1_AttachmentJ-17NYSCIPHospital.pdf

Provider ID Hospital Name Address City State ZIP Code

330027 Nassau University Medical Center 2201 Hempstead Turnpike East Meadow NY 11554 330036 Community Hospital At Dobbs Ferry 128 Ashford Avenue Dobbs Ferry NY 10522 330041 Parkway Hospital 70-35 113th Street Forest Hills NY 11375 330047 St. Marys Hospital At Amsterdam 427 Guy Park Avenue Amsterdam NY 12010 330053 Medina Memorial Hospital 200 Ohio Street Medina NY 14103 330061 Lawrence Hospital Center 55 Palmer Avenue Bronxville NY 10708 330078 Catholic Health System @ Sisters Of Charity 2157 Main Street Buffalo NY 14214 330133 Cabrini Medical Center 227 East 19th Street New York NY 10003 330135 Bon Secours Community Hospital 160 East Main Street Port Jervis NY 12771 330141 Brookhaven Memorial Hospital Medical Center 101 Hospital Road Patchogue NY 11772 330201 Kingsbrook Jewish Medical Center 585 Schenectady Avenue Brooklyn NY 11203 330203 Crouse Hospital 736 Irving Avenue Syracuse NY 13210 330218 Oswego Hospital 110 West Sixth Street Oswego NY 13126 330219 Erie County Medical Center 462 Grider Street Buffalo NY 14215 330222 Saratoga Hospital 211 Church Street Saratoga Springs NY 12866 330223 Massena Memorial Hospital 1 Hospital Drive Massena NY 13662 330232 Seton Health System/St. Mary'S Hospital 1300 Massachusetts Avenue Troy NY 12180 330234 Westchester Medical Center Grasslands Reservation Valhalla NY 10595 330235 Auburn Memorial Hospital 17 Lansing Street Auburn NY 13021 330240 Harlem Hospital Center 506 Lenox Ave New York NY 10037 330241 Suny Upstate Medical University Hospital 750 East Adams Street Syracuse NY 13210 330250 Champlain Valley Physicians Hospital Medical Center 75 Beekman St Plattsburgh NY 12901

NY 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.

330263 Carthage Area Hospital, Inc 1001 West Street Road Carthage NY 13619 330279 Catholic Health System / Mercy Hospital Of Buffalo 565 Abbott Road Buffalo NY 14220 330290 Svcmc-St. Vincent'S Hospital/Manhattan 170 West 12th Street New York NY 10011 330340 Southampton Hospital 240 Meeting House Lane Southampton NY 11968 330357 Caritas Health 90-02 Queens Boulevard Elmhurst NY 11373 330394 United Health Services/Binghamton General Hospital 33-57 Harrison Street Johnson City NY 13790 330397 Interfaith Medical Center 1545 Atlantic Avenue Brooklyn NY 11213 330399 St. Barnabas Hospital 4422 Third Avenue Bronx NY 10457