# Care Compare Market Analysis — Inland Empire / Riverside–San Bernardino Hospitals **Scope:** 21 acute-care hospitals across San Bernardino and Riverside counties, anchored on Redlands Community Hospital (RCH, CCN 050272). **Source:** CMS Care Compare / Provider Data Catalog (data.cms.gov), Hospital General Information and the per-measure publish files (HCAHPS, Complications & Deaths, Unplanned Hospital Visits, Healthcare-Associated Infections, Timely & Effective Care, Medicare Spending per Beneficiary, Maternal Health, Outpatient Imaging). Data as pulled to `_build/carecompare/` on 2026-06-28. **Measurement periods (vary by domain):** HCAHPS and HAI = 07/01/2024–06/30/2025; mortality/complications = rolling 3-yr windows ending 03/31/2024 or 06/30/2024; readmissions/return-days = windows ending 06/30/2024 or 12/31/2024; Timely & Effective = CY2024 (sepsis/ED) through 03/31/2025 for some eCQMs; MSPB and maternal = CY2024; outpatient imaging = 07/01/2023–06/30/2024. > **Note on flags.** "Mortality flags" and "Readmission flags" count measures CMS labels in the unfavorable direction versus the national benchmark — for mortality, "Worse Than the National Rate"; for readmissions, "Worse Than the National Rate" **plus** the excess-days measures (EDAC) flagged "More Days Than Average per 100 Discharges." Complication (PSI) flags count "Worse Than the National Rate/Value." These per-measure flags are stricter than the rolled-up group counts in Hospital General Information, which also fold in measures with too few cases to compare. --- ## 1. Overall star ratings — where the market sits CMS overall star distribution across the 21 facilities: **1 hospital at 1 star, 6 at 2 stars, 9 at 3 stars, 5 at 4 stars, none at 5 stars.** - **Leaders (4 stars):** Loma Linda University Medical Center (LLUMC), Kaiser Foundation Hospital Riverside, Kaiser Foundation Hospital Moreno Valley, Eisenhower Medical Center (Rancho Mirage), and Chino Valley Medical Center. - **Laggard (1 star):** Hemet Global Medical Center — also dead last on patient experience. - **RCH = 2 stars.** Redlands sits in the lower-middle tier, tied with five other 2-star hospitals (LLUMC-Murrieta, St. Bernardine, Arrowhead Regional, Riverside Community, Desert Regional). RCH trails the academic flagship LLUMC (4) and all three rated Kaiser facilities (3–4), and is one star behind nearby San Antonio Regional, Pomona Valley, Community Hospital of San Bernardino, and San Gorgonio (all 3). The county-safety-net and for-profit community hospitals cluster at 2–3 stars; the integrated Kaiser plants and the academic LLUMC pull the top of the distribution. --- ## 2. Patient experience (HCAHPS, 07/01/2024–06/30/2025) "Definitely recommend" (H_RECMND_DY) percent, top of market: | Rank | Hospital | Recommend % | HCAHPS summary star | |---|---|---|---| | 1 (tie) | Kaiser Fontana/Ontario | 78 | 4 | | 1 (tie) | LLUMC | 78 | 4 | | 1 (tie) | Eisenhower | 78 | 3 | | 4 (tie) | **Redlands Community** | **75** | **3** | | 4 (tie) | LLU Children's | 75 | 3 | | … | Riverside Community | 63 | 2 | | … | Corona Regional | 48 | 2 | | 21 | Hemet Global | 38 | 1 | **Kaiser Fontana leads patient experience** (4-star HCAHPS, 78% recommend) alongside academic LLUMC and Eisenhower. **RCH is a relative bright spot on experience:** a 3-star HCAHPS summary and 75% recommend place it 4th of 21 on recommend-rate — well above its overall 2-star rating would suggest, and ahead of every for-profit community competitor. Patient experience is RCH's strongest domain relative to the market. The bottom of the market (Hemet 38%, Corona 48%, Montclair 58%) is where experience risk concentrates. --- ## 3. Mortality (Complications & Deaths, 3-yr windows ending 2024) Worse-than-national mortality flags are **rare** across this market — only one measure is flagged worse-than-national anywhere: - **RCH — Death rate for stroke patients (MORT_30_STK) = 18.5, "Worse Than the National Rate."** This is RCH's single most notable quality red flag in the dataset and the only worse-than-national 30-day mortality measure among all 21 hospitals. Every other RCH mortality measure (HF, PN, COPD, hybrid hospital-wide) is "No Different Than the National Rate." - Better-than-national mortality bright spots: Pomona Valley (heart-failure mortality), Chino Valley and Montclair (pneumonia mortality). - LLUMC posts zero worse-than-national mortality flags (8 of 8 measures "No Different"), consistent with its 4-star rating and academic case-mix adjustment. **Takeaway for RCH:** stroke mortality is the headline clinical gap to investigate (volume, door-to-needle/thrombectomy pathways, neuro coverage), and it is a differentiator competitors do not share. --- ## 4. Safety / infections (HAI SIRs, 07/01/2024–06/30/2025) Standardized Infection Ratios (SIR <1.0 = better than national benchmark). Selected: | Hospital | CLABSI | CAUTI | MRSA | C. diff | |---|---|---|---|---| | **Redlands Community** | **0.71** | **0.69** | **1.06** | **0.95** | | LLUMC | 0.44 | 0.25 | 0.57 | 0.35 | | Kaiser Fontana | 0.21 | 0.43 | 0.32 | 0.20 | | Kaiser Moreno Valley | 0.48 | 0.79 | 0.89 | 0.12 | | St. Bernardine | 0.00 | 0.16 | 1.32 | 0.19 | | Riverside Community | 0.75 | 0.76 | 0.93 | 0.46 | | RUHS Medical Center | 0.30 | 0.29 | 1.47 | 0.13 | - **LLUMC and the Kaiser plants run the cleanest infection profiles** — most SIRs well under 0.5, reflecting mature infection-prevention programs and scale. - **RCH is middling on safety:** CLABSI (0.71) and CAUTI (0.69) are below benchmark (good), C. diff (0.95) is roughly at benchmark, but **MRSA bacteremia SIR = 1.06 is slightly above national** — the one infection metric where RCH runs hot. RCH's device-related infection control is solid; bloodstream/MRSA is the watch item. - Worst MRSA outliers in the market: RUHS (1.47), St. Bernardine (1.32), Desert Regional (1.01), RCH (1.06). - All facilities' complication/PSI measures are "No Different Than the National Rate" — no worse-than-national PSI flags anywhere in the market, so safety differentiation lives in the HAI SIRs, not the PSIs. --- ## 5. ED throughput (OP_18b — median minutes ED arrival to departure, lower is better) | Fastest | min | | Slowest | min | |---|---|---|---|---| | Community Hospital of San Bernardino | 147 | | LLUMC | 464 | | Montclair | 151 | | Eisenhower | 259 | | Chino Valley | 173 | | San Antonio Regional | 256 | | St. Bernardine / Desert Regional | 181 | | RUHS Medical Center | 245 | - **RCH = 222 minutes — slower than the market median,** ranking in the bottom third of reporting hospitals (12th of 18 with data). RCH's ED throughput trails every San Bernardino safety-net competitor (Community Hospital 147, St. Bernardine 181, Arrowhead 207) and is ~75 minutes slower than the fastest local option. - **LLUMC's 464-minute median is an extreme outlier** — more than double RCH and triple the market's fastest — typical of an academic Level I trauma/tertiary referral center boarding complex and transfer patients. - The three rated Kaiser hospitals do not report OP_18b (closed-system EDs report selectively), so Kaiser is excluded from this comparison. **Takeaway for RCH:** ED length-of-stay is an operational gap versus same-county community competitors and a concrete throughput target. --- ## 6. Sepsis (SEP-1, CY2024) and spending (MSPB, CY2024) **SEP-1 (appropriate severe-sepsis/septic-shock care, higher is better):** San Gorgonio leads at 92%, then Kaiser Fontana 87% and Kaiser Moreno Valley 86%. **RCH = 82% — top third of the market (5th of 21)** and a genuine strength; it beats LLUMC (56%), Eisenhower (56%), Riverside Community (62%), and the two Kaiser referral sites it trails only narrowly. Sepsis bundle compliance is a domain where RCH outperforms much larger competitors. **MSPB-1 (Medicare spending per beneficiary, ratio; <1.0 = lower-cost than national):** Kaiser Fontana is most efficient (0.93), then Kaiser Riverside (0.97), LLUMC and Pomona Valley (0.99). **RCH = 1.05 — modestly above the national average** and mid-pack locally. The highest-cost facilities are Montclair (1.23), Community Hospital of San Bernardino (1.16), and Riverside Community (1.12). The integrated Kaiser model and LLUMC's scale produce the lowest per-beneficiary spend; RCH is neither a cost leader nor an outlier. --- ## 7. Where RCH ranks — composite read | Domain | RCH value | Market position | |---|---|---| | Overall star | 2 / 5 | Lower-middle (6 hospitals tie at 2; 14 of 21 rated ≥ RCH) | | HCAHPS recommend | 75% | **4th of 21 (strength)** | | HCAHPS summary star | 3 / 5 | Upper-middle | | Mortality flags | 1 (stroke) | **Only worse-than-national mortality flag in market (weakness)** | | Readmission/EDAC flags | 1 (pneumonia excess days) | Better than peers (Riverside Community has 4) | | MRSA SIR | 1.06 | Slightly above benchmark (watch item) | | Other HAI SIRs | 0.69–0.95 | At/below benchmark (acceptable) | | ED median (OP_18b) | 222 min | **Bottom third (weakness)** | | SEP-1 | 82% | **Top third (strength)** | | MSPB | 1.05 | Mid-pack, slightly above national | **Net:** RCH's 2-star overall rating is dragged down primarily by the stroke-mortality flag and a slow ED, not by patient experience (3-star, strong recommend) or sepsis care (top-third), where it competes well above its weight class. The strategic gaps are concrete and narrow: stroke 30-day mortality and ED throughput. --- ## 8. Notable structural contrasts - **Academic (LLUMC) vs. community vs. Kaiser vs. county/safety-net:** - **LLUMC (academic, 4-star):** cleanest infections, zero mortality flags, top patient experience — but the slowest ED in the market by a wide margin (464 min), the classic tertiary/trauma tradeoff. Loma Linda's children's hospital and Murrieta satellite rate lower (3 and 2 stars), so the brand is not uniform. - **Kaiser (integrated, 3–4 star):** strongest on cost efficiency (MSPB 0.93–0.97), strong infections and patient experience, high sepsis compliance — but opaque on ED throughput (OP_18b not reported). The closed integrated model is the cost-and-experience benchmark of the market. - **County / safety-net (Arrowhead, RUHS):** 2–3 stars, fast-to-moderate EDs, but elevated MRSA (RUHS 1.47) — high-acuity, high-volume safety-net signatures. - **For-profit community (Hemet, Corona, Montclair, Chino, Desert Regional):** widest spread — Chino reaches 4 stars while same-operator Hemet sits at 1 star with the market's worst patient experience (38% recommend) and Montclair carries the highest cost (1.23) plus a worse-than-national pneumonia readmission flag. - **Voluntary non-profit community (RCH, San Antonio Regional, Pomona Valley, San Gorgonio, Eisenhower):** RCH's true peer set. Within it, Eisenhower (4-star) and San Antonio/Pomona/San Gorgonio (3-star) all out-rank RCH on the overall star, but RCH leads or ties several of them on recommend-rate and sepsis. --- ## Sources - CMS Care Compare / Provider Data Catalog (data.cms.gov / data.medicare.gov) — Hospital General Information; Patient Survey (HCAHPS); Complications and Deaths; Unplanned Hospital Visits; Healthcare-Associated Infections; Timely and Effective Care; Medicare Hospital Spending per Patient (MSPB); Maternal Health; Outpatient Imaging Efficiency. Hospital Compare datasets, accessed for this build 2026-06-28. - Measurement periods per domain as listed in the header above; periods are carried in the `Start Date`/`End Date` of each source file and are domain-specific. - Star-rating methodology: CMS Overall Hospital Quality Star Rating (1–5), summary across Mortality, Safety, Readmission, Patient Experience, and Timely & Effective Care measure groups.