ENDLESS MOUNTAINS HEALTH SYSTEMS — Quality & Patient Safety
MONTROSE, PA · Critical Access Hospitals · Emergency services available
Source: CMS Hospital Compare, HCAHPS Survey
By BillRazor Research · Last updated June 1, 2026 · View pricing data
CMS Overall Hospital Quality
Out of 5 stars · CMS Hospital Compare rating
N/A
Patients recommend
91
Survey responses
Patient Satisfaction
N/A
Overall HCAHPS score
Avg Readmission Ratio
N/A
At or below average
Quality Measures
15
CMS-tracked metrics
Quality Score
60
Composite index
Healthcare-Associated Infections (HAI)
Performance vs national benchmarks on hospital-acquired infection measures.
0
Better than average
Lower infection rates
0
Same as average
Near national rate
0
Worse than average
Higher infection rates
| Measure | Score | vs National |
|---|---|---|
| Central Line Associated Bloodstream Infection: Number of Device Days | 23.00 | Not Available |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases | 0.01 | Not Available |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases | 0.00 | Not Available |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days | 348.00 | Not Available |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases | 0.23 | Not Available |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases | 0.00 | Not Available |
| MRSA Bacteremia: Patient Days | 2670.00 | Not Available |
| MRSA Bacteremia: Predicted Cases | 0.06 | Not Available |
| MRSA Bacteremia: Observed Cases | 0.00 | Not Available |
| Clostridium Difficile (C.Diff): Patient Days | 2521.00 | Not Available |
| Clostridium Difficile (C.Diff): Predicted Cases | 0.72 | Not Available |
| Clostridium Difficile (C.Diff): Observed Cases | 0.00 | Not Available |
What quality scores mean for patients at ENDLESS MOUNTAINS HEALTH SYSTEMS
ENDLESS MOUNTAINS HEALTH SYSTEMS holds a CMS overall rating of 3 out of 5 stars, based on publicly reported quality measures. This places it at #55 out of 122 hospitals in PA. Quality ratings aggregate dozens of individual measures — from nurse communication and cleanliness to surgical complication rates and timely care — into a single composite. While no single number captures the full patient experience, the star rating provides a useful starting point for understanding whether a hospital consistently meets or falls short of national performance standards.
Readmission rates are one of the strongest indicators of care quality. Hospitals with high readmission rates often face challenges in discharge planning and care coordination — issues that can also manifest in billing complexity. When a patient is readmitted, the resulting bills multiply, making accurate billing on the initial stay even more critical.
Research consistently shows a correlation between hospital operational quality and billing accuracy. Hospitals that perform well on patient safety, infection control, and care coordination tend to have more robust administrative processes, including medical coding and billing. Conversely, facilities with lower quality scores — particularly those with higher-than-average infection rates (0 measures worse than average at ENDLESS MOUNTAINS HEALTH SYSTEMS) or elevated readmission ratios — often exhibit higher rates of billing discrepancies. If you have received a bill from a hospital with mixed quality indicators, a line-by-line review against regional benchmarks can identify charges that may not align with the care actually delivered.
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Data from CMS Hospital Compare, HCAHPS Patient Survey, Hospital-Acquired Infection (HAI) reports, and Hospital Readmissions Reduction Program (HRRP). All data is publicly available.
Star ratings and quality measures are published by the Centers for Medicare & Medicaid Services (CMS). This page is for informational purposes only and does not constitute medical advice.
Frequently Asked Questions About ENDLESS MOUNTAINS HEALTH SYSTEMS Quality
What is ENDLESS MOUNTAINS HEALTH SYSTEMS's CMS star rating?
ENDLESS MOUNTAINS HEALTH SYSTEMS has an overall CMS star rating of 3 out of 5, based on the Hospital Compare quality rating system. This rating incorporates patient experience, safety, readmission rates, mortality outcomes, and timely & effective care. Star ratings are updated annually by the Centers for Medicare & Medicaid Services.
How do patients rate ENDLESS MOUNTAINS HEALTH SYSTEMS?
Patient satisfaction data for ENDLESS MOUNTAINS HEALTH SYSTEMS is based on the HCAHPS patient survey, which measures experience across dimensions including nurse and doctor communication, staff responsiveness, and cleanliness. Detailed scores are available on this page.
Does ENDLESS MOUNTAINS HEALTH SYSTEMS have higher-than-average readmission rates?
Readmission rate data for ENDLESS MOUNTAINS HEALTH SYSTEMS is based on the CMS Hospital Readmissions Reduction Program, which tracks whether patients are readmitted within 30 days for conditions like heart failure, pneumonia, and hip/knee replacement.
How does ENDLESS MOUNTAINS HEALTH SYSTEMS compare to other PA hospitals?
ENDLESS MOUNTAINS HEALTH SYSTEMS's quality metrics, including star rating, patient satisfaction, readmission rates, and infection data, can be compared against other PA hospitals on this page. The state peers section shows the top-rated hospitals in PA for context.
Data sourced from CMS Hospital Compare and HCAHPS Patient Survey. All information is for educational purposes only.