JCIPatientSafety.orgHospital Quality Directory

Acute Care Hospitals · Proprietary

Baylor Scott and White Medical Center Uptown

Not rated overall

CMS reports safety and quality measures for this hospital but does not assign an overall star rating. See scores below.

Healthcare-Associated Infections

lower is better · 36 measures reported

Rates of infections patients can acquire while receiving care, such as central-line and catheter-associated infections, MRSA, and C. difficile.

MeasureScoreCompared to national
Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit—Not available
Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit—Not available
Central Line Associated Bloodstream Infection: Number of Device Days135Not available
Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases0.091Not available
Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases0Not available
Central Line Associated Bloodstream Infection (ICU + select Wards)—Not available
Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit—Not available
Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit—Not available
Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days312Not available
Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases0.117Not available
Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases0Not available
Catheter Associated Urinary Tract Infections (ICU + select Wards)—Not available
SSI - Colon Surgery: Lower Confidence Limit—Not available
SSI - Colon Surgery: Upper Confidence Limit—Not available
SSI - Colon Surgery: Number of Procedures1Not available
SSI - Colon Surgery: Predicted Cases0.033Not available
SSI - Colon Surgery: Observed Cases0Not available
SSI - Colon Surgery—Not available
SSI - Abdominal Hysterectomy: Lower Confidence Limit—Not available
SSI - Abdominal Hysterectomy: Upper Confidence Limit—Not available
SSI - Abdominal Hysterectomy: Number of Procedures—Not available
SSI - Abdominal Hysterectomy: Predicted Cases—Not available
SSI - Abdominal Hysterectomy: Observed Cases—Not available
SSI - Abdominal Hysterectomy—Not available
MRSA Bacteremia: Lower Confidence Limit—Not available
MRSA Bacteremia: Upper Confidence Limit—Not available
MRSA Bacteremia: Patient Days1519Not available
MRSA Bacteremia: Predicted Cases0.020Not available
MRSA Bacteremia: Observed Cases0Not available
MRSA Bacteremia—Not available
Clostridium Difficile (C.Diff): Lower Confidence Limit—Not available
Clostridium Difficile (C.Diff): Upper Confidence Limit—Not available
Clostridium Difficile (C.Diff): Patient Days1519Not available
Clostridium Difficile (C.Diff): Predicted Cases0.263Not available
Clostridium Difficile (C.Diff): Observed Cases0Not available
Clostridium Difficile (C.Diff)—Not available

Complications & Deaths

lower is better · 20 measures reported

Rates of serious complications (like hip/knee replacement problems or accidental cuts during surgery) and 30-day mortality rates for common conditions.

MeasureScoreCompared to nationalSample
Rate of complications for hip/knee replacement patients3.5Same as national31
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate4.1Same as national71
Death rate for heart attack patients—Not available—
Death rate for CABG surgery patients—Not available—
Death rate for COPD patients—Not available—
Death rate for heart failure patients—Not available—
Death rate for pneumonia patients—Not available—
Death rate for stroke patients—Not available—
Pressure ulcer rate0.60Same as national70
Death rate among surgical inpatients with serious treatable complications—Not available—
Iatrogenic pneumothorax rate0.21Same as national211
In-hospital fall-associated fracture rate0.27Same as national212
Postoperative hemorrhage or hematoma rate2.21Same as national213
Postoperative acute kidney injury requiring dialysis rate1.65Same as national206
Postoperative respiratory failure rate8.13Same as national202
Perioperative pulmonary embolism or deep vein thrombosis rate3.30Same as national213
Postoperative sepsis rate4.99Same as national190
Postoperative wound dehiscence rate1.76Same as national33
Abdominopelvic accidental puncture or laceration rate1.05Same as national73
CMS Medicare PSI 90: Patient safety and adverse events composite0.94Same as national—

Unplanned Hospital Visits & Readmissions

lower is better · 14 measures reported

How often patients return to the hospital unexpectedly within 30 days of discharge — a marker of care quality and discharge planning.

MeasureScoreCompared to nationalSample
Hospital return days for heart attack patients—Not available—
Hospital return days for heart failure patients—Not available—
Hospital return days for pneumonia patients—Not available—
Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)14.7Same as national74
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)—Not available—
Rate of inpatient admissions for patients receiving outpatient chemotherapy—Not available—
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy—Not available—
Ratio of unplanned hospital visits after hospital outpatient surgery0.9Same as national378
Acute Myocardial Infarction (AMI) 30-Day Readmission Rate—Not available—
Rate of readmission for CABG—Not available—
Rate of readmission for chronic obstructive pulmonary disease (COPD) patients—Not available—
Heart failure (HF) 30-Day Readmission Rate—Not available—
Rate of readmission after hip/knee replacement4.9Same as national33
Pneumonia (PN) 30-Day Readmission Rate—Not available—

Patient Experience (HCAHPS)

higher is better · 9 measures reported

What patients say about their hospital stay — communication with nurses and doctors, responsiveness, cleanliness, pain management, and whether they would recommend the hospital.

MeasureScoreSample
Nurse communication - star rating—76
Doctor communication - star rating—76
Communication about medicines - star rating—76
Discharge information - star rating—76
Cleanliness - star rating—76
Quietness - star rating—76
Overall hospital rating - star rating—76
Recommend hospital - star rating—76
Summary star rating—76

Timely & Effective Care

higher is better (unless a wait time) · 30 measures reported

How consistently hospitals follow recommended care processes — for example, giving heart-attack patients aspirin on arrival, or the average time spent in the emergency department.

MeasureScoreSample
Emergency department volumelow—
Global Malnutrition Composite Score——
Global Malnutrition Composite Score: Malnutrition Diagnosis Documented——
Global Malnutrition Composite Score: Malnutrition Risk Screening——
Global Malnutrition Composite Score: Nutrition Assessment——
Global Malnutrition Composite Score: Nutritional Care Plan——
Hospital Harm - Severe Hyperglycemia4193
Hospital Harm - Severe Hypoglycemia170
Hospital Harm - Opioid Related Adverse Events——
Healthcare workers given influenza vaccination91720
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 better105391
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 better101363
Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better12912
Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better25817
Left before being seen24971
Head CT results——
Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients——
Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery——
ST-Segment Elevation Myocardial Infarction (STEMI)——
Safe Use of Opioids - Concurrent Prescribing4365
Appropriate care for severe sepsis and septic shock——
Septic Shock 3-Hour Bundle——
Septic Shock 6-Hour Bundle——
Severe Sepsis 3-Hour Bundle——
Severe Sepsis 6-Hour Bundle——
Discharged on Antithrombotic Therapy——
Anticoagulation Therapy for Atrial Fibrillation/Flutter——
Antithrombotic Therapy by End of Hospital Day 2——
Venous Thromboembolism Prophylaxis7840
Intensive Care Unit Venous Thromboembolism Prophylaxis——

Maternal Health

lower is better · 4 measures reported

Measures of maternal outcomes and safe delivery practices, including severe complications during childbirth.

MeasureScoreSample
Cesarean Birth——
Risk Adjusted Severe Obstetric Complications (All)——
Risk Adjusted Severe Obstetric Complications (excluding blood-transfusion-only cases)——
Maternal Morbidity Structural MeasureNot Applicable (our hospital does not provide inpatient labor/delivery care)—

Frequently asked questions

How is Baylor Scott and White Medical Center Uptown rated?
CMS does not assign an overall star rating to Baylor Scott and White Medical Center Uptown, but does publish underlying safety and quality measures shown on this page.
Does Baylor Scott and White Medical Center Uptown have emergency services?
Yes. Baylor Scott and White Medical Center Uptown operates a 24/7 emergency department.
Where is Baylor Scott and White Medical Center Uptown located?
Baylor Scott and White Medical Center Uptown is located at 2727 East Lemmon Avenue Building I, Dallas, TX 75204.
What type of hospital is Baylor Scott and White Medical Center Uptown?
Baylor Scott and White Medical Center Uptown is classified by CMS as a Acute Care Hospitals facility (Proprietary).

Data as of 2026-06-14. Source: CMS Provider Data Catalog. This is public data provided for informational purposes only and is not medical advice. See our methodology and editorial policy.

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