Quorum Health · Louisa, KY
3 of 5
CMS star rating
84
Beds
864
Inpatient discharges a year
$53.3M
Net patient revenue a year
33
In-network payers
Three Rivers Medical Center is an 84-bed proprietary hospital in Louisa, KY, affiliated with Quorum Health. Below you'll find publicly disclosed negotiated rates and facility details, including 33 in-network payers and 146 disclosed rate categories.
The 24 services Three Rivers 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.
CT imaging
CPT 74177
$425 - $5,720
from 4 insurers · median $4,650
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$1,465 - $4,118
from 4 insurers · median $3,219
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$8,960 - $77,786
from 2 insurers · median $43,373
Typical for a hospital with this service line
CT imaging
CPT 74176
$425 - $4,802
from 4 insurers · median $3,753
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$1,346 - $11,429
from 2 insurers · median $6,388
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$3,141 - $13,772
from 2 insurers · median $8,456
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$2,537 - $5,949
from 4 insurers · median $4,024
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$1,993 - $3,466
from 2 insurers · median $2,729
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$425 - $1,415
from 2 insurers · median $920
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$700 - $5,589
from 4 insurers · median $4,543
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$8,301
negotiated rate
Common here, based on CMS Medicare volume
Ultrasound
CPT 76705
$669 - $1,775
from 4 insurers · median $1,287
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93880
$1,686 - $4,738
from 4 insurers · median $3,703
Common here, based on CMS Medicare volume
Urology
CPT 50590
$12,139 - $46,366
from 4 insurers · median $30,502
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 460
$30,034
negotiated rate
Hospital reports orthopedic surgery services to CMS
X-ray and bone density
CPT 71046
$199 - $529
from 4 insurers · median $386
Common here, based on CMS Medicare volume
MRI imaging
CPT 70551
$595 - $3,363
from 4 insurers · median $2,629
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$595 - $3,363
from 4 insurers · median $2,527
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 473
$22,904
negotiated rate
Hospital reports orthopedic surgery services to CMS
Mammography
CPT 77067
$80 - $495
from 4 insurers · median $167
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 73030
$404 - $1,341
from 4 insurers · median $898
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 29881
$40,382
negotiated rate
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$17,937
negotiated rate
Hospital reports orthopedic surgery services to CMS
X-ray and bone density
CPT 73630
$276 - $778
from 4 insurers · median $607
Common here, based on CMS Medicare volume
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* | 14 | 1278% | 7 | 0 |
| Insurer B* | 19 | 1233% | 15 | 1 |
| Insurer C* | 16 | 837% | 10 | 3 |
| Insurer D* | 22 | 244% | 3 | 17 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 18 are common here based on CMS Medicare volume, and 6 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 Three Rivers 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
3 of 5 stars
Doctors and services
Accredited by The Joint Commission
Finances
$53.3M net patient revenue
Ownership and leadership
Owned by Goldentree Distressed Onshore Master Fund III LP
The employer identification numbers (EINs) health plans and networks list for Three Rivers 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 |
|---|---|---|
| 61-1238190Hospital Of Louisa INC | 54Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 49 more | 1063484483 Hospital Of Louisa Inc.1356313407 Hospital Of Louisa Inc.1952373276 Hospital Of Louisa Inc. |
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.
2485 Highway 644, Louisa, KY 41230
(606) 638-9451
How Three Rivers Medical Center compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
3 of 5
Lower than 42% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
No different on 4 measures
0 better, 4 no different, 0 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
No different on 2 measures
0 better, 2 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
Worse on 1 of 6 measures
0 better, 5 no different, 1 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
5 of 5
The top rating, shared by 7% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
78%
Higher than 72% 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)
0.96
Lower than 50% 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
164 min
Higher than 60% 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
98%
Higher than 99% 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 | 3 of 5 | |
| Death rates | No different on 4 measures | |
| Safety | No different on 2 measures | |
| Readmissions | Worse on 1 of 6 measures | |
| Patient survey ratingCMS: Summary star rating | 5 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 78% | 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) | 0.96 | 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 | 164 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 98% | 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 Three Rivers Medical Center's inpatient payments for its readmissions, quality and cost results.
-0.06% on Medicare payments
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
+2.48% 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 Three Rivers 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 | Three Rivers Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 4.2 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 266 cases | 4.7 | 3.9 | 4.543 | Worse than 83% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 12.11 | |||
| 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 | Not Available | 9.152 | |||
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 26 cases | 13.9 | 11 | 11.98 | Worse than 91% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 66 cases | 19 | 15.2 | 16.6 | Worse than 92% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 | Not Available | 12.38 | |||
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 319 cases | 0.54 | 0.51 | 0.6092 | No Different Than the National Rate | Worse than 54% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 185 | Number of Cases Too Small | ||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 527 cases | 0.21 | 0.2 | 0.2113 | No Different Than the National Rate | Worse than 54% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 529 cases | 0.27 | 0.27 | 0.2787 | No Different Than the National Rate | Worse than 46% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 51 cases | 2.32 | 2.29 | 2.306 | No Different Than the National Rate | Worse than 59% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 | Not Available | 1.711 | Number of Cases Too Small | ||
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 | Not Available | 10.2 | Number of Cases Too Small | ||
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 62 cases | 3.43 | 3.4 | 3.435 | No Different Than the National Rate | Worse than 53% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 | Not Available | 5.85 | Number of Cases Too Small | ||
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 | Not Available | 1.761 | Number of Cases Too Small | ||
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 81 cases | 1.05 | 1.02 | 1.077 | No Different Than the National Rate | Worse than 64% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | Three Rivers 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 · 32 cases | -29.4 | 1.25 | 9.521 | Better than 87% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 71 cases | 48.4 | 3.85 | 12.61 | Worse than 92% 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 · 260 cases | 14.4 | 12.9 | 13.03 | No Different Than the National Rate | Worse than 95% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 10.97 | Number of Cases Too Small | ||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.4 | Number of Cases Too Small | ||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 · 44 cases | 1 | 1 | 1.027 | No Different than expected | Worse than 32% of US hospitals |
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.42 | |||
| 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 · 45 cases | 18.9 | 19.8 | 19.89 | Better than 87% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 43 cases | 21.9 | 21.3 | 21.36 | Worse than 68% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 6.142 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 151 cases | 17.1 | 17.2 | 17.37 | Better than 54% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | Three Rivers 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 | Not Available | 0.339 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.151 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 191 | 1,370 | 2,960 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.121 | 0.9835 | 2.924 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.453 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.7803 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2917 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.135 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 1,441 | 1,799 | 3,041 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.734 | 1.377 | 3.578 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.172 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5965 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.4763 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.932 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 1 | 61 | 98 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.03 | 1.591 | 2.685 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 0 | 1 | 2.881 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.9389 | |||
| 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 | Not Available | 73.52 | |||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.6952 | |||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 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 | 3,487 | 14,451 | 34,235 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.084 | 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 | Not Available | 0.149 | No Different than National Benchmark | ||
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 1.217 | 0.747 | 1.678 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 3,487 | 13,646 | 31,551 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 2.461 | 5.683 | 15.64 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 0 | 2 | 5.011 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0 | 0.279 | 0.3987 | No Different than National Benchmark | The best result, shared by 19% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | Three Rivers Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 119 cases | 93 | 73 | 74.59 | Better than 98% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 119 cases | 1 | 8 | 7.987 | Better than 95% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 119 cases | 6 | 18 | 17.42 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 119 cases | 97 | 87 | 86.82 | Better than 99% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 119 cases | 5 | 4 | 3.533 | The top rating, shared by 12% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 119 cases | 89 | 80 | 82.24 | Better than 92% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 119 cases | 96 | 91 | 92.18 | Better than 96% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 119 cases | 2 | 4 | 3.772 | Better than 76% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 119 cases | 5 | 3 | 3.8 | The top rating, shared by 18% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 119 cases | 9 | 16 | 13.99 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 119 cases | 89 | 79 | 81.87 | Better than 92% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 119 cases | 95 | 91 | 91.67 | Better than 94% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 119 cases | 3 | 5 | 4.823 | Better than 77% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 119 cases | 5 | 3 | 3.417 | The top rating, shared by 6% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 119 cases | 8 | 16 | 13.3 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 119 cases | 70 | 61 | 63.23 | Better than 84% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 119 cases | 84 | 77 | 78.17 | Better than 91% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 119 cases | 14 | 19 | 18.58 | Better than 78% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 119 cases | 4 | 3 | 2.833 | Better than 79% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 119 cases | 16 | 19 | 18.19 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 119 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 · 119 cases | 12 | 13 | 13.37 | Better than 58% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 119 cases | 4 | 3 | 3.317 | Better than 55% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 119 cases | 88 | 87 | 86.63 | Better than 58% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 119 cases | 13 | 14 | 14.65 | Better than 59% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 119 cases | 87 | 86 | 85.35 | Better than 59% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 119 cases | 86 | 74 | 76.86 | Better than 95% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 119 cases | 4 | 7 | 6.333 | Better than 81% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 119 cases | 10 | 19 | 16.81 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 119 cases | 89 | 77 | 80.25 | Better than 96% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 119 cases | 2 | 6 | 5.278 | Better than 91% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 119 cases | 9 | 17 | 14.47 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 119 cases | 91 | 85 | 87.39 | Better than 88% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 119 cases | 2 | 3 | 3.125 | Better than 75% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 119 cases | 7 | 11 | 9.486 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 119 cases | 6 | 8 | 7.544 | Better than 63% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 119 cases | 13 | 20 | 19.38 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 119 cases | 81 | 72 | 73.08 | Better than 82% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 119 cases | 92 | 88 | 88.38 | Better than 86% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 119 cases | 4 | 3 | 3.333 | Better than 55% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 119 cases | 80 | 74 | 75.21 | Better than 80% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 119 cases | 14 | 9 | 9.458 | Worse than 87% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 119 cases | 6 | 16 | 15.33 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 119 cases | 87 | 75 | 77.63 | Better than 97% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 119 cases | 2 | 5 | 5.153 | Better than 90% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 119 cases | 11 | 20 | 17.22 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 119 cases | 88 | 77 | 79.5 | Better than 95% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 119 cases | 2 | 4 | 4.028 | Better than 80% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 119 cases | 10 | 19 | 16.47 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 119 cases | 94 | 86 | 88 | Better than 94% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 119 cases | 1 | 3 | 2.556 | Better than 77% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 119 cases | 5 | 11 | 9.444 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 119 cases | 65 | 59 | 62.39 | Better than 69% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 119 cases | 5 | 9 | 8.089 | Better than 77% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 119 cases | 30 | 31 | 29.52 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 119 cases | 87 | 82 | 83.2 | Better than 85% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 119 cases | 4 | 3 | 3.633 | Better than 56% 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 · 119 cases | 3 | 5 | 5.19 | Better than 70% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 119 cases | 78 | 71 | 70.95 | Better than 72% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 119 cases | 92 | 87 | 86.8 | Better than 83% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 119 cases | 19 | 23 | 23.86 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 119 cases | 5 | 4 | 3.6 | The top rating, shared by 24% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 119 cases | 60 | 47 | 50.82 | Better than 91% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 119 cases | 15 | 30 | 28.18 | Better than 96% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 119 cases | 25 | 22 | 21 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 119 cases | 5 | 3 | 3.433 | The top rating, shared by 7% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 119 cases | 10 | 12 | 11.93 | Better than 70% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 119 cases | 90 | 88 | 88.07 | Better than 70% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | Three Rivers 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 | Not Available | 1.132 | |||
| 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 · 317 cases | 33 | 79 | 74.25 | Worse than 96% 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 · 421 cases | 171 | 154 | 153 | Worse than 61% 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 · 394 cases | 164 | 148 | 147 | Worse than 60% 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 · 20 cases | 359 | 293 | 305 | Worse than 75% of US hospitals | |
| Left before being seen2024-01-01 to 2024-12-31 · 16,139 cases | 2 | 1 | 1.418 | Worse than 58% 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 · 53 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 · 230 cases | 19 | 15 | 16.73 | Worse than 80% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 97 cases | 98 | 65 | 66.02 | Better than 99% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 35 cases | 100 | 73 | 74.36 | The best result, shared by 3% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 25 cases | 100 | 88 | 85.06 | The best result, shared by 11% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 98 cases | 98 | 82 | 81.94 | Better than 98% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 75 cases | 100 | 94 | 94.58 | The best result, shared by 10% 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 | Not Available | 92.33 | |||
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 490 cases | 96 | 90 | 76.94 | Better than 74% of US hospitals | |
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 218 cases | 98 | 97 | 93.3 | Better than 56% of US hospitals |
How often scans were ordered when they may not be needed; lower is better.
| Measure | Three Rivers Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 2.3 | 5 | 7.251 | Better than 82% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | 9.2 | 6.6 | 6.595 | Worse than 77% of US hospitals |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | Three Rivers 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 | 0.88 | 0.99 | 1.007 | Better than 91% of US hospitals |
Measures CMS reports for the hospital's psychiatric unit or for a psychiatric hospital.
| Measure | Three Rivers 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 · 3,827 cases | 0 | 0.05 | 0.1626 | The worst result, shared by 22% of US hospitals | |
| Hours of seclusion use per 1,000 psychiatric patient hours2024-01-01 to 2024-12-31 · 3,827 cases | 0 | 0.03 | 0.09704 | The worst result, shared by 39% of US hospitals | |
| Psychiatric patients screened for and given the flu vaccine2024-10-01 to 2025-03-31 · 289 cases | 99 | 87 | 83.48 | Better than 87% 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 · 69 cases | 20.3 | 19.1 | 19.53 | No Different Than the National Rate | Worse than 68% of US hospitals |
| Psychiatric patients screened for metabolic disorders2024-01-01 to 2024-12-31 · 391 cases | 100 | 92 | 90.93 | The best result, shared by 14% of US hospitals | |
| Alcohol use brief intervention provided or offered2024-01-01 to 2024-12-31 · 57 cases | 82 | 74 | 70.89 | Better than 58% of US hospitals | |
| Alcohol use brief intervention provided2024-01-01 to 2024-12-31 · 56 cases | 52 | 81 | 80.93 | Worse than 77% of US hospitals | |
| Alcohol and other drug use disorder treatment provided or offered at discharge2024-01-01 to 2024-12-31 · 166 cases | 86 | 77 | 83.83 | Better than 61% of US hospitals | |
| Alcohol and other drug use disorder treatment provided at discharge2024-01-01 to 2024-12-31 · 166 cases | 40 | 56 | 62.17 | Worse than 66% of US hospitals | |
| Tobacco use treatment provided or offered at discharge2024-01-01 to 2024-12-31 · 301 cases | 82 | 64 | 64.23 | Better than 69% of US hospitals | |
| Tobacco use treatment provided at discharge2024-01-01 to 2024-12-31 · 301 cases | 1 | 4 | 13.77 | Worse than 61% of US hospitals | |
| Discharged patients who received a transition record with the specified elements2024-01-01 to 2024-12-31 · 594 cases | 94 | 77 | 77.04 | Better than 73% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | Three Rivers Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 0 | 20 | 14.1 | The worst result, shared by 11% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 0 | 5 | 3.571 | The worst result, shared by 11% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 70 | 10 | 19.82 | Better than 92% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 17.5 | 2.5 | 5.134 | Better than 91% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 90 | 34 | 44.76 | Better than 99% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 22.5 | 8.75 | 11.37 | Better than 97% of US hospitals | |
| VBP safety domain scoreFY 2026 | 100 | 40 | 46.5 | Better than 99% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 25 | 10 | 11.8 | Better than 99% of US hospitals | |
| VBP total performance scoreFY 2026 | 65 | 29.5 | 31.05 | Better than 99% of US hospitals |
| By fiscal year | FY 2021 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 36.67 | 0 | 0 | 0 | 0 |
| VBP clinical outcomes weighted domain score | 12.22 | 0 | 0 | 0 | 0 |
| VBP efficiency and cost reduction domain score | 50 | 60 | 50 | 30 | 70 |
| VBP efficiency and cost reduction weighted domain score | 16.67 | 15 | 12.5 | 10 | 17.5 |
| VBP person and community engagement domain score | 77 | Not Available | 50 | 79 | 90 |
| VBP person and community engagement weighted domain score | 25.67 | Not Available | 12.5 | 26.33 | 22.5 |
| VBP safety domain score | Not Available | Not Available | 0 | Not Available | 100 |
| VBP safety weighted domain score | Not Available | Not Available | 0 | Not Available | 25 |
| VBP total performance score | 54.56 | Not Available | 25 | 36.33 | 65 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | Three Rivers Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.011 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9628 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | 0.9753 | 0.9969 | 1.008 | Better than 70% of US hospitals | |
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 | 0.9988 | 0.9983 | 1.009 | Worse than 50% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 · 0 cases | N/A | 1.084 | |||
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 · 68 cases | 1.005 | 0.9955 | 1.006 | Worse than 56% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-CABG-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-COPD-HRRP | 1.1 | 1.062 | 1.044 | 0.992 | 0.9694 | 0.9753 |
| READM-30-HF-HRRP | 1.078 | 1.024 | 1.021 | 0.9774 | 0.9866 | 0.9988 |
| READM-30-HIP-KNEE-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-PN-HRRP | 1.031 | 1.004 | 1.012 | 1.025 | 1.018 | 1.005 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | Three Rivers Medical Center | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.489 | 0.5632 | The best result, shared by 14% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.228 | 0.346 | 0.3899 | Better than 68% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.9125 | |||
| HAC Reduction Program payment reductionFY 2026 | No | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.8459 | |||
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 0.9622 | 0.9628 | 1.023 | Better than 50% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.8867 | |||
| Total HAC scoreFY 2026 | -0.6938 | -0.0453 | 0.1443 | Better than 87% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | No | Yes | N/A | Yes | Yes | No |
| Total HAC score | -0.4877 | 1.267 | 0 | 0.9021 | 0.581 | -0.6938 |
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
None
Medical school affiliation
Private (for profit)
Ownership type
90
Medicare-certified beds
90
Registered nurses (full-time equivalent)
1974
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Three Rivers Medical Center reported to Medicare in its latest cost report, covering Apr 1, 2025 to Mar 31, 2026.
864
Inpatient discharges
Medicare 23%, Medicaid 2%
3,003
Inpatient days
13% of available bed days used
171
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 844003). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Three Rivers Medical Center reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 643 | 68 | 2,292 | 3,003 |
| Discharges | 201 | 13 | 650 | 864 |
| Average length of stay | 3.2 days | 5.2 days | 3.5 days | 3.5 days |
| Average daily census | 1.8 | 0.2 | 6.3 | 8.2 |
1,031
Medicare Advantage days
263 discharges
607
Medicaid managed care days
180 discharges
1,367
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 59 | 2,383 | 508 | 11% |
| Intensive care unit | 6 | 503 | 85 | 23% |
| Subprovider - ipf | 19 | 4,243 | 318 | 61% |
Source: CMS cost report (HCRIS, Form 2552-10), report 844003, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What Three Rivers Medical Center treats Medicare patients for most often, in 2024. 86 Medicare discharges in 4 published DRGs; 0% surgical; 86% 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 | 43 | $63,736 | $13,877 | $13,640 | 1.98 |
| Heart failure and shock with MCCMS-DRG 291, medical | 16 | $49,912 | $9,185 | $10,681 | 1.28 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 15 | $57,898 | $8,978 | $12,390 | 1.33 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 12 | $42,752 | $6,752 | $9,149 | 1.03 |
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) Three Rivers Medical Center billed Medicare for most in 2024: 214 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 97 | 84 | $19,962 | $1,969 | $2,090 |
| Level 2 Upper GI ProceduresAPC 5302 | 71 | 56 | $27,337 | $1,316 | $1,445 |
| Level 3 Urology and Related ServicesAPC 5373 | 29 | 27 | $23,392 | $1,407 | $1,516 |
| Level 5 Urology and Related ServicesAPC 5375 | 17 | 16 | $47,251 | $3,268 | $3,918 |
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 Three Rivers 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 705 in 2020 to 400 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 41230 | 238 | 60% | 877 | $16.9M | 33% | 44% |
| 25514 | 70 | 18% | 300 | $5.4M | 29% | 37% |
| 41224 | 52 | 13% | 189 | $3.2M | 18% | 32% |
| 41124 | 16 | 4% | 50 | $1.1M | 34% | 58% |
| 25674 | 13 | 3% | 33 | $893,931 | 8% | 21% |
| 25669 | 11 | 3% | 40 | $713,801 | 28% | 68% |
Source: CMS Hospital Service Area file. Shares are of the 400 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 Three Rivers Medical Center reported at its latest Medicare certification survey (2018). Counts are people, not full-time equivalents.
4
Operating rooms
1
Endoscopy rooms
19
Psychiatric unit beds
90
Registered nurses
4
Licensed practical nurses
1
Nurse anesthetists (CRNAs)
3
Pharmacists
8
Respiratory therapists
1
Physical therapists
1
Occupational therapists
1
Speech pathologists and audiologists
10
Radiology technicians
1
Nuclear medicine technicians
4
Laboratory technicians
3
Medical technologists
2
Dietitians
2
Social workers
97
Other personnel
Source: CMS Provider of Services file.
94 clinicians who bill Medicare list Three Rivers 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.
Matthew Wilson, MD
Allergy Physician
NPI 1891726295
See commercial rates for Matthew Wilson, MDZane Darnell, MD
Cardiovascular Disease Physician
NPI 1356330732
See commercial rates for Zane Darnell, MDKatherine Carias, M.D.
Specialist
NPI 1205828282
See commercial rates for Katherine Carias, M.D.David Mcnaul, M.D.
Diagnostic Radiology Physician
NPI 1144262668
See commercial rates for David Mcnaul, M.D.Bradley Wells, M.D.
Diagnostic Radiology Physician
NPI 1427202621
See commercial rates for Bradley Wells, M.D.Yogendra Prasad, MD
Cardiovascular Disease Physician
NPI 1366447286
See commercial rates for Yogendra Prasad, MDAmanda Romesberg, D.O.
Diagnostic Radiology Physician
NPI 1780064980
See commercial rates for Amanda Romesberg, D.O.Akshay Goel, MD
Orthopaedic Surgery Physician
NPI 1659652451
See commercial rates for Akshay Goel, MDMayola Boykin, MD
Diagnostic Radiology Physician
NPI 1104995091
See commercial rates for Mayola Boykin, MDMatthew Harper, M.D.
Diagnostic Radiology Physician
NPI 1568783744
See commercial rates for Matthew Harper, M.D.Robin Arora, M.D.
Nephrology Physician
NPI 1144481565
See commercial rates for Robin Arora, M.D.Basel Edris, MD
Clinical Cardiac Electrophysiology Physician
NPI 1629381116
See commercial rates for Basel Edris, MDJami Lyon, D.O.
Diagnostic Radiology Physician
NPI 1083057178
See commercial rates for Jami Lyon, D.O.Roger Klein, M.D.
Cardiovascular Disease Physician
NPI 1205947868
See commercial rates for Roger Klein, M.D.Jerry White
Cardiovascular Disease Physician
NPI 1245655968
See commercial rates for Jerry WhiteChristopher Epling, DO
Interventional Cardiology Physician
NPI 1649269101
See commercial rates for Christopher Epling, DOMohamad Abul-Khoudoud, MD
Pulmonary Disease Physician
NPI 1396710091
See commercial rates for Mohamad Abul-Khoudoud, MDDaniel Snavely, MD
Interventional Cardiology Physician
NPI 1972544047
See commercial rates for Daniel Snavely, MDPratap Singh, M.B., B.S.
Clinical Cardiac Electrophysiology Physician
NPI 1417203001
See commercial rates for Pratap Singh, M.B., B.S.John Vanderen, MD
Clinical Cardiac Electrophysiology Physician
NPI 1811986094
See commercial rates for John Vanderen, MDKevin Willis, M.D.
Family Medicine Physician
NPI 1700919776
See commercial rates for Kevin Willis, M.D.Joseph De Lapa, M.D.
Pain Medicine (Anesthesiology) Physician
NPI 1346464963
See commercial rates for Joseph De Lapa, M.D.Jasyn Blankenship, DO
Cardiovascular Disease Physician
NPI 1659810208
See commercial rates for Jasyn Blankenship, DOJohn Kasey, DO
Nephrology Physician
NPI 1831371368
See commercial rates for John Kasey, DOSource: 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 Three Rivers Medical Center reported to Medicare for Apr 1, 2025 to Mar 31, 2026. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $358.4M | 672.7% |
| Inpatient | $78.2M | 146.7% |
| Outpatient | $280.2M | 526.0% |
| Contractual allowances and discounts | -$305.1M | -572.7% |
| Net patient revenue | $53.3M | 100.0% |
| Operating expenses | -$44.6M | -83.7% |
| Operating income from patient care | $8.7M | 16.3% |
| Other income | $403,657 | 0.8% |
| Net income | $9.1M | 17.1% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $45.8M | 12.8% |
| Medicaid (including managed care) | $119M | 33.2% |
| Other payers and self-pay | $193.6M | 54.0% |
| Total charges | $358.4M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 844003, 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 Three Rivers Medical Center's latest cost report.
16.3%
Operating margin
Operating income from patient care / net patient revenue
17.0%
Total margin
Net income / net patient revenue plus other income
19.9%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
37% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$34.97
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
30.2%
Return on assets
Net income for a year / total assets
16.7%
Return on equity
Net income for a year / fund balance
0.00
Long-term debt to fund balance
Mortgages, notes and loans / fund balance
-0.52
Current ratio
Current assets / current liabilities
-0.46
Quick ratio
Cash, temporary investments and net receivables / current liabilities
-6 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
83 days
Days in patient receivables
Net patient receivables / daily net patient revenue
-209 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.78
Asset turnover
Total revenue for a year / total assets
5.5 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 844003, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Three Rivers Medical Center owned and owed at the end of its reporting period (Mar 2026), across all fund types: $30.1M in total assets and a $54.6M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | -$718,817 | -2.4% |
| Patient receivables, net | $12.1M | 40.1% |
| Inventory | $953,855 | 3.2% |
| Total current assets | $12.8M | 42.5% |
| Property and equipment, net of depreciation | $14.9M | 49.6% |
| Investments and other assets | $2.4M | 7.9% |
| Total assets | $30.1M | 100.0% |
| Current liabilities | -$24.6M | -81.8% |
| Long-term debt | $216,621 | 0.7% |
| Total liabilities | -$24.4M | -81.0% |
| Fund balance (net assets) | $54.6M | 181.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 844003, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Three Rivers Medical Center provided without full payment, as reported on Worksheet S-10 of its cost report.
$246,930
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$7.2M
Bad debt
Patient bills written off as uncollectible, at charges
-$9.5M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$1.1M
Total unreimbursed and uncompensated care
2.4% 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 844003, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Three Rivers Medical Center's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Mar 2021 | Mar 2022 | Mar 2023 | Mar 2024 | Mar 2025 | Mar 2026 |
|---|---|---|---|---|---|---|
| Net patient revenue | $41M | $49.6M | $43M | $48.5M | $53.8M | $53.3M |
| Operating expenses | $35.3M | $42M | $39.5M | $41.3M | $44.6M | $44.6M |
| Operating margin | 13.9% | 15.3% | 8.2% | 14.8% | 17.2% | 16.3% |
| Net income | $12.7M | $10.3M | $3.9M | $7.4M | $9.4M | $9.1M |
| Total assets | $34.1M | $31.2M | $29.2M | $26.9M | $27.1M | $30.1M |
| Discharges | 1,605 | 1,567 | 1,294 | 1,119 | 1,105 | 864 |
| Inpatient days | 5,575 | 7,123 | 5,038 | 3,833 | 3,861 | 3,003 |
| Medicare Advantage days | 649 | 546 | 1,619 | 1,065 | 1,375 | 1,031 |
| Beds | 84 | 84 | 84 | 84 | 84 | 84 |
| Employees (FTE) | 178 | 193 | 177 | 173 | 174 | 171 |
Source: CMS cost report (HCRIS, Form 2552-10), report 844003, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Three Rivers 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 |
|---|---|---|---|---|---|
| Operating room | $1M | $5.4M | $65.3M | 0.08 | 10,937 |
| Emergency | $1.5M | $4.1M | $61.6M | 0.07 | 7,182 |
| Drugs charged to patients | $2.9M | $27.7M | 0.10 | ||
| Laboratory | $597,524 | $2.2M | $44.9M | 0.05 | 1,281 |
| Observation beds (non-distinct part | $2.2M | $3.7M | 0.59 | ||
| Radiology-diagnostic | $702,982 | $2M | $14.6M | 0.14 | 2,465 |
| Physical therapy | $3,501 | $1.7M | $8.2M | 0.21 | 3,083 |
| Respiratory therapy | $546,319 | $1.7M | $4.3M | 0.39 | 1,580 |
| Medical supplies charged to patient | $875,586 | $7.1M | 0.12 | ||
| Impl. dev. charged to patients | $642,259 | $2M | 0.32 | ||
| Recovery room | $227,999 | $536,059 | $15.1M | 0.04 | |
| Ct scan | $511,474 | $46.3M | 0.01 | 884 | |
| Radioisotope | $171,359 | $473,023 | $3.3M | 0.14 | 207 |
| Sleep lab | $122,638 | $303,051 | $823,543 | 0.37 | 741 |
| Speech pathology | $278,229 | $1.8M | 0.15 | ||
| Mri | $231,865 | $4.1M | 0.06 | 700 | |
| Electrocardiology | $58,404 | $225,143 | $7.7M | 0.03 | 1,080 |
| Anesthesiology | $102,143 | $12.3M | 0.01 | ||
| Ultra sound | $50,770 | $2.5M | 0.02 | 138 | |
| Occupational therapy | $4,120 | $16,112 | 0.26 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $1.9M | $6M | $6.8M | 0.88 | 17,959 |
| Subprovider - ipf | $1.8M | $4.7M | $14.9M | 0.32 | 6,642 |
| Intensive care unit | $612,846 | $1.9M | $3.3M | 0.58 | 6,767 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $1.7M | $11.6M | 27,980 | $57.16 | 10,905 |
| Operation of plant | $284,821 | $2M | 10,888 | $26.16 | 17,330 |
| Employee benefits department | $75,788 | $1.6M | 2,131 | $35.57 | |
| Nursing administration | $1.2M | $1.5M | 26,019 | $49.03 | 582 |
| Cap rel costs-mvble equip | $1.3M | ||||
| Pharmacy | $694,688 | $959,658 | 16,472 | $42.17 | 1,598 |
| Cafeteria | $662,230 | 18,824 | $15.96 | 1,212 | |
| Cap rel costs-bldg & fixt | $634,671 | 114,845 | |||
| Housekeeping | $307,366 | $408,928 | 20,030 | $15.34 | 455 |
| Medical records & library | $108,269 | $267,422 | 960 | $112.84 | 1,232 |
| Laundry & linen service | $209,199 | 287 | |||
| Dietary | $375,114 | $195,992 | 4,685 | $15.96 | 2,063 |
| Central services & supply | $166,289 | $136,116 | 7,861 | $21.15 | 974 |
Source: CMS cost report (HCRIS, Form 2552-10), report 844003, 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 Three Rivers Medical Center for an inpatient stay.
1.42
Case mix index
Higher than 19% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
33.4%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
239
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Urban (metro area)
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 | 1.19 | 1.19 | 1.46 | 1.58 | 1.40 | 1.38 | 1.42 |
| Wage index | 0.821 | 0.822 | 0.819 | 0.825 | 0.843 | 0.864 | 0.879 |
| Readmissions adjustment | -1.20% | -1.34% | -0.53% | -0.31% | -0.11% | -0.03% | -0.06% |
| Value-based purchasing adjustment | +0.98% | +1.50% | +1.50% | -0.59% | +0.37% | +1.25% | +2.48% |
| Medicare inpatient stays | 648 | 648 | 527 | 398 | 299 | 260 | 239 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations Three Rivers Medical Center reports to Medicare as owners or with operational control.
Goldentree Distressed Onshore Master Fund III LP
5% or greater indirect ownership interest, 100%, since 2020
Quincy Health LLC
5% or greater indirect ownership interest, 100%, since 2020
Quorum Health Corporation
5% or greater direct ownership interest, 100%, since 2016
Goldentree Select Offshore Intermediate Fund LP
5% or greater indirect ownership interest, 82.4%, since 2020
Gtam Onshore Blocker 2 LLC
5% or greater indirect ownership interest, 19.3%, since 2023
Goldentree Distressed Master Fund III Ltd
5% or greater indirect ownership interest, 11%, since 2020
Sources: CMS Hospital All Owners.
The officers and board members on Three Rivers 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 6 of 9 are shown.
Three rivers medical ctr psyche unit
CCN 18S128, certified 1995, Medicare prospective payment
Three rivers medical ctr swing beds
CCN 18U128, certified 1989, Medicare prospective payment
Source: Worksheet S-2 Part I of Three Rivers Medical Center's latest Medicare cost report (HCRIS).
About Three Rivers Medical Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Three Rivers Medical Center range from $700 to $5,589 across 4 insurers. Cigna's rate is $5,489. The median at nearby comparable hospitals is $935. 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 Three Rivers Medical Center range from $425 to $5,720 across 4 insurers. UnitedHealthcare's rate is $3,682. The median at nearby comparable hospitals is $1,989. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with biopsy (CPT 45380), published negotiated rates at Three Rivers Medical Center range from $3,141 to $13,772 across 2 insurers. Aetna's rate is $13,772. The median at nearby comparable hospitals is $2,240. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Three Rivers Medical Center range from $80 to $495 across 4 insurers. Blue Cross Blue Shield's rate is $103. The median at nearby comparable hospitals is $193. 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 Three Rivers Medical Center range from $17,937 to $17,937 across 1 insurers. Blue Cross Blue Shield's rate is $17,937. The median at nearby comparable hospitals is $27,062. What a patient pays depends on their plan's deductible, coinsurance and network status.
Three Rivers Medical Center has a CMS overall hospital star rating of 3 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 42% of US hospitals.
CMS reports no Medicare-funded interns or residents at Three Rivers Medical Center for fiscal year 2027.
Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Three Rivers Medical Center's base inpatient payments by an estimated 0.06% 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 (43 discharges), heart failure and shock with mcc (16 discharges), simple pneumonia and pleurisy with mcc (15 discharges).
Three Rivers Medical Center's Medicare case mix index is 1.42 for fiscal year 2027, higher than 19% of hospitals paid under the inpatient prospective payment system.
Three Rivers Medical Center reported 864 inpatient discharges and 3,003 inpatient days from Apr 1, 2025 to Mar 31, 2026.
Three Rivers Medical Center reported 171 full-time-equivalent employees on payroll from Apr 1, 2025 to Mar 31, 2026.
Three Rivers Medical Center reported $53.3M in net patient revenue on $358.4M of gross charges for Apr 1, 2025 to Mar 31, 2026, an operating margin of 16.3%, and net income of $9.1M.
Three Rivers Medical Center reported $1.1M of unreimbursed and uncompensated care for Apr 1, 2025 to Mar 31, 2026, including $246,930 of charity care at cost.
Three Rivers Medical Center's Medicare enrollment lists Christopher M Harrison as President since 2025.
Insurers' price transparency files list Three Rivers Medical Center under employer identification number 61-1238190 (Hospital Of Louisa INC). 54 health plans and networks list 61-1238190 for it.
94 clinicians who bill Medicare list Three Rivers Medical Center as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are family nurse practitioner (18), family medicine physician (13), diagnostic radiology physician (6).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Three Rivers Medical Center, effective 2000.
In its Medicare enrollment, Three Rivers Medical Center reports Goldentree Distressed Onshore Master Fund III LP as 5% or greater indirect ownership interest (100%).
CMS lists 32 services at Three Rivers Medical Center, including Acute Renal Dialysis, Adult Inpatient Psychiatric Care, Anesthesia, CARF Inpatient Rehabilitation (Commission On Accreditation Of Rehabilitation Facilities Inpatient Rehabilitation), Clinical Laboratory, Coronary Care Unit.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Three Rivers Medical Center came from ZIP codes 41230 (238), 25514 (70), 41224 (52).
Three Rivers Medical Center has 84 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 90 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
Three Rivers Medical Center is located at 2485 Highway 644, Louisa, KY 41230. Its main phone number is (606) 638-9451.
Three Rivers Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 180128.
The National Provider Identifier (NPI) on file for Three Rivers Medical Center is 1063484483.
Three Rivers Medical Center is affiliated with Quorum Health.
Three Rivers Medical Center lists 33 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.
146 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