Review and Compare Hospitals Using Hospital Report Cards (2019)

Consumers can make informed decisions when choosing a Vermont hospital by using Hospital Report Cards. Hospital Report Cards can be used to review and compare information about community and psychiatric hospitals in quality of care (outcomes, patient satisfaction and more), costs for common services, healthcare-associated infection ratios, nurse staffing levels, patient safety, and hospitals’ financial information.

Consumers can also find information on each hospital’s website to help them make decisions. The information includes discount and free care policies for financial assistance, Community health needs assessment (CHNA) reports, CHNA implementation plans, annual progress reports of CHNA implementation plan, hospital governance description, and  hospital complaint process.

Community Hospital Comparisons

Survey of Patients' Experiences

HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is a national survey that asks patients about their experiences during a recent hospital stay. Use the results shown here to compare hospitals based on 10 important hospital quality topics.

Readmission Rates

Returning to the hospital for unplanned care disrupts patients’ lives, increases their risk of harmful events like healthcare-associated infections, and costs more money. Hospitals that give high quality care can keep patients from returning to the hospital and reduce their stay if they have to come back.

Death Rates

Patients who are admitted to the hospital for treatment of medical problems sometimes get other serious injuries, complications, or conditions, and may even die. Death rates show how often patients die, for any reason, within 30 days of admission to a hospital.

Healthcare-Associated Infections

Healthcare-associated Infections (HAI) are infections that people can get while receiving services at a healthcare facility. Bacteria, viruses and fungi can be passed from patient, healthcare provider to surfaces and back. Hospitals can reduce the risk of HAIs by taking steps developed by the Centers for Disease Control and Prevention and the Institute for Healthcare Improvement.

When using these reports, it helps to understand the Standardized Infection Ratio. SIR is a statistic used to track healthcare-associated infection prevention progress over time. The SIR is adjusted to account for factors that might cause infection rates to be higher or lower, such as hospital size, the type of patients a hospital serves, surgery types and patient characteristics.

Some known healthcare-associated infections are:

Central Line-Associated Bloodstream Infection (CLABSI) - a serious infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line. CLABSIs result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system, yet these infections are preventable.

Clostridioides difficile (C. Diff) - a bacterium that causes diarrhea and colitis (an inflammation of the colon). C. Diff causes almost half a million illnesses in the United States each year.

Surgical Site Infections (SSI) - an infection that occurs after surgery in the part of the body where the surgery took place. It can be a superficial infection or more serious and can involve tissues under the skin, organs, or implanted material. 

Patient Safety Measures

Vermont hospitals must report Serious Reportable Events (SREs) that occur in the hospital, such as falls with injury, pressure ulcers and events related to surgery. The Vermont’s Patient Safety Surveillance and Improvement System (VPSSIS) collects mandatory reports from hospitals to improve patient safety, eliminate adverse events and support quality improvement efforts by Vermont hospitals.

Read the 2019 Annual Report of Vermont's Serious Reportable Events.

Pricing of Common Services at Community Hospitals

Charges are the list price set by the hospital before any discounts, write-offs, insurance adjustments, etc. are applied.
Charges by hospital are the charges of the top 20 inpatient diagnoses and outpatient procedures.
Counts by hospital are the counts of the top 20 inpatient diagnoses and outpatient procedures.

Charges by hospital

Counts by hospital

Pricing by service type

Frequently Asked Questions About the Pricing Reports

Why does Vermont report charges for hospital and physician services?
Hospitals are required to report charges for "high volume health care services" according to Vermont law (18 V.S.A. § 9405b) with "...valid, reliable, useful, and efficient information," patients can make informed decisions about their healthcare.

What services are included in the charge lists?
There are three different lists: hospital charges for inpatient stays (DRG codes), hospital charges for outpatient procedures (CCS - Services and Procedures), and hospital and physician charges for common outpatient services (CPT codes). For inpatient stays and outpatient procedures, the list shows hospital charges for higher volume procedures they performed. For common outpatient services, the list is from a selection of charges developed by reviewing other states’ websites, employer claims data, and data from Vermont hospitals. Hospital and physician charges are shown for this list where applicable.

Why do charges for certain procedures vary across hospitals?
Charges could vary because of the unique circumstances related to each patient’s illness. Also, hospitals have a unique mix of patients served, as well as different types and quantities of services they provide. All of these factors affect the charge for a service.

Is the amount that’s listed for a procedure the actual amount that I will be charged and have to pay?
The amounts that are listed for hospital inpatient stays (DRGs) and hospital outpatient services and procedures (CCS) are the average full charge for a procedure. However, very few people actually pay full charges. The actual amount paid will depend upon many variables, including an individual’s insurance plan and the complexity of his/her procedure. The amounts that are listed for common outpatient services (CPT) are the actual price for that service as listed in the hospital chargemaster as of October 1 (some prices are established on January 1).

What is the chargemaster?
The chargemaster is a comprehensive and hospital-specific listing of each item and service that can be billed to a patient, insurance company, or other payer. Every item and service has a specific code and corresponding charge in the charge master. Since there are usually multiple healthcare services provided to a patient, the total invoice typically includes a list of multiple services for a given visit or admission. A patient’s bill is the sum total of this array of services. For example, selected medical events for a given patient may have one code or several codes included in the final invoice for patient care.

What if I have insurance? How does that affect the charge, and how much will I have to pay?
What you will pay depends upon your insurance plan. If you are insured, you will pay only the co-payment, co-insurance, and/or deductible required by your plan, regardless of the total gross charge. Your insurance company will pay a negotiated amount to the hospital that represents some portion of the charge – generally less than the full charge. In some cases, a negotiated discount may be applied to your deductible.

What do I have to pay if I don’t have insurance?
Some hospitals have discount policies for patients who have no insurance, under which the patient receives a discount off of the full charge, similar to the discounts negotiated by insurance companies. All hospitals have free care policies for low-income patients. You can call a hospital to learn about its policies and application process. Financial counselors are available at the hospitals to help answer specific questions and guide you through the process.

Are physician charges included in the prices shown?
Physician charges are included in the list of common CPT outpatient services where applicable. However, the amounts shown for inpatient stays and outpatient procedures do NOT include physician charges. Those charges only include hospital charges.

How do I find information on charges for procedures that are not listed in this report?
If you want to find charges on procedures that are not listed, call the hospital directly and talk to their consumer services representative or someone in the billing department. In nearly all cases, the hospital can provide an estimated charge, but will not be able to give you an absolute price. Individual circumstances can affect the final charges for care.

Should I make a decision based on the charges listed or are there other factors I should consider?
The gross charge is simply one factor in deciding where to go for healthcare. Other factors that should be considered are the location of your doctor, the services offered by a particular hospital, how many of the procedures the hospital has performed, the quality reporting by a hospital, waiting times for the procedure, etc. You also may want to ask questions of your healthcare provider for a better understanding of options for your personal situation.

Where does the pricing information come from for these different hospital services?
The source of the inpatient (DRG) and outpatient (CCS - Services and Procedures) pricing information is the Vermont Uniform Hospital Discharge Data Set. Billing information is compiled into a database and the charges are taken from the database under a set of agreed upon standards. Hospital and physician pricing for outpatient diagnostic services are based upon Common Procedural Terminology (CPT®) code charges that are contained in each hospital’s chargemaster. The hospitals provide these prices directly to the Vermont Department of Health.

Nurse Staffing Information and Data

Adequate nurse staffing has shown to help achieve improvements in patient care including:

  • Patient satisfaction and health-related quality of life
  • Decrease in: 
    • medical and medication errors.
    • number of preventable events such as patient falls, pressure ulcers, healthcare-associated infections (HAIs) and other complications related to hospitalizations.
    • patient mortality, hospital readmissions and length of stay.
    • patient care costs through avoidance of unplanned readmissions.
    • nurse fatigue, thus promoting nursing safety, nurse retention and job satisfaction, which all contribute to safer patient care.

Nurse staffing is measured by nursing care hours per patient day (the number of nursing care hours relative to the patient workload). This measure was developed by the American Nurses Association for the National Database of Nursing Quality Indicators.

There is no national standard for optimal nurse staffing level. This is due to varying factors like intensity of patient's needs, the number of admissions, discharges and transfers during a shift, level of experience of nursing staff, layout of the unit and availability of resources (ancillary staff, technology etc.). Patients can get a sense of staffing levels at Vermont hospitals by reading the reports in this section.

Frequently Asked Questions about Nurse Staffing:

What are “nursing care hours”?
Nursing Care Hours Per Patient Day refers to the number of hours of nursing care provided on a hospital unit, compared to the number of patients on that unit during a 24-hour period. This measure was developed by the American Nurses Association for the National Database of Nursing Quality Indicators. “Nursing care hours” are the number of hours worked by nursing staff that have direct patient care responsibilities for more than 50% of their shift.

  • RN nursing care hours include hours worked by registered nurses (RNs).
  • Total nursing care hours include hours worked by registered nurses (RNs), licensed practical and vocational nurses, licensed nurse’s aides, and mental health technicians.

What are “patient days”?
“Patient days” are the daily average of the number of patients on the unit, as counted at least once during each shift for 24 hours.

Should the results of this measure be compared among hospitals?
There are some very important reasons why hospitals should not be compared to each other for this measure, including:

  • There are no published national averages or standards with which to compare the Vermont results. 
  • The measure does not account for hospital differences in physical layout, frequency of admissions and discharges, or other factors that might impact nurse staffing needs.
  • The results are not adjusted to account for factors that might require more nursing care hours (e.g., age of patients, severity of patient illnesses).
Nurse Staffing Reports
Hospital Name Units included in the report
Brattleboro Memorial Hospital Medical/Surgical (2nd Floor) Unit, Progressive Care Unit, Birthing Center
Central Vermont Medical Center Medical/Surgical Unit, Women and Children’s Unit, Intensive Care Unit, Psychiatric Unit
Copley Hospital Acute Care Nursing Unit, Birthing Center
The University of Vermont Medical Center Intensive Care Unit, Inpatient Psychiatric Unit, Inpatient Rehabilitation Unit, Medical/Surgical Unit, Mother-Baby Unit, Pediatrics Unit, Neonatal Intensive Care Unit
Gifford Medical Center Medical/Surgical Unit, Birthing Center
Grace Cottage Family Health & Hospital Medical/Surgical Unit
Mt. Ascutney Hospital Medical/Surgical Unit
North Country Hospital Medical/Surgical Unit, Intensive Care Unit
Northeastern Vermont Regional Hospital Intensive Care Unit, Birthing Center, Medical/Surgical Unit
Northwestern Medical Center Intensive Care Unit, Medical/Surgical Unit, Progressive Carre Unit (temporary), Progressive Care Unit West (temporary), Progressive Care Unit Combined
Porter Medical Center Medical/Surgical Combined Unit
Rutland Regional Medical Center Medical/Surgical Unit (5th floor), Progressive Care Unit, Surgical Care Unit, Intensive Care Unit, Psychiatric Inpatient Services and Intensive Care Unit, Women & Children's Unit
Southwestern Vermont Medical Center Intensive Care Unit, Medical/Surgical Unit
Springfield Hospital Inpatient Care Unit, Psychiatric Unit (Windham Center)

 

Mental Health Scorecard

How are we doing in our efforts to promote mental health, screen for depression, and prevent suicide? 

Hospital Financial Information and Budget Data from the Green Mountain Care Board

These documents show the financial health of the different hospitals as required by Vermont statute.

Psychiatric Hospital Comparisons

Find Nurse Staffing by Vermont Psychiatric Hospital
hospital name units included in the report
Brattleboro Retreat Adult Behavioral Health Units (CORE), Adult Acute Care Unit, Adult Psychiatric Unit (Osgood 2), Adult Intensive Unit (Tyler 4), The Emerging Adult Unit (EAU), Adolescent Unit, Children's Unit
Vermont Psychiatric Care Hospital  
Psychiatric Hospital Quality of Care Report
Psychiatric Hospital Healthcare-Associated Infection Report

information available on vermont hospitals' websites

Vermont hospitals share information for consumers including community health needs assessments, strategic plans, annual progress reports, hospital governance, discount and free care policies and their complaint processes. Psychiatric hospitals share quality improvements made instead of the needs assessment. Find this information on hospital pages through the links below.

A summary of Vermont hospitals' priority health needs. 

Brattleboro Memorial Hospital

Read the hospital Profile here. 

Brattleboro Retreat

Read the hospital profile here.

Central Vermont Medical Center

Read the hospital profile here.

Copley Hospital

Read the hospital profile here.

Gifford Medical Center
Grace Cottage Family Health & Hospital

Read the hospital profile here.

Mt. Ascutney Hospital
North Country Hospital

Read the hospital profile here.

Northeastern Vermont Regional Hospital

Read the hospital profile here.

Northwestern Medical Center
Porter Medical Center

Read the hospital profile here.

Rutland Regional Medical Center

Read the hospital profile here.

Southwestern Vermont Medical Center
Springfield Hospital

Read the hospital profile here.

The University of Vermont Medical Center

Read the hospital profile here.

Vermont Psychiatric Care Hospital

AMBULAtOrY SURGICAL CENTER-RELATED INFORMATION FOR CONSUMERS

Legislation passed in 2019 requires Vermont's ambulatory surgical centers to publicly report their quality of care measures. Ambulatory surgical centers are also known as surgicenters, elective same day surgery centers, or outpatient surgery centers.

Currently Vermont Eye Surgery Center is the only facility with data. Green Mountain Surgery Center opened in 2019, and we expect to have their quality of care measure data in near future.

Ambulatory Surgical Center Quality of Care Report
 

Date

Date Released by CMS

Report

Notes
Oct. 2019 Feb. 2019 ASC 2/19 Report Descriptions & Footnotes
Feb. 2020  Oct. 2019 ASC 10/19 Report Descriptions & Footnotes

More Resources

For consumers

Healthcare comparison for neighboring states:

Other healthcare quality sites:

Healthcare-related Resources:

For Vermont hospitals

Contact us

To request Hospital Report Cards from previous years, email Teri Hata at teri.hata@vermont.gov. or call (802) 657-4209.