1_AttachmentJ-17MNSCIPHospital.pdf

Provider ID Hospital Name Address City State ZIP Code

240004 Hennepin County Medical Center 701 Park Avenue Minneapolis MN 55415 240006 Olmsted Medical Center 1650 4th Street Se Rochester MN 55904 240036 St Cloud Hospital 1406 6th Ave North Saint Cloud MN 56303 240038 United Hospital 333 North Smith Ave Saint Paul MN 55102 240064 Grand Itasca Clinic And Hospital 1601 Golf Course Road Grand Rapids MN 55744 240084 Virginia Regional Medical Center 901 9th St N Virginia MN 55792 241304 Wheaton Community Hospital 401 12th Street North Wheaton MN 56296 241326 Long Prairie Memorial Hospital 20 Ninth Street Southeast Long Prairie MN 56347 241356 Mille Lacs Health System 200 North Elm Street Onamia MN 56359

MN Hospitals Targeted for Improvement Based on Surgical Care Improvement Plan (SCIP) Quality Measures "SCIP Infection-1" and "SCIP-Infection 3." "SCIP-Infection 1" measures "prophylactic antibiotic received within 1 hour prior to surgical incision." "SCIP-Infection 3" measures "prophylactic antibiotic discontinued within 24 hours after surgery time ends."

NOTE: For more information about CMS' quality measures for hospitals, please visit the Hospital Compare tool at http://www.hospitalcompare.hhs.gov.

The QIO may recruit up to 15% of the total number of providers they will work with from among providers not included in the J-17. The QIO must submit the criteria used to select these providers in their proposal to CMS. In no case may the total number of providers exceed the maximum number of providers as specified in Table B nor may the number of providers not identified in the J-17 exceed 15% of the total number of the providers the QIO recruits to work with.