
A rating
171. Days cash on hand: 174.2
172. Days in accounts receivable: 48.5
A- rating
173. Days cash on hand: 148.5
174. Days in accounts receivable: 44.3
BBB+ rating
175. Days cash on hand: 155.9
176. Days in accounts receivable: 43.9
Health IT
HIMSS Analytics EMR Adoption Model, which runs from Stage 0 to Stage 7
Source: HIMSS Analytics, EMR Adoption Model, fourth quarter of 2017, the latest available data for these measures.
177. Stage 7 providers: 6.4 percent
178. Stage 6 providers: 33.8 percent
179. Stage 5 providers: 32.9 percent
180. Stage 4 providers: 10.2 percent
181. Stage 3 providers: 12 percent
182. Stage 2 providers: 1.8 percent
183. Stage 1 providers: 1.5 percent
184. Stage 0 providers: 1.4 percent
Affiliations
Source: American Hospital Association "Hospital Statistics" report, 2018 Edition.
Part of a group purchasing organization
185. Hospitals with six to 24 beds: 68 percent
186. Hospitals with 25 to 49 beds: 68 percent
187. Hospitals with 50 to 99 beds: 66 percent
188. Hospitals with 100 to 199 beds: 70 percent
189. Hospitals with 200 to 299 beds: 77 percent
190. Hospitals with 300 to 399 beds: 79 percent
191. Hospitals with 400 to 499 beds: 88 percent
192. Hospitals with 500 or more beds: 92 percent
Part of a health system
193. Hospitals with six to 24 beds: 46 percent
194. Hospitals with 25 to 49 beds: 57 percent
195. Hospitals with 50 to 99 beds: 68 percent
196. Hospitals with 100 to 199 beds: 75 percent
197. Hospitals with 200 to 299 beds: 76 percent
198. Hospitals with 300 to 399 beds: 77 percent
199. Hospitals with 400 to 499 beds: 75 percent
200. Hospitals with 500 or more beds: 78 percent
Compensation
Source: Integrated Healthcare Strategies 2017 National Healthcare Leadership Compensation Survey.
Average base salary for independent hospital executives
201. CEO: $527,800
202. CFO: $307,800
203. COO: $335,900
Average total cash compensation for independent hospital executives
204. CEO: $609,400
205. CFO: $343,800
206. COO: $373,600
Average base salary for subsidiary hospital executives
207. CEO: $384,900
208. CFO: $248,200
209. COO: $285,300
Average total cash compensation for subsidiary hospital executives
210. CEO: $464,200
211 .CFO: $280,200
212. COO: $325,200
Average base salary for independent health system executives
213. CEO: $906,900
214. CFO: $501,100
215. COO: $560,300
Average total cash compensation for independent health system executives
216. CEO: $1.15 million
217. CFO: $607,400
218. COO: $698,100
Average base salary for subsidiary health system executives
219. CEO: $611,700
220. CFO: $379,600
221. COO: $407,900
Average total cash compensation for subsidiary health system executives
222. CEO: $709,300
223. CFO: $423,200
224. COO: $463,200