Saint Francis Hospital


About the Facility

CMS Certification Number (CCN)
44T183
Ownership Type
For Profit
CMS Region
Atlanta
Certification Date
Address
5959 Park Avenue
Phone Number
(901) 765-2400

Facility Medical Condition Statistics

All other conditions
57
Brain disease or condition (non-traumatic)
Data not available for this reporting period.
Brain injury (traumatic)
-
Hip or femur fracture
21
Hip or knee replacement, amputation or other bone or joint condition
17
Nervous system disorder (excluding stroke)
Data not available for this reporting period.
Spinal cord disease or condition (non-traumatic)
Data not available for this reporting period.
Spinal cord injury (traumatic)
Data not available for this reporting period.
Stroke
43

Facility Quality of Patient Care Measures

Catheter-associated urinary tract infections (CAUTI)
Standardized infection ratio (SIR) 95% confidence interval - lower limit
Not Available
SIR 95% confidence interval - upper limit
Not Available
Comparative performance category
Not Available
Catheter days
37
Predicted number of infections (B)
0.097
Number of infections reported (A)
1
SIR (A/B)
Not Available
Percentage of patients whose functional abilities were assessed and functional goals were included in their treatment plan
Numerator
138
Denominator
138
Facility rate
100.0
Change in patients ability to care for themselves
Average risk-adjusted change score
12.0
Denominator
124
Average observed change score
9.5
Change in patients ability to move around
Average risk-adjusted change score
22.6
Denominator
124
Average observed change score
20.8
Percentage of patients who are at or above an expected ability to care for themselves at discharge
Numerator
79
Denominator
124
Facility rate
63.7
Percentage of patients who are at or above an expected ability to move around at discharge
Numerator
24
Denominator
124
Facility rate
19.4
Percentage of IRF patients who experience one or more falls with major injury during their IRF stay
Numerator
0
Denominator
138
Facility rate
0.0
Clostridium difficile Infection (CDI)
Standardized infection ratio (SIR) 95% confidence interval - lower limit
Not Available
SIR 95% confidence interval - upper limit
1.051
Comparative performance category
No Different than the National Benchmark
Patient days
8,395
Predicted number of infections (B)
2.849
Number of infections reported (A)
0
SIR (A/B)
0.000
Percentage of healthcare personnel who got a flu shot for the current season
Number of health care workers vaccinated
26
Number of health care workers
40
Rate of flu vaccination
65.0
Rate of potentially preventable hospital readmissions 30 days after discharge from an IRF
Number of potentially preventable readmissions following discharge
11
Number of eligible stays
147
Unadjusted potentially preventable readmission rate
7.48
Risk-standardized potentially preventable readmission rate (RSRR)
8.69
Lower limit of the 95% confidence interval on the RSRR
6.57
Upper limit of the 95% confidence interval on the RSRR
11.00
Comparative performance category
No Different than the National Rate
Rate of potentially preventable hospital readmissions during the IRF stay
Number of potentially preventable readmissions
10
Number of eligible stays
170
Unadjusted potentially preventable readmission rate
5.88
Risk-standardized potentially preventable readmission rate (RSRR)
5.77
Lower limit of the 95% confidence interval on the RSRR
3.50
Upper limit of the 95% confidence interval on the RSRR
8.72
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)
85
Number of eligible stays
121
Observed discharge to community rate
70.25
Risk-standardized discharge to community rate
65.36
Lower limit of the 95% confidence interval on the risk-standardized discharge to community rate
59.34
Upper limit of the 95% confidence interval on the risk-standardized discharge to community rate
70.71
Comparative performance category
No Different than the National Rate
Medicare Spending Per Beneficiary (MSPB) for patients in IRFs
MSPB score
0.91
Number of eligible episodes
141
Percentage of patients whose medications were reviewed and who received follow-up care when medication issues were identified
Numerator
133
Denominator
138
Facility rate
96.4
Percentage of patients with pressure ulcers/pressure injuries that are new or worsened
Numerator
2
Denominator
137
Facility observed rate
1.5
Facility risk-adjusted rate
2.0
Percentage of IRF healthcare personnel who completed COVID-19 primary vaccination series
Number of health care workers vaccinated
29
Number of health care workers
64
Rate of COVID-19 vaccination
45.3