Hillcrest Hospital

Hospital in Mayfield Heights, OH, Medicare certification number 360230. CMS publishes 66 quality measures for it.

Medicare certification

Provider of Services

CCN: 360230The 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: Nov 23, 1968
Last certification: Aug 4, 2018
Beds: 532
Overall star rating: 5 of 5Care Compare
Most recent change of ownership: May 23, 1996 (1 total)
Address: 6780 Mayfield Road
Mayfield Heights, OH 44124
(440) 312-4500

NPI records for this facility 1

Cleveland Clinic Health System - East Region
- General Acute Care Hospital
- Mayfield HTS, OH
- NPI 1902858152
Medicare enrollment

Patient survey (HCAHPS) 9

Medicare Care Compare

Cleanliness - star rating Better4 of 5
- State average 3.7 (computed here)
- National average 3.44 (computed here)
- Period from 10/01/2024
Communication about medicines - star rating Worse2 of 5
- State average 2.71 (computed here)
- National average 2.71 (computed here)
- Period from 10/01/2024
Discharge information - star rating Worse3 of 5
- State average 3.61 (computed here)
- National average 3.31 (computed here)
- Period from 10/01/2024
Doctor communication - star rating As expected3 of 5
- State average 3.14 (computed here)
- National average 3.12 (computed here)
- Period from 10/01/2024
Nurse communication - star rating Worse3 of 5
- State average 3.84 (computed here)
- National average 3.43 (computed here)
- Period from 10/01/2024
Overall hospital rating - star rating Worse3 of 5
- State average 3.45 (computed here)
- National average 3.29 (computed here)
- Period from 10/01/2024
Quietness - star rating Worse2 of 5
- State average 3.31 (computed here)
- National average 3.27 (computed here)
- Period from 10/01/2024
Recommend hospital - star rating Better4 of 5
- State average 3.79 (computed here)
- National average 3.64 (computed here)
- Period from 10/01/2024
Summary star rating Worse3 of 5
- State average 3.43 (computed here)
- National average 3.27 (computed here)
- Period from 10/01/2024

Complications and deaths 20

Medicare Care Compare

Abdominopelvic accidental puncture or laceration rate As expected0.94
- State average 1.04 (computed here)
- National average 1.06
- No different than the national rate
- 2,481 patients
- Period from 07/01/2022
CMS Medicare PSI 90: Patient safety and adverse events composite Better0.59
- State average 0.97 (computed here)
- National average 1
- Better than the national value
- Period from 07/01/2022
Death rate among surgical inpatients with serious treatable complications As expected158.94
- State average 170.96 (computed here)
- National average 173.3
- No different than the national rate
- 93 patients
- Period from 07/01/2022
Death rate for CABG surgery patients As expected1.5
- State average 2.27 (computed here)
- National average 2.4
- No different than the national rate
- 107 patients
- Period from 07/01/2022
Death rate for COPD patients As expected7.7
- State average 8.28 (computed here)
- National average 8.6
- No different than the national rate
- 204 patients
- Period from 07/01/2022
Death rate for heart attack patients As expected10.1
- State average 11.61 (computed here)
- National average 11.9
- No different than the national rate
- 325 patients
- Period from 07/01/2022
Death rate for heart failure patients Better7.1
- State average 10.63 (computed here)
- National average 11.1
- Better than the national rate
- 917 patients
- Period from 07/01/2022
Death rate for pneumonia patients Better11.1
- State average 14.65 (computed here)
- National average 15.2
- Better than the national rate
- 860 patients
- Period from 07/01/2022
Death rate for stroke patients Better8.5
- State average 11.66 (computed here)
- National average 11.9
- Better than the national rate
- 421 patients
- Period from 07/01/2023
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate Better2.3
- State average 3.92 (computed here)
- National average 3.9
- Better than the national rate
- 6,421 patients
- Period from 07/01/2024
Iatrogenic pneumothorax rate As expected0.12
- State average 0.21 (computed here)
- National average 0.21
- No different than the national rate
- 11,381 patients
- Period from 07/01/2022
In-hospital fall-associated fracture rate As expected0.24
- State average 0.27 (computed here)
- National average 0.27
- No different than the national rate
- 11,562 patients
- Period from 07/01/2022
Perioperative pulmonary embolism or deep vein thrombosis rate As expected2.86
- State average 3.41 (computed here)
- National average 3.52
- No different than the national rate
- 2,493 patients
- Period from 07/01/2022
Postoperative acute kidney injury requiring dialysis rate As expected1
- State average 1.7 (computed here)
- National average 1.67
- No different than the national rate
- 939 patients
- Period from 07/01/2022
Postoperative hemorrhage or hematoma rate As expected1.54
- State average 2.32 (computed here)
- National average 2.34
- No different than the national rate
- 2,293 patients
- Period from 07/01/2022
Postoperative respiratory failure rate Better3.79
- State average 9.31 (computed here)
- National average 9.42
- Better than the national rate
- 958 patients
- Period from 07/01/2022
Postoperative sepsis rate As expected4.22
- State average 5.13 (computed here)
- National average 5.27
- No different than the national rate
- 930 patients
- Period from 07/01/2022
Postoperative wound dehiscence rate As expected1.41
- State average 1.79 (computed here)
- National average 1.77
- No different than the national rate
- 659 patients
- Period from 07/01/2022
Pressure ulcer rate As expected0.18
- State average 0.56 (computed here)
- National average 0.63
- No different than the national rate
- 10,240 patients
- Period from 07/01/2022
Rate of complications for hip/knee replacement patients As expected3
- State average 4.31 (computed here)
- National average 4.1
- No different than the national rate
- 137 patients
- Period from 04/01/2023

Infections 5

Medicare Care Compare

Catheter Associated Urinary Tract Infections (ICU + select Wards) As expected0.66
- State average 0.43
- National average 1
- No different than national benchmark
- Period from 10/01/2024
Central Line Associated Bloodstream Infection (ICU + select Wards) Better0.18
- State average 0.63
- National average 1
- Better than the national benchmark
- Period from 10/01/2024
Clostridium Difficile (C.Diff) Better0.4
- State average 0.45
- National average 1
- Better than the national benchmark
- Period from 10/01/2024
MRSA Bacteremia As expected0.63
- State average 0.84
- National average 1
- No different than national benchmark
- Period from 10/01/2024
SSI - Colon Surgery As expected1.09
- State average 1.08
- 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 2

Medicare Care Compare

Abdomen CT Use of Contrast Material 2.7
- State average 4.61 (computed here)
- National average 5.83 (computed here)
- Period from 07/01/2024
Breast Cancer Screening Recall Rates 8.4
- State average 7.08 (computed here)
- National average 8.08 (computed here)
- Period from 07/01/2024

Spending per patient 1

Medicare Care Compare

Medicare hospital spending per patient (Medicare Spending per Beneficiary) 0.99
- State average 0.98
- National average 0.99 (computed here)
- Period from 01/01/2024

Timely and effective care 16

Medicare Care Compare

Antithrombotic Therapy by End of Hospital Day 2 96
- State average 95.51 (computed here)
- National average 92.79 (computed here)
- 233 patients
- Period from 01/01/2024
Appropriate care for severe sepsis and septic shock 57
- State average 63
- National average 65
- 162 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 205
- State average 164
- National average 168
- 405 patients
- Period from 10/01/2024
Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better 446
- State average 343
- National average 287
- 15 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 200
- State average 158
- National average 162
- 382 patients
- Period from 10/01/2024
Discharged on Antithrombotic Therapy 100
- State average 97.97 (computed here)
- National average 96.1 (computed here)
- 245 patients
- Period from 01/01/2024
Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients 97
- State average 96
- National average 93
- 61 patients
- Period from 01/01/2024
Head CT results 72
- State average 71
- National average 69
- 29 patients
- Period from 10/01/2024
Healthcare workers given influenza vaccination 87
- State average 82
- National average 78
- 8,412 patients
- Period from 10/01/2024
Intensive Care Unit Venous Thromboembolism Prophylaxis 84
- State average 94.4 (computed here)
- National average 93.49 (computed here)
- 2,500 patients
- Period from 01/01/2024
Left before being seen 2
- State average 2
- National average 2
- 87,741 patients
- Period from 01/01/2024
Safe Use of Opioids - Concurrent Prescribing 10
- State average 13
- National average 15
- 4,212 patients
- Period from 01/01/2024
Septic Shock 3-Hour Bundle 49
- State average 73
- National average 73
- 49 patients
- Period from 10/01/2024
Septic Shock 6-Hour Bundle 91
- State average 86
- National average 87
- 22 patients
- Period from 10/01/2024
Severe Sepsis 3-Hour Bundle 80
- State average 79
- National average 81
- 162 patients
- Period from 10/01/2024
Severe Sepsis 6-Hour Bundle 92
- State average 93
- National average 93
- 88 patients
- Period from 10/01/2024

Measures CMS does not publish for this facility (14)

Anticoagulation Therapy for Atrial Fibrillation/Flutter — 5
Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better — 1
Emergency department volume — very 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 Hyperglycemia — 5
Hospital Harm - Severe Hypoglycemia — 5
Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery — 5
ST-Segment Elevation Myocardial Infarction (STEMI) — 1
Venous Thromboembolism Prophylaxis — 5

Unplanned visits 13

Medicare Care Compare

Acute Myocardial Infarction (AMI) 30-Day Readmission Rate As expected13.5
- State average 14.52 (computed here)
- National average 14.4
- No different than the national rate
- 587 patients
- Period from 07/01/2023
Heart failure (HF) 30-Day Readmission Rate As expected21.6
- State average 21.66 (computed here)
- National average 21.3
- No different than the national rate
- 1,482 patients
- Period from 07/01/2023
Hospital return days for heart attack patients 12.3
- State average 10.24 (computed here)
- National average 6.71 (computed here)
- Average days per 100 discharges
- 361 patients
- Period from 07/01/2022
Hospital return days for heart failure patients 16.4
- State average 3.25 (computed here)
- National average 4.02 (computed here)
- Average days per 100 discharges
- 1,042 patients
- Period from 07/01/2022
Hospital return days for pneumonia patients 27.7
- State average 2.29 (computed here)
- National average 5.65 (computed here)
- More days than average per 100 discharges
- 909 patients
- Period from 07/01/2022
Pneumonia (PN) 30-Day Readmission Rate As expected18.4
- State average 17.27 (computed here)
- National average 17.3
- No different than the national rate
- 1,400 patients
- Period from 07/01/2023
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy Better3.4
- State average 5.36 (computed here)
- National average 5.4
- Better than the national rate
- 377 patients
- Period from 01/01/2024
Rate of inpatient admissions for patients receiving outpatient chemotherapy As expected12.4
- State average 11.09 (computed here)
- National average 10.7
- No different than the national rate
- 377 patients
- Period from 01/01/2024
Rate of readmission after hip/knee replacement As expected5.3
- State average 6.07 (computed here)
- National average 5.8
- No different than the national rate
- 146 patients
- Period from 07/01/2023
Rate of readmission for CABG As expected10.6
- State average 11.07 (computed here)
- National average 11
- No different than the national rate
- 156 patients
- Period from 07/01/2023
Rate of readmission for chronic obstructive pulmonary disease (COPD) patients As expected20.4
- State average 19.74 (computed here)
- National average 20
- No different than the national rate
- 450 patients
- Period from 07/01/2023
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies) As expected13.6
- State average 13.26 (computed here)
- National average 13
- No different than the national rate
- 839 patients
- Period from 01/01/2022
Ratio of unplanned hospital visits after hospital outpatient surgery As expected0.9
- State average 1.02 (computed here)
- National average 1.01 (computed here)
- No different than expected
- 1,407 patients
- Period from 01/01/2024

Measures CMS does not publish for this facility (1)

Hybrid Hospital-Wide All-Cause Readmission Measure (HWR) — 4

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.