★★★★★5 out of 5 StarsWhy 5 stars?Baptist Health West Kendall Baptist Hospital's 5-star rating reflects above-average performance on Mortality, Safety of Care, and Timely Care.
CMS Overall Hospital Quality Star Rating · Baptist Health West Kendall Baptist Hospital
How was Baptist Health West Kendall Baptist Hospital's 5-star rating calculated?
The CMS Overall Hospital Quality Star Rating applies to
acute care hospitals like Baptist Health West Kendall Baptist Hospital. CMS standardizes
every underlying measure against the national rate, computes
a weighted score for each of five domains, sums them by the
fixed weights below, and assigns 1–5 stars using k-means
clustering across all reporting hospitals.
Domains that fed Baptist Health West Kendall Baptist Hospital's rating
Domain
Weight
Measures reported
Hospital performance vs. national
Mortality
22%
5 of 7
2 better3 same0 worse
Safety of Care
22%
17 of 19
2 better15 same0 worse
Readmissions
22%
3 of 6
1 better1 same1 worse
Timely & Effective Care
12%
15 of 22
11 better4 same0 worse
Patient Experience
22%
HCAHPS
See HCAHPS detail below
How star meaning varies by hospital type.
This CMS Overall Star Rating only applies to acute care
hospitals. Children's hospitals (Pediatric Quality), psychiatric
hospitals (IPFQR), inpatient rehabilitation facilities (IRF QRP),
long-term acute care hospitals (LTACH QRP), and VA medical centers
each use separate quality programs designed for their patient
populations. Comparing star ratings across these facility types
isn't meaningful — see the methodology page for the full mapping
of which program applies to which facility.
Measures the rate at which patients die within 30 days of hospital admission for specific conditions. A lower mortality rate indicates better outcomes.
Baptist Health West Kendall…
WorseUS AvgBetter
Underlying measures:Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateBetter Than the National RateHospital score: 3.10 95% interval: 2.40 – 3.90 Sample size: 540Reporting period: 07/01/2023 – 06/30/2024CMS measure id: Hybrid_HWMDeath rate for pneumonia patientsBetter Than the National RateHospital score: 12.00 95% interval: 9.60 – 14.90 Sample size: 251Reporting period: 07/01/2021 – 06/30/2024CMS measure id: MORT_30_PNDeath rate for COPD patientsNo Different Than the National RateHospital score: 7.40 95% interval: 4.50 – 12.00 Sample size: 50Reporting period: 07/01/2021 – 06/30/2024CMS measure id: MORT_30_COPDDeath rate for heart failure patientsNo Different Than the National RateHospital score: 9.60 95% interval: 7.10 – 13.20 Sample size: 157Reporting period: 07/01/2021 – 06/30/2024CMS measure id: MORT_30_HFDeath rate for stroke patientsNo Different Than the National RateHospital score: 11.40 95% interval: 8.10 – 15.60 Sample size: 54Reporting period: 07/01/2021 – 06/30/2024CMS measure id: MORT_30_STKDeath rate for CABG surgery patientsNot AvailableHospital score: — Reporting period: 07/01/2021 – 06/30/2024CMS measure id: MORT_30_CABGDeath rate for heart attack patientsNumber of Cases Too SmallHospital score: — Reporting period: 07/01/2021 – 06/30/2024CMS measure id: MORT_30_AMI
Safety of Care
Better than National Average
Tracks hospital-acquired infections, surgical complications, and other patient safety indicators. Lower rates indicate better safety practices.
Baptist Health West Kendall…
WorseUS AvgBetter
Underlying measures:Clostridium Difficile (C.Diff)Better than the National BenchmarkHospital score: 0.33 SIR Reporting period: 07/01/2024 – 06/30/2025CMS measure id: HAI_6_SIRSSI - Colon SurgeryBetter than the National BenchmarkHospital score: 0.00 SIR Reporting period: 07/01/2024 – 06/30/2025CMS measure id: HAI_3_SIRAbdominopelvic accidental puncture or laceration rateNo Different Than the National RateHospital score: 0.96 95% interval: 0.00 – 2.00 Sample size: 346Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_15Catheter Associated Urinary Tract Infections (ICU + select Wards)No Different than National BenchmarkHospital score: 0.28 SIR Reporting period: 07/01/2024 – 06/30/2025CMS measure id: HAI_2_SIRCentral Line Associated Bloodstream Infection (ICU + select Wards)No Different than National BenchmarkHospital score: 0.00 SIR Reporting period: 07/01/2024 – 06/30/2025CMS measure id: HAI_1_SIRIatrogenic pneumothorax rateNo Different Than the National RateHospital score: 0.31 95% interval: 0.09 – 0.54 Sample size: 2,513Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_06In-hospital fall-associated fracture rateNo Different Than the National RateHospital score: 0.29 95% interval: 0.08 – 0.49 Sample size: 2,605Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_08MRSA BacteremiaNo Different than National BenchmarkHospital score: 0.00 SIR Reporting period: 07/01/2024 – 06/30/2025CMS measure id: HAI_5_SIRPostoperative hemorrhage or hematoma rateNo Different Than the National RateHospital score: 2.78 95% interval: 1.11 – 4.45 Sample size: 324Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_09Perioperative pulmonary embolism or deep vein thrombosis rateNo Different Than the National RateHospital score: 3.42 95% interval: 0.98 – 5.85 Sample size: 345Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_12Postoperative acute kidney injury requiring dialysis rateNo Different Than the National RateHospital score: 1.65 95% interval: 0.00 – 3.37 Sample size: 63Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_10Postoperative respiratory failure rateNo Different Than the National RateHospital score: 8.46 95% interval: 0.00 – 18.13 Sample size: 55Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_11Postoperative sepsis rateNo Different Than the National RateHospital score: 4.91 95% interval: 0.70 – 9.12 Sample size: 56Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_13Pressure ulcer rateNo Different Than the National RateHospital score: 0.28 95% interval: 0.00 – 1.19 Sample size: 2,311Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_03CMS Medicare PSI 90: Patient safety and adverse events compositeNo Different Than the National ValueHospital score: 0.88 95% interval: 0.46 – 1.30 Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_90SSI - Abdominal HysterectomyNo Different than National BenchmarkHospital score: 1.69 SIR Reporting period: 07/01/2024 – 06/30/2025CMS measure id: HAI_4_SIRPostoperative wound dehiscence rateNo Different Than the National RateHospital score: 1.72 95% interval: 0.21 – 3.24 Sample size: 109Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_14Rate of complications for hip/knee replacement patientsNot AvailableHospital score: — Reporting period: 04/01/2021 – 03/31/2024CMS measure id: COMP_HIP_KNEEDeath rate among surgical inpatients with serious treatable complicationsNumber of Cases Too SmallHospital score: — Reporting period: 07/01/2022 – 06/30/2024CMS measure id: PSI_04
Readmissions
Same as National Average
Measures how often patients return to the hospital within 30 days of discharge. Lower readmission rates suggest effective treatment and discharge planning.
Based on the HCAHPS survey — patient satisfaction with communication, cleanliness, pain management, and discharge information.
Baptist Health West Kendall…
WorseUS AvgBetter
Patient survey detail — the questions feeding the Patient Experience domain above
expand ↓
CMS computes the Patient Experience domain from the federal HCAHPS survey.
Each bar below is one survey question; the percentage is the share of
Baptist's recent patients who gave the most positive
response. HCAHPS percentages aren't directly comparable across all measures —
see the methodology page for how CMS weights them.
Communication with Nurses77%
Communication with Doctors77%
Hospital Cleanliness75%
Hospital Quietness66%
Staff ResponsivenessN/A
Discharge Information83%
Overall Hospital Rating (9 or 10)72%
Would Recommend Hospital75%
Percentages represent patients who gave the most positive response. Survey conducted by CMS through the HCAHPS program.
Timely & Effective Care
Better than National Average
Measures how quickly the hospital provides important treatments such as antibiotics for pneumonia or interventions for heart attacks.
Baptist Health West Kendall…
WorseUS AvgBetter
Underlying measures:Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patientsBetter than ~75% of hospitalsHospital score: 100.00 % National median: 97.00 % (higher is better)
Sample size: 62Reporting period: 01/01/2024 – 12/31/2024CMS measure id: OP_29Safe Use of Opioids - Concurrent PrescribingBetter than ~75% of hospitalsHospital score: 10.00 % National median: 15.00 % (lower is better)
Sample size: 1,836Reporting period: 01/01/2024 – 12/31/2024CMS measure id: SAFE_USE_OF_OPIOIDSHead CT resultsBetter than ~75% of hospitalsHospital score: 90.00 % National median: 74.00 % (higher is better)
Sample size: 20Reporting period: 07/01/2024 – 06/30/2025CMS measure id: OP_23Intensive Care Unit Venous Thromboembolism ProphylaxisBetter than ~75% of hospitalsHospital score: 100.00 % National median: 97.00 % (higher is better)
Sample size: 774Reporting period: 01/01/2024 – 12/31/2024CMS measure id: VTE_2Left before being seenBetter than ~75% of hospitalsHospital score: 1.00 % National median: 1.00 % (lower is better)
Sample size: 114,857Reporting period: 01/01/2024 – 12/31/2024CMS measure id: OP_22Appropriate care for severe sepsis and septic shockBetter than ~75% of hospitalsHospital score: 90.00 % National median: 64.00 % (higher is better)
Sample size: 436Reporting period: 07/01/2024 – 06/30/2025CMS measure id: SEP_1Septic Shock 3-Hour BundleBetter than ~75% of hospitalsHospital score: 91.00 % National median: 72.00 % (higher is better)
Sample size: 141Reporting period: 07/01/2024 – 06/30/2025CMS measure id: SEP_SH_3HRSeptic Shock 6-Hour BundleBetter than ~75% of hospitalsHospital score: 99.00 % National median: 89.00 % (higher is better)
Sample size: 113Reporting period: 07/01/2024 – 06/30/2025CMS measure id: SEP_SH_6HRSevere Sepsis 3-Hour BundleBetter than ~75% of hospitalsHospital score: 95.00 % National median: 81.00 % (higher is better)
Sample size: 437Reporting period: 07/01/2024 – 06/30/2025CMS measure id: SEV_SEP_3HRSevere Sepsis 6-Hour BundleBetter than ~75% of hospitalsHospital score: 98.00 % National median: 94.00 % (higher is better)
Sample size: 317Reporting period: 07/01/2024 – 06/30/2025CMS measure id: SEV_SEP_6HRVenous Thromboembolism ProphylaxisBetter than ~75% of hospitalsHospital score: 99.00 % National median: 90.00 % (higher is better)
Sample size: 6,815Reporting period: 01/01/2024 – 12/31/2024CMS measure id: VTE_1Antithrombotic Therapy by End of Hospital Day 2Near the national medianHospital score: 96.00 % National median: 94.00 % (higher is better)
Sample size: 189Reporting period: 01/01/2024 – 12/31/2024CMS measure id: STK_05Average (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 betterNear the national medianHospital score: 186.00 min National median: 148.00 min (lower is better)
Sample size: 370Reporting period: 07/01/2024 – 06/30/2025CMS measure id: OP_18bAverage (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 betterNear the national medianHospital score: 187.00 min National median: 154.00 min (lower is better)
Sample size: 387Reporting period: 07/01/2024 – 06/30/2025CMS measure id: OP_18aHealthcare workers given influenza vaccinationNear the national medianHospital score: 85.00 % National median: 79.00 % (higher is better)
Sample size: 2,344Reporting period: 10/01/2024 – 03/31/2025CMS measure id: IMM_3
Clinical Staff
Baptist Health West Kendall Baptist Hospital has 381 CMS-affiliated
clinicians on its roster — physicians, advanced practice providers, and other
Medicare-enrolled professionals who list this hospital as an affiliated facility.
Top specialties
Diagnostic Radiology52
Emergency Medicine40
Hospitalist35
Internal Medicine25
Physician Assistant20
Certified Registered Nurse Anesthetist (Crna)19
Nurse Practitioner18
Cardiovascular Disease (Cardiology)17
Self-reported primary specialty in the CMS Doctors & Clinicians dataset. Many clinicians serve multiple facilities.
Practice characteristics
Accept Medicare assignment
377(99%)
Bill Medicare directly at the approved rate — patients only owe co-insurance/deductible.
Offer telehealth
109(29%)
Indicated by the clinician in their CMS profile as routinely providing virtual visits.
Medicare quality scoring (MIPS)
219 of these clinicians have a published
Merit-based Incentive Payment System (MIPS) final score.
Of those, 87
(40%) score above the national median of 85.5.
MIPS scoring is heavily compressed at the top of the 0–100 range, so individual scores
are not a reliable consumer signal. We surface roster-level coverage and the share
above the national median instead.
Source: CMS Doctors and Clinicians (Care Compare) national downloadable file
and MIPS Performance Year final scores, as of 2026-05-27.
Affiliations from the CMS Facility Affiliations dataset. About 16% of small
facilities (critical access, rural emergency, freestanding psych, IRF/LTCH)
do not appear in the affiliations file and therefore have no panel.
Find a Doctor
Search the 381 clinicians affiliated with Baptist Health West Kendall Baptist Hospital.
Each name links to that clinician's official Medicare Care Compare profile, where you can see
their credentials, secondary specialties, group affiliations, and (when applicable) MIPS quality scores.
No clinicians match that search. Try a broader term like "internal medicine" or just a last name.
Roster from CMS Doctors and Clinicians (Care Compare), updated 2026-05-27.
A clinician may also practice at other facilities; "affiliated" means this hospital is on their CMS
profile, not that they exclusively work here.
Quality and ratings data are sourced from the U.S. Centers for
Medicare & Medicaid Services (CMS) Hospital Compare program.
Star ratings are CMS's own calculation; CareRanks does not modify
or re-weight them. Facility-level details (address, beds,
ownership, teaching status) come from CMS provider files and the
CMS Provider of Services file.
Pricing data, where shown, is drawn from the hospital's own
Machine-Readable File (MRF) published under the federal Hospital
Price Transparency Rule. See our methodology for the full update
cadence and limitations.