JCIPatientSafety.orgHospital Quality Directory

Acute Care Hospitals · Voluntary non-profit - Private

Beloit Health System

3 / 5

At a glance

Beloit Health System carries a 3-star CMS overall rating — in line with the national norm.

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 LimitSame as national
Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit1.605Same as national
Central Line Associated Bloodstream Infection: Number of Device Days3051Same as national
Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases1.867Same as national
Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases0Same as national
Central Line Associated Bloodstream Infection (ICU + select Wards)0.000Same as national
Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence LimitSame as national
Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit1.703Same as national
Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days3104Same as national
Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases1.759Same as national
Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases0Same as national
Catheter Associated Urinary Tract Infections (ICU + select Wards)0.000Same as national
SSI - Colon Surgery: Lower Confidence LimitSame as national
SSI - Colon Surgery: Upper Confidence Limit1.155Same as national
SSI - Colon Surgery: Number of Procedures91Same as national
SSI - Colon Surgery: Predicted Cases2.593Same as national
SSI - Colon Surgery: Observed Cases0Same as national
SSI - Colon Surgery0.000Same as national
SSI - Abdominal Hysterectomy: Lower Confidence LimitNot available
SSI - Abdominal Hysterectomy: Upper Confidence LimitNot available
SSI - Abdominal Hysterectomy: Number of Procedures58Not available
SSI - Abdominal Hysterectomy: Predicted Cases0.530Not available
SSI - Abdominal Hysterectomy: Observed Cases0Not available
SSI - Abdominal HysterectomyNot available
MRSA Bacteremia: Lower Confidence LimitSame as national
MRSA Bacteremia: Upper Confidence Limit2.741Same as national
MRSA Bacteremia: Patient Days19963Same as national
MRSA Bacteremia: Predicted Cases1.093Same as national
MRSA Bacteremia: Observed Cases0Same as national
MRSA Bacteremia0.000Same as national
Clostridium Difficile (C.Diff): Lower Confidence Limit0.121Same as national
Clostridium Difficile (C.Diff): Upper Confidence Limit1.290Same as national
Clostridium Difficile (C.Diff): Patient Days19385Same as national
Clostridium Difficile (C.Diff): Predicted Cases6.328Same as national
Clostridium Difficile (C.Diff): Observed Cases3Same as national
Clostridium Difficile (C.Diff)0.474Same as national

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 patientsNot available
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate5.1Same as national554
Death rate for heart attack patients10.9Same as national86
Death rate for CABG surgery patientsNot available
Death rate for COPD patients9.3Same as national61
Death rate for heart failure patients14.9Same as national231
Death rate for pneumonia patients16.2Same as national161
Death rate for stroke patients15.4Same as national51
Pressure ulcer rate1.52Same as national1854
Death rate among surgical inpatients with serious treatable complicationsNot available
Iatrogenic pneumothorax rate0.19Same as national2299
In-hospital fall-associated fracture rate0.29Same as national2328
Postoperative hemorrhage or hematoma rate3.29Same as national421
Postoperative acute kidney injury requiring dialysis rate1.56Same as national112
Postoperative respiratory failure rate7.94Same as national119
Perioperative pulmonary embolism or deep vein thrombosis rate4.72Same as national435
Postoperative sepsis rate5.53Same as national107
Postoperative wound dehiscence rate2.38Same as national105
Abdominopelvic accidental puncture or laceration rate0.93Same as national385
CMS Medicare PSI 90: Patient safety and adverse events composite1.29Same 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-15.9Not available85
Hospital return days for heart failure patients12Not available290
Hospital return days for pneumonia patients9.3Not available164
Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)15.5Same as national871
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)11.9Same as national1360
Rate of inpatient admissions for patients receiving outpatient chemotherapy11.3Same as national87
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy5.9Same as national87
Ratio of unplanned hospital visits after hospital outpatient surgery1.1Same as national326
Acute Myocardial Infarction (AMI) 30-Day Readmission Rate13.3Same as national85
Rate of readmission for CABGNot available
Rate of readmission for chronic obstructive pulmonary disease (COPD) patients17.3Same as national64
Heart failure (HF) 30-Day Readmission Rate19.8Same as national290
Rate of readmission after hip/knee replacementNot available
Pneumonia (PN) 30-Day Readmission Rate16.8Same as national164

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 rating4644
Doctor communication - star rating2644
Communication about medicines - star rating2644
Discharge information - star rating3644
Cleanliness - star rating3644
Quietness - star rating2644
Overall hospital rating - star rating2644
Recommend hospital - star rating2644
Summary star rating3644

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 volumemedium
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 Hyperglycemia
Hospital Harm - Severe Hypoglycemia
Hospital Harm - Opioid Related Adverse Events
Healthcare workers given influenza vaccination932011
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 better132406
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 better122380
Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better34118
Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better
Left before being seen035026
Head CT results9212
Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients10044
Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery
ST-Segment Elevation Myocardial Infarction (STEMI)
Safe Use of Opioids - Concurrent Prescribing14939
Appropriate care for severe sepsis and septic shock68293
Septic Shock 3-Hour Bundle7791
Septic Shock 6-Hour Bundle9760
Severe Sepsis 3-Hour Bundle81294
Severe Sepsis 6-Hour Bundle91158
Discharged on Antithrombotic Therapy9865
Anticoagulation Therapy for Atrial Fibrillation/Flutter
Antithrombotic Therapy by End of Hospital Day 210067
Venous Thromboembolism Prophylaxis
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 MeasureYes

Frequently asked questions

How is Beloit Health System rated?
Beloit Health System has a 3 out of 5 CMS overall star rating as of the latest CMS release.
Does Beloit Health System have emergency services?
Yes. Beloit Health System operates a 24/7 emergency department.
Where is Beloit Health System located?
Beloit Health System is located at 1969 W Hart Rd, Beloit, WI 53511.
What type of hospital is Beloit Health System?
Beloit Health System is classified by CMS as a Acute Care Hospitals facility (Voluntary non-profit - Private).

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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