Ten Charlotte-area hospitals have been cited as “top performers on key quality measures” by the Joint Commission, the leading accreditation body for U.S. hospitals.

For the second consecutive year, the Joint Commission’s annual “Improving America’s Hospitals” report on quality and safety identified top-performing hospitals based on their use of “evidence-based” medical practices that result in good patient outcomes for common medical conditions and procedures.

Four hospitals owned or managed by Carolinas HealthCare System made the list. They are Carolinas Medical Center-Mercy in Charlotte, Carolinas Medical Center-Pineville, Carolinas Medical Center-Union in Monroe, and Anson Community Hospital in Wadesboro.

Other area hospitals on the list: Lake Norman Regional Medical Center in Mooresville, Davis Regional Medical Center and Iredell Memorial Hospital in Statesville, Rutherford Hospital in Rutherfordton, Springs Memorial Hospital in Lancaster, S.C., and Piedmont Medical Center in Rock Hill.

No hospitals from Presbyterian Healthcare made the list, and the area’s largest hospital, Carolinas Medical Center, owned by Carolinas HealthCare, also did not make the list.

Dr. Roger Ray, the Carolinas HealthCare System’s chief medical officer, said CMC’s absence is partly a function of how the Joint Commission evaluates hospitals for this report.

To be recognized, a hospital had to meet 95 percent of performance on a composite score that included all the accountability measures it reports to the Joint Commission, such as heart attack care, heart failure care and pneumonia care. Each hospital also had to meet a 95 percent performance target for every accountability measure for which it reported to the Joint Commission.

As a result, the Anson hospital – with only 30 acute care beds in a rural county – made the list when the much larger, more sophisticated CMC did not. Ray said Anson was scored on only one measure, whereas “a big complex hospital has lots more (measures) that would have to be at 95 or more.”

The Joint Commission report is only one of many evaluations that use publicly reported data to rank hospitals. Results differ depending on the list and the criteria used. The Joint Commission report focuses on how frequently hospitals accomplish tasks that have been shown to benefit patients, such as giving an aspirin to every heart attack patient on arrival.

“They’re really preaching it,” Ray said. “How reliably do you actually get it done?”

Charlotte’s Presbyterian Hospital nearly made the list, achieving a 95 percent performance on the composite score and on 37 of 38 accountability measures, officials said. On the remaining measure, the hospital scored 94.2 percent. Presbyterian’s three other hospitals in Mecklenburg County were ineligible for this year’s ranking because of a recent change in the how they’re accredited by the Joint Commission.

Three Charlotte-area hospitals made the list last year, but dropped off this year. They are Rowan Regional Medical Center in Salisbury, Gaston Memorial Hospital in Gastonia and Chester Regional Medical Center in Chester, S.C.

The Joint Commission said most hospitals that didn’t make the 2012 list “are performing well on accountability measures, but there is still room for improvement.”