JCIPatientSafety.orgHospital Quality Directory

Acute Care Hospitals · Proprietary

Great Falls Clinic Hospital

2 / 5

At a glance

Great Falls Clinic Hospital carries a 2-star CMS overall rating — below 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 LimitNot available
Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence LimitNot available
Central Line Associated Bloodstream Infection: Number of Device Days653Not available
Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases0.432Not 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 LimitNot available
Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence LimitNot available
Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days1663Not available
Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases0.740Not 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 LimitNot available
SSI - Colon Surgery: Upper Confidence LimitNot available
SSI - Colon Surgery: Number of Procedures19Not available
SSI - Colon Surgery: Predicted Cases0.492Not available
SSI - Colon Surgery: Observed Cases0Not available
SSI - Colon SurgeryNot available
SSI - Abdominal Hysterectomy: Lower Confidence LimitNot available
SSI - Abdominal Hysterectomy: Upper Confidence LimitNot available
SSI - Abdominal Hysterectomy: Number of Procedures76Not available
SSI - Abdominal Hysterectomy: Predicted Cases0.632Not available
SSI - Abdominal Hysterectomy: Observed Cases1Not available
SSI - Abdominal HysterectomyNot available
MRSA Bacteremia: Lower Confidence LimitNot available
MRSA Bacteremia: Upper Confidence LimitNot available
MRSA Bacteremia: Patient Days8382Not available
MRSA Bacteremia: Predicted Cases0.253Not available
MRSA Bacteremia: Observed Cases0Not available
MRSA BacteremiaNot available
Clostridium Difficile (C.Diff): Lower Confidence Limit0.342Same as national
Clostridium Difficile (C.Diff): Upper Confidence Limit2.599Same as national
Clostridium Difficile (C.Diff): Patient Days8382Same as national
Clostridium Difficile (C.Diff): Predicted Cases3.712Same as national
Clostridium Difficile (C.Diff): Observed Cases4Same as national
Clostridium Difficile (C.Diff)1.078Same 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 patients3.7Same as national83
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate4.2Same as national363
Death rate for heart attack patients13.9Same as national44
Death rate for CABG surgery patients5.7Same as national31
Death rate for COPD patients9.3Same as national28
Death rate for heart failure patients14.3Same as national81
Death rate for pneumonia patients18.1Same as national90
Death rate for stroke patientsNot available
Pressure ulcer rate0.48Same as national778
Death rate among surgical inpatients with serious treatable complicationsNot available
Iatrogenic pneumothorax rate0.20Same as national1066
In-hospital fall-associated fracture rate0.26Same as national1111
Postoperative hemorrhage or hematoma rate2.64Same as national403
Postoperative acute kidney injury requiring dialysis rate2.00Same as national267
Postoperative respiratory failure rate10.36Same as national263
Perioperative pulmonary embolism or deep vein thrombosis rate3.04Same as national425
Postoperative sepsis rate7.29Same as national258
Postoperative wound dehiscence rate1.73Same as national90
Abdominopelvic accidental puncture or laceration rate1.02Same as national163
CMS Medicare PSI 90: Patient safety and adverse events composite1.04Same 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 patientsNot available
Hospital return days for heart failure patients10.3Not available88
Hospital return days for pneumonia patients11.9Not available89
Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)15Same as national477
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)11.8Same as national732
Rate of inpatient admissions for patients receiving outpatient chemotherapy8.4Same as national119
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy5.9Same as national119
Ratio of unplanned hospital visits after hospital outpatient surgery1Same as national224
Acute Myocardial Infarction (AMI) 30-Day Readmission Rate13.2Same as national44
Rate of readmission for CABG11.5Same as national28
Rate of readmission for chronic obstructive pulmonary disease (COPD) patients17.7Same as national28
Heart failure (HF) 30-Day Readmission Rate19.3Same as national88
Rate of readmission after hip/knee replacement4.5Same as national76
Pneumonia (PN) 30-Day Readmission Rate15.5Same as national89

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 rating4303
Doctor communication - star rating3303
Communication about medicines - star rating3303
Discharge information - star rating5303
Cleanliness - star rating4303
Quietness - star rating4303
Overall hospital rating - star rating4303
Recommend hospital - star rating5303
Summary star rating4303

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 Hyperglycemia01902
Hospital Harm - Severe Hypoglycemia0549
Hospital Harm - Opioid Related Adverse Events
Healthcare workers given influenza vaccination791026
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 better138384
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 better136352
Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better15711
Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better20724
Left before being seen111831
Head CT results
Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients42350
Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery
ST-Segment Elevation Myocardial Infarction (STEMI)
Safe Use of Opioids - Concurrent Prescribing131039
Appropriate care for severe sepsis and septic shock5058
Septic Shock 3-Hour Bundle8614
Septic Shock 6-Hour Bundle
Severe Sepsis 3-Hour Bundle7958
Severe Sepsis 6-Hour Bundle7232
Discharged on Antithrombotic Therapy
Anticoagulation Therapy for Atrial Fibrillation/Flutter
Antithrombotic Therapy by End of Hospital Day 2
Venous Thromboembolism Prophylaxis901498
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 Great Falls Clinic Hospital rated?
Great Falls Clinic Hospital has a 2 out of 5 CMS overall star rating as of the latest CMS release.
Does Great Falls Clinic Hospital have emergency services?
Yes. Great Falls Clinic Hospital operates a 24/7 emergency department.
Where is Great Falls Clinic Hospital located?
Great Falls Clinic Hospital is located at 3010 15th Avenue South, Great Falls, MT 59405.
What type of hospital is Great Falls Clinic Hospital?
Great Falls Clinic Hospital 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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