Christus St Vincent Regional Medical Center

Hospital in Santa Fe, NM, Medicare certification number 320002. CMS publishes 62 quality measures for it.

Medicare certification

Provider of Services

CCN: 320002The number CMS certifies the facility under, not a provider identifier
Status: Active
Provider type: Hospital – Short-term
Listed by Care Compare as: Acute Care Hospitals
Ownership: Voluntary non-profit - Private
Control type: Private (not for profit)
Participating since: Jul 1, 1966
Last certification: May 1, 2025
Beds: 248
Overall star rating: 4 of 5Care Compare
Address: 455 St Michael'S Drive
Santa Fe, NM 87505
(505) 983-3361

NPI records for this facility 1

St Vincent Hospital
- General Acute Care Hospital
- Santa Fe, NM
- NPI 1578587150
Medicare enrollment

Patient survey (HCAHPS) 9

Medicare Care Compare

Cleanliness - star rating Worse3 of 5
- State average 3.15 (computed here)
- National average 3.44 (computed here)
- Period from 10/01/2024
Communication about medicines - star rating Worse2 of 5
- State average 2.73 (computed here)
- National average 2.71 (computed here)
- Period from 10/01/2024
Discharge information - star rating Worse2 of 5
- State average 2.58 (computed here)
- National average 3.31 (computed here)
- Period from 10/01/2024
Doctor communication - star rating As expected3 of 5
- State average 2.88 (computed here)
- National average 3.12 (computed here)
- Period from 10/01/2024
Nurse communication - star rating Worse3 of 5
- State average 2.92 (computed here)
- National average 3.43 (computed here)
- Period from 10/01/2024
Overall hospital rating - star rating Worse3 of 5
- State average 2.88 (computed here)
- National average 3.29 (computed here)
- Period from 10/01/2024
Quietness - star rating Worse3 of 5
- State average 3.27 (computed here)
- National average 3.27 (computed here)
- Period from 10/01/2024
Recommend hospital - star rating Better4 of 5
- State average 3.15 (computed here)
- National average 3.64 (computed here)
- Period from 10/01/2024
Summary star rating Worse3 of 5
- State average 2.92 (computed here)
- National average 3.27 (computed here)
- Period from 10/01/2024

Complications and deaths 18

Medicare Care Compare

Abdominopelvic accidental puncture or laceration rate As expected1.06
- State average 1.03 (computed here)
- National average 1.06
- No different than the national rate
- 1,120 patients
- Period from 07/01/2022
CMS Medicare PSI 90: Patient safety and adverse events composite Worse1.37
- State average 1.08 (computed here)
- National average 1
- Worse than the national value
- Period from 07/01/2022
Death rate among surgical inpatients with serious treatable complications As expected160.46
- State average 175.16 (computed here)
- National average 173.3
- No different than the national rate
- 73 patients
- Period from 07/01/2022
Death rate for COPD patients As expected7.8
- State average 9.14 (computed here)
- National average 8.6
- No different than the national rate
- 73 patients
- Period from 07/01/2022
Death rate for heart attack patients As expected11
- State average 11.59 (computed here)
- National average 11.9
- No different than the national rate
- 300 patients
- Period from 07/01/2022
Death rate for heart failure patients As expected8.2
- State average 11.32 (computed here)
- National average 11.1
- No different than the national rate
- 321 patients
- Period from 07/01/2022
Death rate for pneumonia patients As expected14.3
- State average 15.71 (computed here)
- National average 15.2
- No different than the national rate
- 537 patients
- Period from 07/01/2022
Death rate for stroke patients As expected9.9
- State average 12.8 (computed here)
- National average 11.9
- No different than the national rate
- 216 patients
- Period from 07/01/2023
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate As expected3.9
- State average 4.11 (computed here)
- National average 3.9
- No different than the national rate
- 2,898 patients
- Period from 07/01/2024
Iatrogenic pneumothorax rate As expected0.16
- State average 0.2 (computed here)
- National average 0.21
- No different than the national rate
- 5,581 patients
- Period from 07/01/2022
In-hospital fall-associated fracture rate As expected0.26
- State average 0.28 (computed here)
- National average 0.27
- No different than the national rate
- 5,406 patients
- Period from 07/01/2022
Perioperative pulmonary embolism or deep vein thrombosis rate As expected3.33
- State average 3.58 (computed here)
- National average 3.52
- No different than the national rate
- 1,283 patients
- Period from 07/01/2022
Postoperative acute kidney injury requiring dialysis rate As expected1.48
- State average 1.73 (computed here)
- National average 1.67
- No different than the national rate
- 242 patients
- Period from 07/01/2022
Postoperative hemorrhage or hematoma rate As expected2.41
- State average 2.4 (computed here)
- National average 2.34
- No different than the national rate
- 1,203 patients
- Period from 07/01/2022
Postoperative respiratory failure rate As expected8.72
- State average 9.83 (computed here)
- National average 9.42
- No different than the national rate
- 219 patients
- Period from 07/01/2022
Postoperative sepsis rate As expected4.46
- State average 5.61 (computed here)
- National average 5.27
- No different than the national rate
- 222 patients
- Period from 07/01/2022
Postoperative wound dehiscence rate As expected1.65
- State average 1.85 (computed here)
- National average 1.77
- No different than the national rate
- 299 patients
- Period from 07/01/2022
Pressure ulcer rate Worse2.17
- State average 0.83 (computed here)
- National average 0.63
- Worse than the national rate
- 4,331 patients
- Period from 07/01/2022

Measures CMS does not publish for this facility (2)

Death rate for CABG surgery patients — 5
Rate of complications for hip/knee replacement patients — 1

Infections 5

Medicare Care Compare

Catheter Associated Urinary Tract Infections (ICU + select Wards) As expected1.03
- State average 0.65
- National average 1
- No different than national benchmark
- Period from 10/01/2024
Central Line Associated Bloodstream Infection (ICU + select Wards) As expected1.5
- State average 0.94
- National average 1
- No different than national benchmark
- Period from 10/01/2024
Clostridium Difficile (C.Diff) Better0.31
- State average 0.6
- National average 1
- Better than the national benchmark
- Period from 10/01/2024
MRSA Bacteremia As expected1.09
- State average 0.66
- National average 1
- No different than national benchmark
- Period from 10/01/2024
SSI - Colon Surgery As expected0.61
- State average 1.12
- National average 1
- No different than national benchmark
- Period from 10/01/2024

Measures CMS does not publish for this facility (1)

SSI - Abdominal Hysterectomy — 13

Outpatient imaging 1

Medicare Care Compare

Abdomen CT Use of Contrast Material 1.7
- State average 6.75 (computed here)
- National average 5.83 (computed here)
- Period from 07/01/2024

Measures CMS does not publish for this facility (1)

Breast Cancer Screening Recall Rates — 7

Spending per patient 1

Medicare Care Compare

Medicare hospital spending per patient (Medicare Spending per Beneficiary) 0.93
- State average 0.94
- National average 0.99 (computed here)
- Period from 01/01/2024

Timely and effective care 17

Medicare Care Compare

Antithrombotic Therapy by End of Hospital Day 2 93
- State average 92.2 (computed here)
- National average 92.79 (computed here)
- 150 patients
- Period from 01/01/2024
Appropriate care for severe sepsis and septic shock 75
- State average 54
- National average 65
- 122 patients
- Period from 10/01/2024
Average (median) time all patients spent in the emergency department before leaving from the visit, including psychiatric/mental health patients and patients who were transferred to another facility. A lower number of minutes is better 176
- State average 170
- National average 168
- 405 patients
- Period from 10/01/2024
Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better 173
- State average 163
- National average 162
- 379 patients
- Period from 10/01/2024
Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better 285
- State average 274
- National average 257
- 23 patients
- Period from 10/01/2024
Discharged on Antithrombotic Therapy 95
- State average 95.63 (computed here)
- National average 96.1 (computed here)
- 174 patients
- Period from 01/01/2024
Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients 85
- State average 87
- National average 93
- 52 patients
- Period from 01/01/2024
Head CT results 36
- State average 50
- National average 69
- 42 patients
- Period from 10/01/2024
Healthcare workers given influenza vaccination 77
- State average 68
- National average 78
- 3,285 patients
- Period from 10/01/2024
Hospital Harm - Severe Hyperglycemia 3
- State average 7.9 (computed here)
- National average 8.08 (computed here)
- 13,264 patients
- Period from 01/01/2024
Left before being seen 1
- State average 3
- National average 2
- 47,570 patients
- Period from 01/01/2024
Safe Use of Opioids - Concurrent Prescribing 11
- State average 13
- National average 15
- 2,483 patients
- Period from 01/01/2024
Septic Shock 3-Hour Bundle 88
- State average 67
- National average 73
- 48 patients
- Period from 10/01/2024
Septic Shock 6-Hour Bundle 91
- State average 80
- National average 87
- 35 patients
- Period from 10/01/2024
Severe Sepsis 3-Hour Bundle 87
- State average 75
- National average 81
- 122 patients
- Period from 10/01/2024
Severe Sepsis 6-Hour Bundle 97
- State average 88
- National average 93
- 79 patients
- Period from 10/01/2024
ST-Segment Elevation Myocardial Infarction (STEMI) 59
- State average 39.4 (computed here)
- National average 46.51 (computed here)
- 29 patients
- Period from 01/01/2024

Measures CMS does not publish for this facility (13)

Anticoagulation Therapy for Atrial Fibrillation/Flutter — 5
Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better — 1
Emergency department volume — high
Global Malnutrition Composite Score — 5
Global Malnutrition Composite Score: Malnutrition Diagnosis Documented — 5
Global Malnutrition Composite Score: Malnutrition Risk Screening — 5
Global Malnutrition Composite Score: Nutrition Assessment — 5
Global Malnutrition Composite Score: Nutritional Care Plan — 5
Hospital Harm - Opioid Related Adverse Events — 5
Hospital Harm - Severe Hypoglycemia — 5
Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery — 5
Intensive Care Unit Venous Thromboembolism Prophylaxis — 5
Venous Thromboembolism Prophylaxis — 5

Unplanned visits 11

Medicare Care Compare

Acute Myocardial Infarction (AMI) 30-Day Readmission Rate As expected12.7
- State average 14.15 (computed here)
- National average 14.4
- No different than the national rate
- 327 patients
- Period from 07/01/2023
Heart failure (HF) 30-Day Readmission Rate As expected19.6
- State average 21.13 (computed here)
- National average 21.3
- No different than the national rate
- 414 patients
- Period from 07/01/2023
Hospital return days for heart attack patients -9
- State average 2.35 (computed here)
- National average 6.71 (computed here)
- Average days per 100 discharges
- 283 patients
- Period from 07/01/2022
Hospital return days for heart failure patients -34.8
- State average -3.92 (computed here)
- National average 4.02 (computed here)
- Fewer days than average per 100 discharges
- 349 patients
- Period from 07/01/2022
Hospital return days for pneumonia patients -29.9
- State average -4.25 (computed here)
- National average 5.65 (computed here)
- Fewer days than average per 100 discharges
- 573 patients
- Period from 07/01/2022
Pneumonia (PN) 30-Day Readmission Rate As expected15.9
- State average 17 (computed here)
- National average 17.3
- No different than the national rate
- 741 patients
- Period from 07/01/2023
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy As expected5.7
- State average 5.47 (computed here)
- National average 5.4
- No different than the national rate
- 269 patients
- Period from 01/01/2024
Rate of inpatient admissions for patients receiving outpatient chemotherapy As expected9.2
- State average 10.42 (computed here)
- National average 10.7
- No different than the national rate
- 269 patients
- Period from 01/01/2024
Rate of readmission for chronic obstructive pulmonary disease (COPD) patients As expected19.1
- State average 19.53 (computed here)
- National average 20
- No different than the national rate
- 112 patients
- Period from 07/01/2023
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies) As expected14.7
- State average 13.19 (computed here)
- National average 13
- No different than the national rate
- 415 patients
- Period from 01/01/2022
Ratio of unplanned hospital visits after hospital outpatient surgery Better0.8
- State average 1.06 (computed here)
- National average 1.01 (computed here)
- Better than expected
- 1,486 patients
- Period from 01/01/2024

Measures CMS does not publish for this facility (3)

Hybrid Hospital-Wide All-Cause Readmission Measure (HWR) — 4
Rate of readmission after hip/knee replacement — 1
Rate of readmission for CABG — 5

Sources for this page

Provider of Services: the certification, provider type, beds and status.
Medicare Care Compare: the star rating and every measure on this page, with the state and national rates CMS publishes beside them.
NPPES NPI Registry: the NPI records connected to this certification.

Better and worse are CMS's own comparison with the national rate, not ours: for most measures a low score is the good one (deaths, infections) and for others a high one is, so measures where CMS states no comparison are left uncoloured. The exception is star ratings, which are read against the national average here. Quality measures are published by CMS and are not adjusted or re-scored here. Averages marked “computed here” are the mean of every facility reporting that measure, worked out by NPIMap because CMS publishes no comparison for it. Confirm anything you rely on at Medicare Care Compare.