St. Josephs Wayne Hospital


About the Facility

CMS Certification Number (CCN)
31T019
Ownership Type
Non-profit
CMS Region
New York
Certification Date
Address
224 Hamburg Tpk
Phone Number
(973) 754-2481

Facility Medical Condition Statistics

All other conditions
72
Brain disease or condition (non-traumatic)
17
Brain injury (traumatic)
17
Hip or femur fracture
44
Hip or knee replacement, amputation or other bone or joint condition
36
Nervous system disorder (excluding stroke)
12
Spinal cord disease or condition (non-traumatic)
Data not available for this reporting period.
Spinal cord injury (traumatic)
-
Stroke
89

Facility Quality of Patient Care Measures

Catheter-associated urinary tract infections (CAUTI)
Standardized infection ratio (SIR) 95% confidence interval - lower limit
0.043
SIR 95% confidence interval - upper limit
4.230
Comparative performance category
No Different than the National Benchmark
Catheter days
614
Predicted number of infections (B)
1.166
Number of infections reported (A)
1
SIR (A/B)
0.858
Percentage of patients whose functional abilities were assessed and functional goals were included in their treatment plan
Numerator
280
Denominator
280
Facility rate
100.0
Change in patients ability to care for themselves
Average risk-adjusted change score
8.9
Denominator
244
Average observed change score
8.7
Change in patients ability to move around
Average risk-adjusted change score
17.5
Denominator
244
Average observed change score
19.2
Percentage of patients who are at or above an expected ability to care for themselves at discharge
Numerator
65
Denominator
244
Facility rate
26.6
Percentage of patients who are at or above an expected ability to move around at discharge
Numerator
27
Denominator
244
Facility rate
11.1
Percentage of IRF patients who experience one or more falls with major injury during their IRF stay
Numerator
0
Denominator
280
Facility rate
0.0
Clostridium difficile Infection (CDI)
Standardized infection ratio (SIR) 95% confidence interval - lower limit
0.143
SIR 95% confidence interval - upper limit
2.811
Comparative performance category
No Different than the National Benchmark
Patient days
5,605
Predicted number of infections (B)
2.351
Number of infections reported (A)
2
SIR (A/B)
0.851
Percentage of healthcare personnel who got a flu shot for the current season
Number of health care workers vaccinated
9
Number of health care workers
9
Rate of flu vaccination
100.0
Rate of potentially preventable hospital readmissions 30 days after discharge from an IRF
Number of potentially preventable readmissions following discharge
16
Number of eligible stays
263
Unadjusted potentially preventable readmission rate
6.08
Risk-standardized potentially preventable readmission rate (RSRR)
8.28
Lower limit of the 95% confidence interval on the RSRR
6.50
Upper limit of the 95% confidence interval on the RSRR
10.31
Comparative performance category
No Different than the National Rate
Rate of potentially preventable hospital readmissions during the IRF stay
Number of potentially preventable readmissions
13
Number of eligible stays
288
Unadjusted potentially preventable readmission rate
4.51
Risk-standardized potentially preventable readmission rate (RSRR)
5.02
Lower limit of the 95% confidence interval on the RSRR
3.49
Upper limit of the 95% confidence interval on the RSRR
7.13
Comparative performance category
No Different than the National Rate
Rate of successful return to home or community from an IRF
Observed number of discharges to community (DTC)
177
Number of eligible stays
260
Observed discharge to community rate
68.08
Risk-standardized discharge to community rate
66.28
Lower limit of the 95% confidence interval on the risk-standardized discharge to community rate
61.15
Upper limit of the 95% confidence interval on the risk-standardized discharge to community rate
70.72
Comparative performance category
No Different than the National Rate
Medicare Spending Per Beneficiary (MSPB) for patients in IRFs
MSPB score
0.93
Number of eligible episodes
265
Percentage of patients whose medications were reviewed and who received follow-up care when medication issues were identified
Numerator
280
Denominator
280
Facility rate
100.0
Percentage of patients with pressure ulcers/pressure injuries that are new or worsened
Numerator
0
Denominator
280
Facility observed rate
0.0
Facility risk-adjusted rate
0.0
Percentage of IRF healthcare personnel who completed COVID-19 primary vaccination series
Number of health care workers vaccinated
33
Number of health care workers
34
Rate of COVID-19 vaccination
97.1