Critical access hospitals with the highest readmission rates

The Centers for Medicare and Medicaid Services (CMS) created the Hospital Readmissions Reduction Program (HRRP) in 2012. The goal of this program is to reduce 30-day readmissions for the following six conditions:

This value-based care reimbursement program is designed to improve care coordination and link payment to the quality of care the hospital provides to patients. Providing the highest level of care and reducing complications are goals of all hospitals.

Critical access hospitals (CAHs), which provide essential care to rural populations that might not otherwise have healthcare access, are exempt from high readmission rate reimbursement penalties but still report readmission rates to CMS and track rates as a measure of hospital performance.

We reviewed the all-cause readmission rates for 910 CAHs tracked in the Definitive Healthcare HospitalView product. Here are the top 25 critical access hospitals by all-cause hospital-wide readmission rate.

Top 25 CAHs by all-cause hospital-wide readmission rate

Rank Definitive ID Hospital Name Location Number of staffed beds Number of discharges All cause hospital-wide readmission rate
1 4467 St Joseph's Hospital Buckhannon, WV 25 859 16.80%
2 6311 Towner County Medical Center Cando, ND 20 149 16.70%
3 1069 Wills Memorial Hospital Washington, GA 25 291 16.70%
4 3908 Coon Memorial Hospital Dalhart, TX 21 601 16.60%
5 2606 Desert View Hospital Pahrump, NV 25 1,277 16.60%
6 4559 Richland Hospital Richland Center, WI 25 840 16.50%
7 3878 Memorial Medical Center Port Lavaca, TX 25 688 16.40%
8 2728 Mimbres Memorial Hospital Deming, NM 25 1,091 16.40%
9 1592 Neosho Memorial Regional Medical Center Chanute, KS 21 1,352 16.40%
10 5407 North Caddo Medical Center Vivian, LA 25 598 16.40%
11 1477 Burgess Health Center Onawa, IA 25 418 16.30%
12 3892 Coleman County Medical Center Coleman, TX 25 446 16.30%
13 1598 Phillips County Hospital Phillipsburg, KS 25 220 16.30%
14 463 Tahoe Forest Hospital Truckee, CA 25 1,464 16.30%
15 2944 Cape Fear Valley - Bladen County Hospital Elizabethtown, NC 25 559 16.20%
16 1268 Horizon Health Paris, IL 25 518 16.20%
17 2088 Marlette Regional Hospital Marlette, MI 25 200 16.20%
18 1930 Marthas Vineyard Hospital Oak Bluffs, MA 25 892 16.20%
19 2598 Mesa View Regional Hospital Mesquite, NV 25 1,100 16.20%
20 1499 Myrtue Medical Center Harlan, IA 25 525 16.20%
21 3165 OhioHealth Hardin Memorial Hospital Kenton, OH 25 346 16.20%
22 3877 Ascension Seton Edgar B Davis Luling, TX 23 546 16.10%
23 4422 Braxton County Memorial Hospital Gassaway, WV 25 310 16.10%
24 1267 Carle Hoopeston Regional Health Center Hoopeston, IL 22 305 16.10%
25 3169 Hocking Valley Community Hospital Logan, OH 25 401 16.10%

Fig. 1 Data is from the Definitive Healthcare HospitalView product. All-cause hospital readmission rates are sourced from CMS Hospital Compare. Data accurate as of July 2022.

Which critical access hospitals have the highest all-cause readmission rates?

St. Joseph's Hospital in Buckhannon, West Virginia has the highest all-cause readmission rates among CAHs at 16.80%. Towner County Medical Center and Wills Memorial Hospital have readmission rates of 16.70%. Four of the CAHs on the list are located in Texas.

We might expect that hospitals with more total discharges to report higher readmission rates. With each patient discharge, there is a risk for 30-day readmission. Interestingly, there does not seem to be a correlation between total discharges and readmission rate.

For instance, some of the top 25 CAHs report more than 1,000 total discharges and have readmission rates similar to hospitals with about 200 discharges. Instead, these differences may be due to factors such as the case complexity or co-morbidities of recent patients receiving care at the hospital.

What is the average all-cause hospital-wide readmission rate?

The average all-cause hospital-wide readmission rate for U.S. hospitals is 15.50%. This is based on readmission data from 4,100 hospitals tracked in the Definitive Healthcare HospitalView product. Rates range from 11.50% to 21.20%.

The current average represents a slight decrease in all-cause readmission rates. Compared to a previous analysis of this data in September 2020, the average all-cause readmission rate at U.S. hospitals was 15.59%.

What are critical access hospitals?

Critical access hospitals (CAHs) are defined by the Centers for Medicare and Medicaid Services (CMS) as healthcare facilities that:

  • have fewer than 25 acute care inpatient beds
  • are located more than 35 miles from the nearest hospital (or 15 miles by mountain or secondary roads)
  • maintain an average length of stay of 96 hours or less
  • must provide 24-hour emergency care services

The Definitive Healthcare HospitalView product tracks more than 1,400 CAHs.

Because of this designation and the areas in which they are located, CAHs usually have less specialists, limited service line offerings, have less access to funding and employ fewer physicians.

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