Saint Claire Regional Medical Center · Morehead, KY
2 of 5
CMS star rating
133
Beds
4,508
Inpatient discharges a year
$281.5M
Net patient revenue a year
30
In-network payers
St. Claire Medical Center is a 133-bed government - federal hospital in Morehead, KY, affiliated with Saint Claire Regional Medical Center. Below you'll find publicly disclosed negotiated rates and facility details, including 30 in-network payers and 110 disclosed rate categories.
The 24 services St. Claire Medical Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.
Childbirth · Inpatient
MS-DRG 807
$3,756 - $7,716
from 3 insurers · median $5,754
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$5,335 - $17,474
from 3 insurers · median $8,067
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74177
$301 - $1,202
from 3 insurers · median $1,062
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$106 - $1,202
from 3 insurers · median $1,062
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$219 - $1,547
from 3 insurers · median $1,498
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$129 - $371
from 3 insurers · median $334
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$3,756 - $7,716
from 3 insurers · median $5,754
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74176
$199 - $1,202
from 3 insurers · median $1,062
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$294 - $2,134
from 3 insurers · median $1,556
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$282 - $1,202
from 3 insurers · median $1,062
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$405 - $2,154
from 3 insurers · median $1,603
Common here, based on CMS Medicare volume
Urology
CPT 50590
$2,746 - $11,963
from 2 insurers · median $7,354
47 Medicare claims in Level 4 Urology and Related Services (CMS 2024)
Ultrasound
CPT 76705
$88 - $820
from 3 insurers · median $728
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$386 - $2,699
from 3 insurers · median $1,450
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$366 - $2,154
from 3 insurers · median $1,556
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 470
$11,115 - $47,538
from 3 insurers · median $16,247
Hospital reports orthopedic surgery services to CMS
Cardiology and vascular testing
CPT 93880
$187 - $1,722
from 3 insurers · median $1,492
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$900 - $1,390
from 3 insurers · median $1,228
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45378
$305 - $2,938
from 3 insurers · median $1,621
Common here, based on CMS Medicare volume
MRI imaging
CPT 70551
$900 - $1,390
from 3 insurers · median $1,228
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$900 - $1,390
from 3 insurers · median $1,228
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 66984
$2,326
negotiated rate
187 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
Urology
CPT 52000
$1,312 - $1,428
from 2 insurers · median $1,370
84 Medicare claims in Level 2 Urology and Related Services (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 743
$7,066 - $25,050
from 3 insurers · median $10,646
Hospital reports inpatient surgical services to CMS
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 23 | 364% | 12 | 2 |
| Insurer B* | 24 | 298% | 10 | 11 |
| Insurer C* | 21 | 82% | 1 | 15 |
How we chose these services: 3 appear in this hospital's own Medicare claims, 16 are common here based on CMS Medicare volume, and 5 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for St. Claire Medical Center, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
2 of 5 stars
Doctors and services
Accredited by The Joint Commission
Finances
$281.5M net patient revenue
Ownership and leadership
Federal
The employer identification numbers (EINs) health plans and networks list for St. Claire Medical Center in the in-network rate files they publish, with the organization NPIs billed under each.
| Tax ID (EIN) | Plans and networks listing it | Organization NPIs |
|---|---|---|
| 61-0605336(multi-state) St. Claire Medical Center INC | 45Aetna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter, Ameri Health and 40 more | 1124078696 St Claire Medical Center Inc1043736135 St. Claire Medical Center Inc.1013957620 St. Claire Medical Center Inc.and 47 more |
Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.
222 Medical Circle, Morehead, KY 40351
(606) 783-6502
How St. Claire Medical Center compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
2 of 5
Lower than 73% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
No different on 7 measures
0 better, 7 no different, 0 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
Better on 1 of 5 measures
1 better, 4 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
Worse on 2 of 8 measures
0 better, 6 no different, 2 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
4 of 5
Higher than 60% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
68%
Lower than 61% of US hospitals
US median: 71%
Surveyed patients who would definitely recommend the hospital
Hospital-acquired condition penalty
Not penalized
Not among the worst-performing 25%
Medicare cuts payments 1% for the worst-performing 25% of hospitals on infections and injuries acquired in the hospital
Serious complications (PSI 90)
1.07
Higher than 76% of US hospitals
US median: 0.96
Risk-adjusted composite of complications such as bedsores, falls with hip fracture and blood clots after surgery; lower is better
Time in the ER before going home
178 min
Higher than 69% of US hospitals
US median: 148 min
Median minutes from arrival to leaving for ER patients who were sent home; lower is better
Sepsis care
87%
Higher than 94% of US hospitals
US median: 65%
Patients with severe sepsis or septic shock who got every step of the recommended early treatment; higher is better
| Measure | Result | Period |
|---|---|---|
| Overall star ratingCMS: Overall hospital quality star rating | 2 of 5 | |
| Death rates | No different on 7 measures | |
| Safety | Better on 1 of 5 measures | |
| Readmissions | Worse on 2 of 8 measures | |
| Patient survey ratingCMS: Summary star rating | 4 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 68% | 2024-10-01 to 2025-09-30 |
| Hospital-acquired condition penaltyCMS: HAC Reduction Program payment reduction | Not penalized | 2026 |
| Serious complications (PSI 90)CMS: Patient safety and adverse events composite (PSI 90) | 1.07 | 2022-07-01 to 2024-06-30 |
| Time in the ER before going homeCMS: 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 | 178 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 87% | 2024-10-01 to 2025-09-30 |
Source: CMS Provider Data Catalog, released 2026-08-13. US comparisons rank this facility among every facility CMS reports for each measure. See Medicare Care Compare.
How Medicare adjusts St. Claire Medical Center's inpatient payments for its readmissions, quality and cost results.
-0.95% on Medicare payments
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
+0.69% on Medicare payments
Value-based purchasing
Hospital Value-Based Purchasing bonus or reduction for quality and cost, as estimated in the FY 2027 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2027).
Each result CMS publishes for St. Claire Medical Center, beside the US median and the average of KY hospitals. The rank says what share of US hospitals the result is better or worse than; counts and confidence limits are not ranked.
Risk-adjusted 30-day death rates and surgical complications; lower is better.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 · 26 cases | 3.9 | 4.1 | 4.2 | Better than 57% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 1,364 cases | 4.2 | 3.9 | 4.543 | Worse than 63% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 · 40 cases | 11.8 | 11.8 | 12.11 | Worse than 49% of US hospitals | |
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.485 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 · 42 cases | 8.8 | 8.5 | 9.152 | Worse than 58% of US hospitals | |
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 114 cases | 9.7 | 11 | 11.98 | Better than 74% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 200 cases | 16 | 15.2 | 16.6 | Worse than 62% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 · 67 cases | 11.6 | 11.6 | 12.38 | Better than 50% of US hospitals | |
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 1,192 cases | 0.39 | 0.51 | 0.6092 | No Different Than the National Rate | Better than 68% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 · 29 cases | 209 | 173 | 185 | No Different Than the National Rate | Worse than 93% of US hospitals |
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 1,748 cases | 0.19 | 0.2 | 0.2113 | No Different Than the National Rate | Better than 66% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 1,804 cases | 0.3 | 0.27 | 0.2787 | No Different Than the National Rate | Worse than 78% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 262 cases | 2.2 | 2.29 | 2.306 | No Different Than the National Rate | Better than 66% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 · 50 cases | 1.65 | 1.63 | 1.711 | No Different Than the National Rate | Worse than 55% of US hospitals |
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 · 56 cases | 10.93 | 8.88 | 10.2 | No Different Than the National Rate | Worse than 75% of US hospitals |
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 274 cases | 4.54 | 3.4 | 3.435 | No Different Than the National Rate | Worse than 92% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 · 50 cases | 6.79 | 5.105 | 5.85 | No Different Than the National Rate | Worse than 91% of US hospitals |
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 · 45 cases | 1.74 | 1.72 | 1.761 | No Different Than the National Rate | Worse than 59% of US hospitals |
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 235 cases | 1.3 | 1.02 | 1.077 | No Different Than the National Rate | Worse than 88% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 13.02 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 133 cases | -28.8 | 1.25 | 9.521 | Better than 87% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 230 cases | 24.8 | 3.85 | 12.61 | Worse than 77% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)2024-07-01 to 2025-06-30 | Not Available | ||||
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)2022-01-01 to 2024-12-31 · 321 cases | 12.9 | 12.9 | 13.03 | No Different Than the National Rate | Better than 50% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 · 48 cases | 11.3 | 10.7 | 10.97 | No Different Than the National Rate | Worse than 67% of US hospitals |
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 · 48 cases | 5.1 | 5.3 | 5.4 | No Different Than the National Rate | Better than 62% of US hospitals |
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 · 135 cases | 1.1 | 1 | 1.027 | No Different than expected | Worse than 69% of US hospitals |
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 86 cases | 14.1 | 14.4 | 14.42 | Better than 61% of US hospitals | |
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 10.55 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 106 cases | 19.3 | 19.8 | 19.89 | Better than 73% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 272 cases | 23.1 | 21.3 | 21.36 | Worse than 91% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 · 26 cases | 6.1 | 5.8 | 6.142 | Worse than 66% of US hospitals | |
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 455 cases | 19.8 | 17.2 | 17.37 | Worse than 98% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | 0.323 | 0.172 | 0.339 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | 3.454 | 1.504 | 2.151 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 2,697 | 1,370 | 2,960 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 2.364 | 0.9835 | 2.924 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 3 | 0 | 2.453 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | 1.269 | 0.484 | 0.7803 | No Different than National Benchmark | Worse than 91% of US hospitals |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | 0.782 | 0.138 | 0.2917 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | 2.941 | 1.392 | 2.135 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 5,512 | 1,799 | 3,041 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 5.615 | 1.377 | 3.578 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 9 | 0 | 2.172 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | 1.603 | 0.399 | 0.5965 | No Different than National Benchmark | Worse than 96% of US hospitals |
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.4763 | No Different than National Benchmark | ||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | 2.239 | 2.135 | 2.932 | No Different than National Benchmark | |
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 49 | 61 | 98 | No Different than National Benchmark | |
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 1.338 | 1.591 | 2.685 | No Different than National Benchmark | |
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 0 | 1 | 2.881 | No Different than National Benchmark | |
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | 0 | 0.7155 | 0.9389 | No Different than National Benchmark | The best result, shared by 19% of US hospitals |
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2818 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.126 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | 15 | 38 | 73.52 | ||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | 0.173 | 0.328 | 0.6952 | ||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 0.8043 | ||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 0.9479 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2803 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.29 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 23,311 | 14,451 | 34,235 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.826 | 0.567 | 2.406 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.093 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.7481 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | 0.061 | 0.127 | 0.149 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 0.654 | 0.747 | 1.678 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 22,660 | 13,646 | 31,551 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 12.48 | 5.683 | 15.64 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 3 | 2 | 5.011 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0.24 | 0.279 | 0.3987 | Better than the National Benchmark | Better than 56% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 690 cases | 72 | 73 | 74.59 | Worse than 53% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 690 cases | 9 | 8 | 7.987 | Worse than 53% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 690 cases | 19 | 18 | 17.42 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 690 cases | 87 | 87 | 86.82 | Better than 47% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 690 cases | 4 | 4 | 3.533 | Better than 47% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 690 cases | 83 | 80 | 82.24 | Better than 69% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 690 cases | 93 | 91 | 92.18 | Better than 69% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 690 cases | 4 | 4 | 3.772 | Worse than 42% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 690 cases | 4 | 3 | 3.8 | Better than 51% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 690 cases | 13 | 16 | 13.99 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 690 cases | 81 | 79 | 81.87 | Better than 59% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 690 cases | 92 | 91 | 91.67 | Better than 63% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 690 cases | 5 | 5 | 4.823 | Better than 44% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 690 cases | 4 | 3 | 3.417 | Better than 63% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 690 cases | 14 | 16 | 13.3 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 690 cases | 65 | 61 | 63.23 | Better than 68% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 690 cases | 80 | 77 | 78.17 | Better than 72% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 690 cases | 17 | 19 | 18.58 | Better than 63% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 690 cases | 3 | 3 | 2.833 | Better than 47% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 690 cases | 18 | 19 | 18.19 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 690 cases | 87 | 86 | 85.77 | Better than 55% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 690 cases | 13 | 13 | 13.37 | Better than 47% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 690 cases | 4 | 3 | 3.317 | Better than 55% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 690 cases | 87 | 87 | 86.63 | Better than 47% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 690 cases | 14 | 14 | 14.65 | Better than 49% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 690 cases | 86 | 86 | 85.35 | Better than 49% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 690 cases | 75 | 74 | 76.86 | Better than 55% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 690 cases | 6 | 7 | 6.333 | Better than 53% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 690 cases | 19 | 19 | 16.81 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 690 cases | 80 | 77 | 80.25 | Better than 65% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 690 cases | 5 | 6 | 5.278 | Better than 53% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 690 cases | 15 | 17 | 14.47 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 690 cases | 87 | 85 | 87.39 | Better than 62% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 690 cases | 4 | 3 | 3.125 | Worse than 51% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 690 cases | 9 | 11 | 9.486 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 690 cases | 8 | 8 | 7.544 | Worse than 48% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 690 cases | 24 | 20 | 19.38 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 690 cases | 68 | 72 | 73.08 | Worse than 64% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 690 cases | 88 | 88 | 88.38 | Worse than 45% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 690 cases | 3 | 3 | 3.333 | Worse than 45% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 690 cases | 76 | 74 | 75.21 | Better than 59% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 690 cases | 9 | 9 | 9.458 | Better than 48% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 690 cases | 15 | 16 | 15.33 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 690 cases | 78 | 75 | 77.63 | Better than 70% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 690 cases | 6 | 5 | 5.153 | Worse than 51% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 690 cases | 16 | 20 | 17.22 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 690 cases | 80 | 77 | 79.5 | Better than 69% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 690 cases | 4 | 4 | 4.028 | Better than 45% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 690 cases | 16 | 19 | 16.47 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 690 cases | 90 | 86 | 88 | Better than 77% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 690 cases | 2 | 3 | 2.556 | Better than 50% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 690 cases | 8 | 11 | 9.444 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 690 cases | 53 | 59 | 62.39 | Worse than 71% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 690 cases | 14 | 9 | 8.089 | Worse than 76% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 690 cases | 33 | 31 | 29.52 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 690 cases | 78 | 82 | 83.2 | Worse than 72% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 690 cases | 3 | 3 | 3.633 | Worse than 44% of US hospitals | |
| "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it)2024-10-01 to 2025-09-30 · 690 cases | 5 | 5 | 5.19 | Better than 45% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 690 cases | 68 | 71 | 70.95 | Worse than 61% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 690 cases | 87 | 87 | 86.8 | Worse than 49% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 690 cases | 27 | 23 | 23.86 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 690 cases | 4 | 4 | 3.6 | Better than 42% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 690 cases | 54 | 47 | 50.82 | Better than 78% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 690 cases | 25 | 30 | 28.18 | Better than 74% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 690 cases | 21 | 22 | 21 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 690 cases | 4 | 3 | 3.433 | Better than 60% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 690 cases | 11 | 12 | 11.93 | Better than 59% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 690 cases | 89 | 88 | 88.07 | Better than 59% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | low | ||||
| Global Malnutrition Composite Score2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Diagnosis Documented2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Risk Screening2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutrition Assessment2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutritional Care Plan2024-01-01 to 2024-12-31 | Not Available | ||||
| Hospital Harm - Severe Hyperglycemia2024-01-01 to 2024-12-31 | Not Available | 8.032 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 · 1,484 cases | 2 | 1 | 1.132 | Worse than 72% of US hospitals | |
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.4286 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 2,186 cases | 95 | 79 | 74.25 | Better than 86% of US hospitals | |
| 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 better2024-10-01 to 2025-09-30 · 396 cases | 178 | 154 | 153 | Worse than 65% of US hospitals | |
| 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 better2024-10-01 to 2025-09-30 · 387 cases | 178 | 148 | 147 | Worse than 69% of US hospitals | |
| Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 227 | |||
| Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 305 | |||
| Left before being seen2024-01-01 to 2024-12-31 · 13,848 cases | 3 | 1 | 1.418 | Worse than 78% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 68.9 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 66 cases | 92 | 97 | 93.89 | Worse than 72% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | ||||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 63.27 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 1,230 cases | 18 | 15 | 16.73 | Worse than 73% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 763 cases | 87 | 65 | 66.02 | Better than 94% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 267 cases | 90 | 73 | 74.36 | Better than 86% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 204 cases | 96 | 88 | 85.06 | Better than 78% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 763 cases | 93 | 82 | 81.94 | Better than 90% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 444 cases | 99 | 94 | 94.58 | Better than 86% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 | Not Available | 96.88 | |||
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 74 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 · 30 cases | 90 | 94 | 92.33 | Worse than 77% of US hospitals | |
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 2,895 cases | 63 | 90 | 76.94 | Worse than 84% of US hospitals | |
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 93.3 |
How often scans were ordered when they may not be needed; lower is better.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 2.7 | 5 | 7.251 | Better than 78% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | 3.9 | 6.6 | 6.595 | Better than 85% of US hospitals |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 0.92 | 0.99 | 1.007 | Better than 81% of US hospitals |
Measures CMS reports for the hospital's psychiatric unit or for a psychiatric hospital.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Follow-up care within 30 days after psychiatric hospitalization2023-07-01 to 2024-06-30 | Not Available | 58.28 | |||
| Follow-up care within 7 days after psychiatric hospitalization2023-07-01 to 2024-06-30 | Not Available | 30.75 | |||
| Hours of physical-restraint use per 1,000 psychiatric patient hours2024-01-01 to 2024-12-31 · 4,651 cases | 0.73 | 0.05 | 0.1626 | Better than 92% of US hospitals | |
| Hours of seclusion use per 1,000 psychiatric patient hours2024-01-01 to 2024-12-31 · 4,651 cases | 0.59 | 0.03 | 0.09704 | Better than 90% of US hospitals | |
| Psychiatric patients screened for and given the flu vaccine2024-10-01 to 2025-03-31 · 295 cases | 93 | 87 | 83.48 | Better than 67% of US hospitals | |
| Medication continuation after psychiatric discharge2022-07-01 to 2024-06-30 | Not Available | 76.4 | |||
| Readmitted to any hospital within 30 days of psychiatric discharge2022-07-01 to 2024-06-30 · 106 cases | 21.4 | 19.1 | 19.53 | No Different Than the National Rate | Worse than 80% of US hospitals |
| Psychiatric patients screened for metabolic disorders2024-01-01 to 2024-12-31 · 329 cases | 97 | 92 | 90.93 | Better than 70% of US hospitals | |
| Alcohol use brief intervention provided or offered2024-01-01 to 2024-12-31 · 80 cases | 78 | 74 | 70.89 | Better than 53% of US hospitals | |
| Alcohol use brief intervention provided2024-01-01 to 2024-12-31 · 73 cases | 81 | 81 | 80.93 | Better than 50% of US hospitals | |
| Alcohol and other drug use disorder treatment provided or offered at discharge2024-01-01 to 2024-12-31 · 133 cases | 85 | 77 | 83.83 | Better than 60% of US hospitals | |
| Alcohol and other drug use disorder treatment provided at discharge2024-01-01 to 2024-12-31 · 133 cases | 38 | 56 | 62.17 | Worse than 68% of US hospitals | |
| Tobacco use treatment provided or offered at discharge2024-01-01 to 2024-12-31 · 224 cases | 100 | 64 | 64.23 | The best result, shared by 5% of US hospitals | |
| Tobacco use treatment provided at discharge2024-01-01 to 2024-12-31 · 224 cases | 0 | 4 | 13.77 | The worst result, shared by 31% of US hospitals | |
| Discharged patients who received a transition record with the specified elements2024-01-01 to 2024-12-31 · 624 cases | 93 | 77 | 77.04 | Better than 71% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 10 | 20 | 14.1 | Worse than 70% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 2.5 | 5 | 3.571 | Worse than 70% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 50 | 10 | 19.82 | Better than 84% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 12.5 | 2.5 | 5.134 | Better than 83% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 64 | 34 | 44.76 | Better than 89% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 16 | 8.75 | 11.37 | Better than 88% of US hospitals | |
| VBP safety domain scoreFY 2026 | 32 | 40 | 46.5 | Worse than 65% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 8 | 10 | 11.8 | Worse than 65% of US hospitals | |
| VBP total performance scoreFY 2026 | 39 | 29.5 | 31.05 | Better than 78% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 52 | 56 | 42.5 | 17.5 | 25 | 10 |
| VBP clinical outcomes weighted domain score | 13 | 14 | 10.63 | 4.375 | 6.25 | 2.5 |
| VBP efficiency and cost reduction domain score | 40 | Not Available | 0 | 40 | 40 | 50 |
| VBP efficiency and cost reduction weighted domain score | 10 | Not Available | 0 | 10 | 10 | 12.5 |
| VBP person and community engagement domain score | 36 | Not Available | Not Available | 9 | 36 | 64 |
| VBP person and community engagement weighted domain score | 9 | Not Available | Not Available | 2.25 | 9 | 16 |
| VBP safety domain score | 66.67 | Not Available | Not Available | 56.67 | 42.5 | 32 |
| VBP safety weighted domain score | 16.67 | Not Available | Not Available | 14.17 | 10.63 | 8 |
| VBP total performance score | 48.67 | Not Available | Not Available | 30.79 | 35.88 | 39 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | 1.013 | 0.9995 | 1.011 | Worse than 58% of US hospitals | |
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9628 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | 1.018 | 0.9969 | 1.008 | Worse than 67% of US hospitals | |
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 · 163 cases | 1.022 | 0.9983 | 1.009 | Worse than 65% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | N/A | 1.084 | |||
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 · 238 cases | 1.107 | 0.9955 | 1.006 | Worse than 93% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | 0.9864 | 0.9626 | 0.9411 | 0.9828 | 0.9591 | 1.013 |
| READM-30-CABG-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-COPD-HRRP | 1.009 | 1.025 | 1.028 | 1.082 | 1.093 | 1.018 |
| READM-30-HF-HRRP | 1.032 | 1.059 | 1.052 | 1.012 | 1.08 | 1.022 |
| READM-30-HIP-KNEE-HRRP | 1.14 | 1.147 | 1.084 | N/A | N/A | N/A |
| READM-30-PN-HRRP | 1.069 | 1.039 | 1.049 | 1.035 | 1.077 | 1.107 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | St. Claire Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 0.416 | 0.489 | 0.5632 | Better than 58% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.385 | 0.346 | 0.3899 | Worse than 56% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | 1.101 | 0.559 | 0.9125 | Worse than 87% of US hospitals | |
| HAC Reduction Program payment reductionFY 2026 | No | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.6405 | 0.8459 | The best result, shared by 12% of US hospitals | |
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 1.067 | 0.9628 | 1.023 | Worse than 76% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | 1.017 | 0.7945 | 0.8867 | Worse than 65% of US hospitals | |
| Total HAC scoreFY 2026 | 0.0396 | -0.0453 | 0.1443 | Worse than 55% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | No | No | N/A | No | No | No |
| Total HAC score | -0.1066 | -0.4342 | 0 | -0.0761 | -0.2977 | 0.0396 |
Source: CMS Care Compare hospital files, latest release 2026-09-30, with program results for earlier fiscal years from CMS's archived snapshots. US medians and ranks count every hospital CMS reports; state averages are plain means of the state's reporting hospitals, not CMS's patient-weighted state rates.
The Joint Commission (since 2000)
Accreditation
Limited
Medical school affiliation
Federal
Ownership type
149
Medicare-certified beds
198
Registered nurses (full-time equivalent)
1966
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What St. Claire Medical Center reported to Medicare in its latest cost report, covering Jul 1, 2024 to Jun 30, 2025.
4,508
Inpatient discharges
Medicare 20%, Medicaid 3%
21,314
Inpatient days
58% of available bed days used
1,564
Employees (full-time equivalent)
15
Interns and residents (full-time equivalent)
Source: CMS cost report (HCRIS) (report 839844). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges St. Claire Medical Center reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 3,915 | 684 | 16,715 | 21,314 |
| Discharges | 909 | 142 | 3,457 | 4,508 |
| Average length of stay | 4.3 days | 4.8 days | 4.8 days | 4.7 days |
| Average daily census | 10.7 | 1.9 | 45.8 | 58.4 |
9,889
Medicare Advantage days
2,134 discharges
4,412
Medicaid managed care days
952 discharges
2,145
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 86 | 16,757 | 3,148 | 53% |
| Intensive care unit | 14 | 3,905 | 767 | 76% |
| Nursery | 652 | |||
| Subprovider - ipf | 20 | 4,418 | 460 | 61% |
| Subprovider - irf | 10 | 2,095 | 479 | 57% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839844, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What St. Claire Medical Center treats Medicare patients for most often, in 2024. 486 Medicare discharges in 15 published DRGs; 5% surgical; 85% in DRGs with complications (CC or MCC).
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 198 | $40,775 | $13,048 | $14,842 | 1.98 |
| Heart failure and shock with MCCMS-DRG 291, medical | 39 | $24,350 | $8,318 | $8,863 | 1.28 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 35 | $42,167 | $11,681 | $15,349 | 1.65 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 28 | $26,711 | $8,201 | $9,723 | 1.23 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 25 | $37,393 | $10,072 | $13,611 | 1.70 |
| Renal failure with CCMS-DRG 683, medical | 23 | $17,100 | $5,335 | $6,224 | 0.90 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 22 | $92,997 | $34,393 | $33,851 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 21 | $16,248 | $6,295 | $5,914 | 1.03 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 20 | $28,497 | $8,382 | $10,373 | 1.33 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 14 | $15,715 | $4,445 | $5,720 | 0.74 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 13 | $35,254 | $6,584 | $12,832 | 1.08 |
| Renal failure with MCCMS-DRG 682, medical | 13 | $23,129 | $9,779 | $8,419 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 12 | $16,857 | $4,655 | $6,136 | 0.81 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 12 | $23,438 | $9,475 | $8,532 | 1.40 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 11 | $18,413 | $6,581 | $6,702 | 1.17 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
The comprehensive outpatient service groups (APCs) St. Claire Medical Center billed Medicare for most in 2024: 951 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 1 Intraocular ProceduresAPC 5491 | 187 | 103 | $10,096 | $1,711 | $1,752 |
| Comprehensive Observation ServicesAPC 8011 | 179 | 165 | $13,328 | $2,009 | $2,090 |
| Level 2 Urology and Related ServicesAPC 5372 | 84 | 68 | $1,411 | $499 | $502 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 78 | 49 | $5,244 | $1,189 | $1,220 |
| Level 3 Urology and Related ServicesAPC 5373 | 54 | 40 | $7,604 | $1,495 | $1,516 |
| Level 4 Urology and Related ServicesAPC 5374 | 47 | 40 | $16,586 | $2,560 | $2,629 |
| Level 1 Nerve ProceduresAPC 5431 | 46 | 38 | $8,770 | $1,413 | $1,407 |
| Level 1 Endovascular ProceduresAPC 5191 | 44 | 44 | $24,505 | $2,159 | $2,208 |
| Level 5 Urology and Related ServicesAPC 5375 | 34 | 30 | $22,241 | $3,799 | $3,918 |
| Level 3 Vascular ProceduresAPC 5183 | 29 | 28 | $13,517 | $2,341 | $2,405 |
See all 19 Medicare outpatient services at St. Claire Medical Center
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.
ZIP codes with the most Medicare inpatient stays at St. Claire Medical Center in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 2,260 in 2020 to 2,888 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 40351 | 889 | 31% | 3,760 | $34.2M | 78% | 77% |
| 41164 | 407 | 14% | 1,520 | $14.7M | 50% | 49% |
| 41472 | 257 | 9% | 1,066 | $9.9M | 54% | 44% |
| 40360 | 162 | 6% | 676 | $6.4M | 33% | 31% |
| 41171 | 132 | 5% | 612 | $4.8M | 57% | 54% |
| 40313 | 131 | 5% | 535 | $4.3M | 90% | 81% |
| 41041 | 115 | 4% | 461 | $4.4M | 26% | 11% |
| 40322 | 98 | 3% | 445 | $3.7M | 38% | 38% |
| 40371 | 92 | 3% | 440 | $3.9M | 61% | 66% |
| 40387 | 82 | 3% | 332 | $3.4M | 54% | 49% |
| 41093 | 69 | 2% | 451 | $3M | 49% | 36% |
| 41049 | 63 | 2% | 270 | $2.8M | 79% | 56% |
| 40353 | 42 | 1% | 258 | $2.2M | 3% | 3% |
| 41056 | 42 | 1% | 141 | $1.3M | 5% | 2% |
| 40358 | 37 | 1% | 132 | $1.4M | 100% | 100% |
| 41179 | 31 | 1% | 141 | $1.3M | 9% | 10% |
| 41039 | 27 | 1% | 124 | $990,232 | 20% | |
| 40621 | 25 | 1% | 116 | $867,163 | 2% | 1% |
| 41143 | 25 | 1% | 107 | $758,225 | 3% | 3% |
| 41425 | 25 | 1% | 127 | $1.2M | 100% | 100% |
| 41465 | 24 | 1% | 130 | $1.1M | 4% | 4% |
| 41135 | 18 | 1% | 85 | $653,941 | 100% | |
| 41408 | 16 | 1% | 55 | $556,533 | 100% | |
| 40346 | 15 | 1% | 114 | $929,462 | 56% | |
| 41301 | 14 | 0% | 67 | $516,149 | 4% |
Source: CMS Hospital Service Area file. Shares are of the 2,888 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Staff by profession and the rooms and units St. Claire Medical Center reported at its latest Medicare certification survey (2012). Counts are people, not full-time equivalents.
20
Psychiatric unit beds
10
Rehabilitation unit beds
198
Registered nurses
23
Licensed practical nurses
71
Physicians
14
Nurse practitioners
11
Physician assistants
6
Nurse anesthetists (CRNAs)
12
Pharmacists
8
Respiratory therapists
8
Physical therapists
4
Occupational therapists
3
Speech pathologists and audiologists
33
Radiology technicians
2
Nuclear medicine technicians
2
Laboratory technicians
11
Medical technologists
3
Dietitians
9
Social workers
1
Psychologists
744
Other personnel
Source: CMS Provider of Services file.
255 clinicians who bill Medicare list St. Claire Medical Center as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
Lacinda Rishel, PA-C
Physician Assistant
NPI 1619286739
See commercial rates for Lacinda Rishel, PA-CJames Rice, MD
Orthopaedic Surgery Physician
NPI 1265509285
See commercial rates for James Rice, MDCharles Crouse, MD
Orthopaedic Surgery Physician
NPI 1518131549
See commercial rates for Charles Crouse, MDMichael Boyd, MD
Family Medicine Physician
NPI 1740270115
See commercial rates for Michael Boyd, MDDavid Duff, CRNA
Certified Registered Nurse Anesthetist
NPI 1306931860
See commercial rates for David Duff, CRNAMansha Kahloon, MD
Interventional Cardiology Physician
NPI 1265498745
See commercial rates for Mansha Kahloon, MDWilliam Lewis, MD
Diagnostic Radiology Physician
NPI 1679573471
See commercial rates for William Lewis, MDAhmad Abuarqoub, M.D.
Cardiovascular Disease Physician
NPI 1568820561
See commercial rates for Ahmad Abuarqoub, M.D.Stephen Williams, M.D.
Diagnostic Radiology Physician
NPI 1598816878
See commercial rates for Stephen Williams, M.D.Evva Allen, APRN, FNP-BC
Family Nurse Practitioner
NPI 1457930430
See commercial rates for Evva Allen, APRN, FNP-BCCraig Butler, MD
Diagnostic Radiology Physician
NPI 1033119839
See commercial rates for Craig Butler, MDBrian Price, M.D.
Interventional Cardiology Physician
NPI 1962536953
See commercial rates for Brian Price, M.D.Christian Weigel, M.D.
Internal Medicine Physician
NPI 1083677421
See commercial rates for Christian Weigel, M.D.Johannes Evans, MD
Ophthalmology Physician
NPI 1780689588
See commercial rates for Johannes Evans, MDMoneera Haque, MD
Cardiovascular Disease Physician
NPI 1003063959
See commercial rates for Moneera Haque, MDAmanda Applegate, MD
Internal Medicine Physician
NPI 1831180967
See commercial rates for Amanda Applegate, MDBrigitte King, MD
Internal Medicine Physician
NPI 1780666305
See commercial rates for Brigitte King, MDKhalil Rahman, MD
Nephrology Physician
NPI 1487757951
See commercial rates for Khalil Rahman, MDAlexandra Pearcy, PA-C
Physician Assistant
NPI 1871072991
See commercial rates for Alexandra Pearcy, PA-CKristi Adams, M.D.
Blood Banking & Transfusion Medicine Physician
NPI 1881623270
See commercial rates for Kristi Adams, M.D.Colby Holmes, DPM
Foot & Ankle Surgery Podiatrist
NPI 1679956098
See commercial rates for Colby Holmes, DPMOlayemi Bolarinwa, MD
Family Medicine Physician
NPI 1376006460
See commercial rates for Olayemi Bolarinwa, MDMuhammad-Ali Zaydan, MD
Hematology & Oncology Physician
NPI 1750350633
See commercial rates for Muhammad-Ali Zaydan, MDDavid Hunt, MD
Anatomic Pathology & Clinical Pathology Physician
NPI 1881674778
See commercial rates for David Hunt, MDSource: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Revenue, expenses and income St. Claire Medical Center reported to Medicare for Jul 1, 2024 to Jun 30, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $792M | 281.4% |
| Inpatient | $222.8M | 79.2% |
| Outpatient | $569.2M | 202.2% |
| Contractual allowances and discounts | -$510.6M | -181.4% |
| Net patient revenue | $281.5M | 100.0% |
| Operating expenses | -$301.1M | -107.0% |
| Operating income from patient care | -$19.7M | -7.0% |
| Other income | $37.7M | 13.4% |
| Contributions and donations | $1.5M | 0.5% |
| Investment income | $1.3M | 0.5% |
| Other | $35M | 12.4% |
| Net income | $18.1M | 6.4% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $86.5M | 11.8% |
| Medicaid (including managed care) | $167.9M | 22.8% |
| Other payers and self-pay | $480.6M | 65.4% |
| Total charges | $735M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839844, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Computed from St. Claire Medical Center's latest cost report.
-7.0%
Operating margin
Operating income from patient care / net patient revenue
5.7%
Total margin
Net income / net patient revenue plus other income
7.1%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
54% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$47.08
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
8.3%
Return on assets
Net income for a year / total assets
13.5%
Return on equity
Net income for a year / fund balance
0.19
Long-term debt to fund balance
Mortgages, notes and loans / fund balance
2.02
Current ratio
Current assets / current liabilities
1.40
Quick ratio
Cash, temporary investments and net receivables / current liabilities
62 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
33 days
Days in patient receivables
Net patient receivables / daily net patient revenue
67 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.46
Asset turnover
Total revenue for a year / total assets
1.1 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 839844, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What St. Claire Medical Center owned and owed at the end of its reporting period (Jun 2025), across all fund types: $218M in total assets and a $134.1M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $50.4M | 23.1% |
| Patient receivables, net | $25.5M | 11.7% |
| Inventory | $4.8M | 2.2% |
| Total current assets | $109.5M | 50.2% |
| Property and equipment, net of depreciation | $99.9M | 45.8% |
| Investments and other assets | $8.7M | 4.0% |
| Total assets | $218M | 100.0% |
| Current liabilities | $54.2M | 24.9% |
| Long-term debt | $25M | 11.5% |
| Total liabilities | $83.9M | 38.5% |
| Fund balance (net assets) | $134.1M | 61.5% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839844, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care St. Claire Medical Center provided without full payment, as reported on Worksheet S-10 of its cost report.
$438,432
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$14.9M
Bad debt
Patient bills written off as uncollectible, at charges
$10.7M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$4.9M
Total unreimbursed and uncompensated care
1.6% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
Source: CMS cost report (HCRIS, Form 2552-10), report 839844, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
St. Claire Medical Center's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Jun 2020 | Jun 2021 | Jun 2022 | Jun 2023 | Jun 2024 | Jun 2025 |
|---|---|---|---|---|---|---|
| Net patient revenue | $138.1M | $156.9M | $175.2M | $204.5M | $239.8M | $281.5M |
| Operating expenses | $151.8M | $164.6M | $193.2M | $222M | $257.9M | $301.1M |
| Operating margin | -9.9% | -4.9% | -10.2% | -8.5% | -7.5% | -7.0% |
| Net income | $2M | $26.2M | $9.2M | -$9.7M | -$19.5M | $18.1M |
| Total assets | $145.3M | $164.7M | $176.2M | $160.4M | $143M | $218M |
| Discharges | 3,974 | 4,154 | 4,305 | 4,033 | 4,147 | 4,508 |
| Inpatient days | 13,511 | 16,283 | 20,469 | 18,496 | 20,280 | 21,314 |
| Medicare Advantage days | 4,193 | 5,189 | 6,736 | 6,680 | 8,540 | 9,889 |
| Beds | 129 | 129 | 126 | 133 | 133 | 133 |
| Employees (FTE) | 778 | 742 | 964 | 974 | 954 | 1,564 |
Source: CMS cost report (HCRIS, Form 2552-10), report 839844, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center St. Claire Medical Center reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Drugs charged to patients | $35.7M | $188.3M | 0.19 | ||
| Operating room | $6.1M | $19.2M | $59.8M | 0.32 | 29,790 |
| Medical supplies charged to patient | $16M | $29M | 0.55 | ||
| Emergency | $10.3M | $14.2M | $60.8M | 0.23 | 10,390 |
| Laboratory | $2.7M | $12.6M | $62.2M | 0.20 | 7,170 |
| Home health agency | $6.2M | $10.2M | $13M | 0.79 | |
| Impl. dev. charged to patients | $7.5M | $21.7M | 0.35 | ||
| Morehead medical | $9.9M | $6.8M | $6.7M | 1.02 | |
| Radiology-diagnostic | $5.9M | $6.8M | $43.8M | 0.15 | 15,700 |
| Clinic | $9.7M | $5.5M | $5.7M | 0.96 | |
| Respiratory therapy | $2.1M | $4M | $19.1M | 0.21 | 2,007 |
| Observation beds (non-distinct part | $3.3M | $3.1M | 1.08 | ||
| Scr family medicine | $3.1M | $3M | $3.3M | 0.91 | |
| Electrocardiology | $1.1M | $2.8M | $46.9M | 0.06 | |
| Rural health clinic ii | $1.1M | $2.7M | $1.8M | 1.52 | |
| Rural health clinic iv | $1.3M | $2.3M | $2.4M | 0.96 | |
| Physical therapy | $1.3M | $2.3M | $7.8M | 0.29 | 6,146 |
| Counseling services | $1.7M | $2.1M | $964,563 | 2.17 | |
| Rural health clinic | $996,205 | $2M | $1.8M | 1.12 | |
| Rural health clinic iii | $806,760 | $1.6M | $1.3M | 1.19 | |
| Occupational therapy | $1M | $1.4M | $7M | 0.19 | |
| Ultra sound | $504,382 | $1.3M | $14.1M | 0.09 | |
| Family medical morehead north | $750,551 | $1.1M | $706,024 | 1.58 | 2,500 |
| Nuclear medicine - diagnostic | $232,106 | $1M | $9.7M | 0.11 | |
| Whole blood & packed red blood cell | $932,452 | $3.6M | 0.26 | ||
| Anesthesiology | $4M | $894,462 | $18.8M | 0.05 | 443 |
| Renal dialysis | $395,926 | $748,258 | $1.3M | 0.58 | |
| Ct scan | $345,565 | $683,989 | $34.5M | 0.02 | |
| Crss podiatry | $995,079 | $499,725 | $854,842 | 0.58 | |
| Speech pathology | $296,815 | $469,255 | $2.7M | 0.18 | 409 |
| Wound care | $580,412 | $416,956 | $2.3M | 0.18 | |
| Delivery room & labor room | $396,899 | $1.4M | 0.29 | 3,088 | |
| Rural health clinic v | $304,884 | $1M | 0.30 | ||
| Pathology | $93,867 | $271,229 | $4.7M | 0.06 | |
| Rural health clinic vi | $191,776 | $816,925 | 0.23 | ||
| Recovery room | $9,342 | $156,682 | $5.6M | 0.03 | 1,825 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $14.6M | $29.5M | $23.9M | 1.24 | 37,600 |
| Intensive care unit | $3.8M | $8.7M | $10.2M | 0.85 | 9,500 |
| Subprovider - ipf | $1.8M | $5M | $5.9M | 0.85 | 13,000 |
| Subprovider - irf | $1.1M | $2.4M | $2.1M | 1.16 | 5,000 |
| Nursery | $372,592 | $309,546 | 1.20 | 720 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $14.5M | $45.8M | 54,697 | ||
| Pharmacy | $2.5M | $23.2M | 61,481 | $40.32 | 2,700 |
| Central services & supply | $971,409 | $17.7M | 34,509 | $28.15 | 4,200 |
| Employee benefits department | $755,861 | $16.3M | 22,925 | $32.97 | 2,000 |
| Operation of plant | $1.8M | $4.8M | 57,991 | $31.69 | 30,309 |
| Cap rel costs-bldg & fixt | $3.7M | 266,384 | |||
| I&r services-other prgm costs apprv | $387,188 | $3.2M | 6,800 | ||
| Housekeeping | $2.2M | $3.2M | 129,384 | $16.73 | 2,000 |
| Nursing administration | $2.3M | $3M | 43,627 | $52.34 | 2,700 |
| Medical records & library | $1.9M | $2.3M | 69,938 | $26.67 | 3,600 |
| Cafeteria | $2.1M | 65,445 | $19.40 | 4,208 | |
| Social service | $859,628 | $1.4M | 23,108 | $37.20 | 800 |
| Scr med group | $714,603 | $749,271 | |||
| Allied health | $224,267 | $707,412 | |||
| Cap rel costs-mvble equip | $694,299 | ||||
| Dietary | $1.4M | $424,672 | 8,951 | $19.40 | 6,892 |
| Scr outpatient center | $261,994 | ||||
| Laundry & linen service | $1,264 | 190 |
Source: CMS cost report (HCRIS, Form 2552-10), report 839844, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
The factors Medicare uses to set what it pays St. Claire Medical Center for an inpatient stay.
1.70
Case mix index
Higher than 52% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
Teaching hospital
Teaching status
0.10 residents per bed
Medicare-funded interns and residents per bed (FY 2027).
34.2%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
960
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Rural
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2027).
| IPPS fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 | FY 2027 |
|---|---|---|---|---|---|---|---|
| Case mix index | 1.51 | 1.51 | 1.64 | 1.79 | 1.76 | 1.78 | 1.70 |
| Wage index | 0.866 | 0.867 | 0.868 | 0.863 | 0.952 | 0.912 | 0.890 |
| Readmissions adjustment | -0.25% | -0.99% | -0.95% | -0.42% | -0.34% | -0.94% | -0.95% |
| Value-based purchasing adjustment | +0.83% | +1.12% | +1.12% | +0.44% | +0.92% | +1.21% | +0.69% |
| Medicare inpatient stays | 1,562 | 1,562 | 1,190 | 1,064 | 933 | 881 | 960 |
Source: CMS IPPS final rule Impact File (FY 2027).
The officers and board members on St. Claire Medical Center's Medicare enrollment and on the IRS Form 990 filed under its tax ID.
Source: CMS Hospital All Owners (PECOS), the people the hospital lists on its Medicare enrollment; the first 16 of 17 are shown.
| Name | Title |
|---|---|
| William L Melahn MD | Chief Medical Officer |
| Donald Lloyd II | Ceo/president, Ex-officio |
| Travis Bailey | Sr. VP Administration/cso |
| Chris Mcclurg | Cfo/treasurer |
| Kathleen Wilson | VP Nursing |
| Andy B Price | VP Info Technology/cio |
| Lesa P Hopson | Secretary |
| Sister Marla Monahan Snd | Chair |
| Dan Markwell | Vice Chairman |
Board members: O Thomas Newcomb IV, Aaron Banks DO, Marie A Dennison MD, Bob Albert PhD, Shelley Irving Pa-C, Angela M Gates, Anthony E Helton, William Redwine, Karen Nichole Smith Lnha, Sr Marge Mouch, John P Northcutt, Russell C Ward.
Source: IRS Form 990 Part VII filed by St Claire Medical Center Inc (EIN 61-0605336), via the IRS e-file data. A health system's return can cover several hospitals.
340B drug pricing program
Participating since 2005
340B ID DSH180018, registered as a disproportionate share hospital; 22 registered outpatient sites; 58 active contract pharmacies. Authorizing official: Chris McClurg, VP Financial Services/cfo.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
Helipad
St Claire Healthcare
FAA location ID 02KT, a medical-use heliport 0.1 mi from the hospital.
Source: FAA National Airspace System Resource data, cycle 2026-10-01.
St. claire psychiatric unit
CCN 18S018, certified 1988, Medicare prospective payment
St. claire rehab unit
CCN 18T018, certified 1999, Medicare prospective payment
St. claire home health agency
CCN 187037, certified 1988, Medicare prospective payment
St. claire hospice agency
CCN 181514, certified 1990
Owingsville (bath) rhc
CCN 183416, certified 1996, Medicare cost reimbursed
Frenchburg (menifee) rhc
CCN 183418, certified 1996, Medicare cost reimbursed
Sandy hook (elliott) rhc
CCN 183415, certified 1996, Medicare cost reimbursed
Olive hill (carter) rhc
CCN 183417, certified 1996, Medicare cost reimbursed
Urgent care us 60
CCN 188572, certified 2025, Medicare cost reimbursed
Urgent care i64
CCN 188571, certified 2025, Medicare cost reimbursed
Source: Worksheet S-2 Part I of St. Claire Medical Center's latest Medicare cost report (HCRIS).
About St. Claire Medical Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at St. Claire Medical Center range from $900 to $1,390 across 3 insurers. Aetna's rate is $900. The median at nearby comparable hospitals is $761. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at St. Claire Medical Center range from $301 to $1,202 across 3 insurers. Aetna's rate is $301. The median at nearby comparable hospitals is $761. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at St. Claire Medical Center range from $405 to $2,154 across 3 insurers. Blue Cross Blue Shield's rate is $1,603. The median at nearby comparable hospitals is $2,302. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at St. Claire Medical Center range from $3,756 to $7,716 across 3 insurers. Aetna's rate is $3,756. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at St. Claire Medical Center range from $129 to $371 across 3 insurers. Aetna's rate is $129. The median at nearby comparable hospitals is $185. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at St. Claire Medical Center range from $11,115 to $47,538 across 3 insurers. Blue Cross Blue Shield's rate is $16,247. The median at nearby comparable hospitals is $24,192. What a patient pays depends on their plan's deductible, coinsurance and network status.
St. Claire Medical Center has a CMS overall hospital star rating of 2 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 73% of US hospitals.
Yes. CMS counts 0.10 Medicare-funded residents per bed at St. Claire Medical Center for fiscal year 2027, so it is a teaching hospital.
Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts St. Claire Medical Center's base inpatient payments by an estimated 0.95% in fiscal year 2027 for more readmissions than expected.
In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (198 discharges), heart failure and shock with mcc (39 discharges), other kidney and urinary tract diagnoses with mcc (35 discharges).
St. Claire Medical Center's Medicare case mix index is 1.70 for fiscal year 2027, higher than 52% of hospitals paid under the inpatient prospective payment system.
St. Claire Medical Center reported 4,508 inpatient discharges and 21,314 inpatient days from Jul 1, 2024 to Jun 30, 2025.
St. Claire Medical Center reported 1,564 full-time-equivalent employees on payroll from Jul 1, 2024 to Jun 30, 2025.
St. Claire Medical Center reported $281.5M in net patient revenue on $792M of gross charges for Jul 1, 2024 to Jun 30, 2025, an operating margin of -7.0%, and net income of $18.1M.
St. Claire Medical Center reported $4.9M of unreimbursed and uncompensated care for Jul 1, 2024 to Jun 30, 2025, including $438,432 of charity care at cost.
St. Claire Medical Center's Medicare enrollment lists Donald H Lloyd as Chief Executive Officer since 2019.
Insurers' price transparency files list St. Claire Medical Center under employer identification number 61-0605336 ((multi-state) St. Claire Medical Center INC). 45 health plans and networks list 61-0605336 for it.
Yes. HRSA's 340B database lists St. Claire Medical Center (340B ID DSH180018) as a participating disproportionate share hospital since 2005, with 58 active contract pharmacies.
255 clinicians who bill Medicare list St. Claire Medical Center as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are family nurse practitioner (39), physician assistant (36), family medicine physician (29).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for St. Claire Medical Center, effective 2000.
CMS lists 38 services at St. Claire Medical Center, including Acute Renal Dialysis, Adult Inpatient Psychiatric Care, Anesthesia, Cardiac Catheterization Lab, CARF Inpatient Rehabilitation (Commission On Accreditation Of Rehabilitation Facilities Inpatient Rehabilitation), Chemotherapy.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at St. Claire Medical Center came from ZIP codes 40351 (889), 41164 (407), 41472 (257).
St. Claire Medical Center has 133 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 149 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
St. Claire Medical Center is located at 222 Medical Circle, Morehead, KY 40351. Its main phone number is (606) 783-6502.
St. Claire Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 180018.
The National Provider Identifier (NPI) on file for St. Claire Medical Center is 1124078696.
St. Claire Medical Center is affiliated with Saint Claire Regional Medical Center.
St. Claire Medical Center lists 30 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
110 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers