ALAMOSA — This week San Luis Valley Health has entered one of the top tiers for hospitals when it received a four-star rating on Thursday. Last year, the first year the overall hospital quality ratings were publicly available, SLV Health was a three-star hospital out of five possible stars.

"To get to this place where we've changed star rating levels is a really exciting day for us because it's an acknowledgment of a lot of years worth of work," said SLV Health CEO Konnie Martin. "Changes and improvements for things like service and quality are not single events. They take long periods of time to adjust."

The rating comes from the Centers for Medicare and Medicaid Services and is based on an analysis of a variety of criteria for Medicare patients receiving inpatient care. Only roughly 20-25 percent of hospitals in the nation are four- or five-star hospitals. A few other four-star and above hospitals in Colorado include Rio Grande Hospital, Swedish Medical Center, Mercy Regional Medical Center and St. Mary-Corwin Medical Center.

"We have a high Medicare population so it is a good reflection of our overall care," said SLV Health Chief Medical Officer Dr. Greg McAuliffe.

Mortality, readmission, safety of care and patient experience each make up 22 percent of the final score. Efficient use of medical imaging like contrast in MRIs, timeliness of care and effectiveness of care are weighted at four percent of the rating. Having high marks in safety and readmission rates is what allowed SLV Health to receive the four-star rating.

To lower readmissions, which are counted 30 days after discharge and apply to a patient visiting any hospital for any reason, SLV Health focused their efforts on follow-up appointments.

"We're even focusing now on chronic obstructive pulmonary disease, which is prevalent in the Valley, to make sure they have ongoing care with pulmonary rehab and primary care follow-up within five days of discharge so they're not coming back into the hospital."

Though there are times readmissions can be out of the hospital's control.

"If you're discharged here for pneumonia and you're up in Denver shopping and fall and break your hip 25 days later, that's a readmission," McAuliffe said. "If our readmission rate exceeds a certain benchmark then there is a certain penalty to it."

SLV Health is also trying to make their hospital the safest it can be by implementing new training, policies and procedures for early intervention.

"Humans make errors and it's our job to have a safety net to keep those from ever reaching the patient," said McAuliffe.

The majority of the criteria use objective statistics to grade the hospital, however the patient experience score is calculated from a voluntary survey called the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). That questionnaire has posed challenges for the hospital, especially because only nines and 10s are counted and an eight has the same impact as a zero.

"It's a little disconcerting for healthcare providers to be measured the same way as Yelp might measure a restaurant...but we're all playing on the same field so I think that also means our four star is as good as a four-star rating in Denver or Boston or wherever," said McAuliffe.

The hospital administration is proud of their staff's hard work and caring that allowed them to receive the new honor. "It's really the physicians and employees' award and recognition," Martin said. "I think that's what makes this such a prideful moment for me."

"There is not one single San Luis Valley Health employee that did contribute to this," added McAuliffe. "Not one. They did this because it's the right thing to do for our patients. We're glad we have four stars but that's not the goal."

Caption: Nurse Sammy Decker, right, and Discharge Planner Helen Ross assist a patient to lower the hospital's readmission rates within 30 days of discharge. San Luis Valley Health scored above the national average in low readmissions. Courtesy photo.