Some hospitals are better than others for seniors in need of a new knee or hip, according to new data from Medicare.

The government agency examined which providers had the highest rates of readmission (returning to the hospital within 30 days of discharge) and post-operative complications (death, sepsis, blood clot or issues with an artificial joint) after performing knee or hip replacement surgery on elderly patients.

At the bottom of the list were nine hospitals that did poorly on both readmission and complication measures:

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  • Reston Hospital Center, Reston, VA
  • Southside Regional Medical Center, Petersburg, VA
  • Peterson Regional Medical Center, Kerrville, TX
  • Shannon Medical Center, San Angelo, TX
  • Froedert Hospital, Milwaukee, WI
  • Northwestern Memorial Hospital, Chicago, IL
  • Hospital of the University of Pennsylvania Health System, Philadelphia, PA
  • Mercy St. Anne Hospital, Toledo, OH
  • Grant Medical Center, Columbus, OH

Many more institutions—25 in total—made it to the top of the list by performing higher than average on both readmission and complication rates:

  • Arkansas Surgical Hospital, Little Rock, AR
  • Hoag Orthopedic Institute, Irvine, CA
  • Saint John's Health Center, Santa Monica, CA
  • St. Joseph Hospital, Orange, CA
  • Sutter General Hospital, Sacramento, CA
  • Washington Hospital, Fremont, CA
  • Poudre Valley Hospital, Fort Collins, CO
  • Heart of Florida Regional Medical Center, Davenport, FL
  • Holy Cross Hospital, Fort Lauderdale, FL
  • Ocala Regional Medical Center, Ocala, FL
  • Saint Joseph's Hospital of Atlanta, Atlanta, GA
  • Orthopaedic Hospital at Parkview North, Fort Wayne, IN
  • Kansas Medical Center, Andover, KS
  • New England Baptist Hospital, Boston, MA
  • Maine Medical Center, Portland, ME
  • St. Joseph Mercy Oakland, Pontiac, MI
  • Heartland Regional Medical Center, Saint Joseph, MO
  • Memorial Mission Hospital and Asheville Surgery center, Asheville, NC
  • Saint Elizabeth Regional Medical Center, Lincoln, NE
  • Hospital for Special Surgery, New York, NY
  • Samaritan Regional Health System, Ashland, OH
  • Oklahoma Surgical Hospital, Tulsa, OK
  • Memorial Healthcare System, Chattanooga, TN
  • Vhs Harlingen Hospital Company, Harlingen, TX
  • Sentara Leigh Hospital, Norfolk, VA

Deciding where to undergo surgery Surgery of any kind is a serious undertaking for an older adult. Risk of complication and infection rise rapidly with advancing years. At the same time, the pain and instability caused by a worn out hip or knee greatly increases the risk of falls for elderly people.

Joint replacement is often considered an elective surgery, which means a senior may have some say in where they would like the procedure to be performed. While it may not be possible for your loved one to go to one of the highest-ranked hospitals, there are plenty of institutions that offer good quality care, as long as you know what to look for.

The National Institutes of Health (NIH) offer some tips for choosing the right place for joint replacement surgery:

  • A well-staffed nursing unit.
  • A set of uniform guidelines outlining what kinds of pre-and post-operative care joint replacement patients should receive.
  • Operating rooms specifically reserved for orthopedic surgeries.
  • A separate unit or floor that is reserved for joint replacement surgeries.
  • How frequently that particular surgery has been performed at the hospital—more procedures indicates a more experienced staff. This is an especially important consideration if you or your loved one is planning on having a surgery that employs newer techniques.

For more information on how to pick the right doctor or hospital, see these 4 Questions to Ask Before Choosing a Health Care Provider.