A team of CHI Memorial operating room personnel prepare for a midday Tuesday broncoscopy under the direction of Dr. Krish Bhadra, third from left. Two Vanderbilt University Medical Center doctors were in the hybrid operating room to observe and gain information on the latest techniques.

CHI Memorial Hospital improved its quality rating for the third consecutive year in the annual study of hospitals by U.S. News & World Report to rise to the second best hospital in the state.

Chattanooga's Memorial hospital was behind only Vanderbilt University Medical Center in Nashville among the 140 hospitals in Tennessee ranked by a variety of performance measurements in 16 adult specialties, nine adult procedures and conditions and 10 pediatric specialties.

The top 5

1. Vanderbilt University Medical Center in Nashville

2. CHI Memorial Hospital in Chattanooga

3. University of Tennessee Medical Center in Knoxville

4. St. Thomas West Hospital in Nashville

5. Baptist Memorial Hospital-Memphis

Source: U.S. News & World Report 2018-2019 Best Hospitals’ Rankings,

"We've had a focused strategy for a number of years to continuously improve quality, safety, patient experience and employee engagement," Melissa Rosen, vice president of quality at CHI Memorial Hospital, said Monday. "We're actively engaged in improving our performance and we've seen our data (measured by Medicare patient data and outcomes) improve year over year."

CHI Memorial ranked third in Tennessee in 2017 and placed fourth in 2016 in the U.S. News & World Report hospital ratings.

The Centers for Medicare and Medicaid Services has given Memorial a 4-star rating on its 5-star scale for both its overall rating and for the patient experience ranking. The hospital was rated "high performing" in all nine adult procedures and conditions.

Vanderbilt hospital in Nashville was ranked nationally in 10 adult and 10 pediatric specialties and was judged to be the 17th best hospital overall on the U.S. News Hospitals Honor Roll.

To be nationally ranked in a specialty, a hospital must excel in caring for the sickest, most medically complex patients. The ratings in procedures and conditions like how Memorial was judged to offer high service for are compiled from data on typical Medicare patients.

The magazine evaluates hospitals based upon comparable data for all Medicare patients across a wide range of conditions and procedures. Within that range, U.S. News said said hospitals can and do perform differently.

No other hospitals in the Chattanooga region were ranked by U.S. News & World Report in its new rating of best hospitals.

Erlanger spokeswoman Pat Charles said Chattanooga's biggest hospital is the region's only academic medical center and safety net hospital and provides more than $120 million a year in uncompensated care. Only about one-forth of Erlanger's revenues come from Medicare fee-for-service, compared with more than 50 percent at Memorial.

"As such (Erlanger) serves a much broader patient base," she said. "Because Erlanger does not primarily serve the elderly, it does not meet the target threshold levels for the Medicare fee-for-service only patients surveyed in this rankings report."