HACRP · fiscal year 2026

Hospital-Acquired Conditions

Every year Medicare scores general hospitals on infections and other harms patients develop during a stay. CMS then cuts payments by 1% for a full year to the quarter of hospitals with the highest scores. For fiscal year 2026, that was 718 of the 2,886 scored hospitals with a payment decision.

Try California, Los Angeles-Long Beach-Glendale, CA, or browse every hospital. New to this? Start with how the program works.

Program summary · FY2026CMS data released August 13, 2026

1Hospitals cut

718

Of 2,886 scored hospitals with a Yes or No

2The cut

Of a hospital’s Medicare inpatient payments

3Estimated dollars

$306M estimate

Likely range $299–312M

This site’s estimate of the cut, for 709 of the 718 hospitals CMS cut

4Scored

2,929

Hospitals with a Total HAC Score

5CMS’s line

0.3799 and up

The lowest score CMS cut.

6Data window

PSI 90: Jul 1, 2022 to Jun 30, 2024
Infections: Jan 1, 2023 to Dec 31, 2024

7Payment year

Oct 1, 2025 to Sep 30, 2026

Fiscal year 2026: the stays whose Medicare payments CMS cuts

Final · released Aug 13, 2026

Every hospital with a payment decision, one hairline each, lowest Total HAC Score to highest. A hairline’s height is the hospital’s score: the rule is zero, the average; above it, worse than average, and below it, better. Red: the hospitals CMS cut.

Part 1

How the program works

CMS runs the same arithmetic for every hospital it scores. Here it is in five steps, on the real fiscal year 2026 numbers.

Step 1

CMS scores hospitals on 6 measures

The measures are 5 kinds of infection and a patient-safety composite called PSI 90.

The hospitals it scores are general acute care hospitals paid under Medicare’s inpatient payment system.

Hospitals report their infections to the CDC’s National Healthcare Safety Network (NHSN), counting patients of every insurer. CMS finds the safety problems in PSI 90, such as serious bedsores and falls that break a bone, in hospitals’ bills to traditional Medicare.

This year’s data cover Jul 1, 2022 to Jun 30, 2024 for PSI 90, and Jan 1, 2023 to Dec 31, 2024 for infections. Hospitals with too few patients for a measure aren’t scored on it.

Figure 1. 1,940 of the 3,055 hospitals in CMS’s file were scored on all 6 measures; 182 on just one, and 126 on none at all.

Bar: hospitals with that set of measures. Red: the ones CMS cut.

Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Measures scored	Hospitals	With a decision	Cut
PSI 90 + CLABSI + CAUTI + SSI + CDI + MRSA	1,940	1,902	448
PSI 90 + CDI	212	212	54
No score	126	0	0
PSI 90 + SSI + CDI	111	111	21
PSI 90	101	101	3
PSI 90 + CLABSI + CAUTI + SSI + CDI	101	101	29
PSI 90 + CLABSI + CAUTI + CDI + MRSA	79	78	27
PSI 90 + CAUTI + CDI	71	71	27
PSI 90 + CAUTI + SSI + CDI	70	70	22
CDI	69	68	26
PSI 90 + CLABSI + CAUTI + CDI	46	45	11
PSI 90 + CAUTI + SSI + CDI + MRSA	29	29	9
PSI 90 + SSI	19	19	4
SSI	11	11	10
PSI 90 + CAUTI + CDI + MRSA	9	9	2
PSI 90 + SSI + CDI + MRSA	8	8	4
SSI + CDI + MRSA	8	7	5
CDI + MRSA	7	7	3
CLABSI + CAUTI + SSI + CDI + MRSA	6	6	6
SSI + CDI	6	6	0
CAUTI + CDI	5	5	2
PSI 90 + CLABSI + SSI + CDI + MRSA	5	5	0
PSI 90 + CLABSI + SSI + CDI	4	4	1
CLABSI + CAUTI + CDI + MRSA	2	2	1
PSI 90 + CDI + MRSA	2	2	0
PSI 90 + CLABSI + CDI	2	1	0
CAUTI	1	1	0
CAUTI + CDI + MRSA	1	1	0
CLABSI + CAUTI	1	1	1
CLABSI + CAUTI + CDI	1	1	1
CLABSI + CDI	1	1	0
CLABSI + SSI	1	1	1

Step 2

Each result is compared with an expected number

Each infection measure is a

standardized infection ratio (SIR) (how CDC figures it)

SIR = infections reported ÷ infections predicted CDC predicts each hospital’s number from national data for 2015, its baseline year, adjusted for what predicts infections: the kind of unit, for example, or a surgical patient’s age and health. This year’s SIRs use the 2015 baseline. CDC is moving it to 2022 data, a change that reaches this program in fiscal year 2028.

: the infections a hospital reported divided by the number CDC’s model predicted for it. An SIR of 1.0 means as many as predicted; higher means more.

PSI 90 reads the same way: a value of 1.0 matches the national composite value, and higher is worse.

When CDC’s model predicts less than a single infection, the hospital gets no result on that measure. Many hospitals with a result reported no infections at all: see the column at zero.

Figure 2. Every hospital’s value on each measure, a dot for every few hospitals. Pick a measure.

301 of the 2,182 hospitals with a CLABSI value reported zero infections; the middle hospital sits at 0.559.

Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Measure	Hospitals with a value	At zero	National median	Above one
PSI 90	2,809	0	0.9623	963
CLABSI	2,182	301	0.559	389
CAUTI	2,355	331	0.489	332
SSI	2,270	275	0.795	809
CDI	2,767	249	0.346	111
MRSA	2,068	250	0.641	476

Step 3

Extreme results are pulled in to a floor and a cap

Before scoring, CMS sets a floor at the 5th percentile of each measure’s results and a cap at the 95th. A result past either end counts as that end.

That limits how far a few extreme results can pull the average for everyone. The lines show each hospital that moves.

Figure 3. Each measure as reported and as scored: every hospital past the cap counts as the cap. Pick a measure.

110 hospitals at or above 1.572 on CLABSI all count as 1.572.

Floor and cap as this site derives them from CMS’s published values.

This site recomputes · Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Measure	Floor	Cap	At or below the floor	At or above the cap
PSI 90	0.7760	1.3482	141	141
CLABSI	0.000	1.572	301	110
CAUTI	0.000	1.537	331	119
SSI	0.000	2.118	275	114
CDI	0.000	0.944	249	138
MRSA	0.000	1.762	250	104

Step 4

Each result becomes a z‑score, and the z‑scores are averaged

CMS turns each result into a z‑score: how far it sits from the average hospital on that measure, counted in standard deviations (a measure of how spread out the results are). Positive is worse than average; negative is better.

The Total HAC Score is the plain average of a hospital’s z‑scores, so each measure it was scored on counts the same. A hospital that didn’t submit an infection measure gets the worst z‑score on it instead.

Drag the cursor along the rule to read any value as a z‑score. Under it, the sum for this site’s hypothetical hospital at the national median on every measure.

Figure 4. A value and its z‑score line up on one rule; the score averages them. Pick a measure and drag the cursor.

On CLABSI, the average hospital (0.606) reads zero, and one standard deviation is 0.431.

The hypothetical hospital at the national median

−0.1827PSI 90−0.1097CLABSI−0.1399CAUTI−0.0946SSI−0.1224CDI−0.1176MRSA÷6measures=−0.1278Total HAC Score

Floor and cap as this site derives them from CMS’s published values.

This site recomputes · Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Measure	Floor	Cap	Mean	SD
PSI 90	0.7760	1.3482	0.9885	0.1432
CLABSI	0.000	1.572	0.606	0.431
CAUTI	0.000	1.537	0.547	0.415
SSI	0.000	2.118	0.850	0.584
CDI	0.000	0.944	0.378	0.258
MRSA	0.000	1.762	0.697	0.478

Step 5

CMS cuts payments to hospitals above its line

CMS cuts payments to hospitals whose Total HAC Score is above the 75th percentile of the scores of hospitals outside Maryland. A hospital it cuts is paid 1% less by Medicare for its inpatient stays that fiscal year.

The line comes from every hospital’s score, not a fixed bar. If every hospital had half as many infections, every SIR would halve, but every z‑score would stay where it is, and so would the line: CMS would cut the same hospitals. Try it.

Maryland’s hospitals are scored but not cut. Maryland has its own arrangement with Medicare: the state sets what its hospitals are paid, by Medicare as well as other payers, and it is held to a target for the growth of traditional Medicare spending in the state.

Figure 5. Halve every hospital’s CLABSI: the values move, the z‑scores don’t, and CMS still cuts the same 718 hospitals.

z‑scores: unchanged · Total HAC Scores: unchanged · hospitals cut: 718

Hypothetical · Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

What	As reported	Half the infections
Median CLABSI	0.560	0.280
Hospitals cut	718	718

What if a measure were different?

Sandbox: a hypothetical hospital at the national median on every measure

Change a measure’s value to see how this site recomputes the score of its hypothetical hospital at the national median on every measure.

The what-if needs JavaScript. Without it, the values below stay as they are.

Show table

	Starting point	Hypothetical
Total HAC Score	−0.1278	same
Payment reduction decision	No	same
Payment cut	0%	same

CMS’s line: between 0.3792 and 0.3799

The faint ticks are CMS’s line in earlier years under the same formula, from about 0.300 (FY2022) to about 0.375 (FY2024). The line moves every year, so a hospital can cross it without changing anything.

This site recomputes a Total HAC Score of −0.1278 and a payment reduction decision of No for its hypothetical hospital at the national median on every measure.

A what-if shows the formula’s arithmetic, not what a hospital could realistically change or how. CMS’s real result also depends on other hospitals.

How much cushion?

From the starting values, one measure at a time, with every other measure held where it starts.

Measure	Highest value that keeps No
PSI 90	any value: every PSI 90 value past the cap (1.3482) scores the same
CLABSI	any value: every CLABSI value past the cap (1.572) scores the same
CAUTI	any value: every CAUTI value past the cap (1.537) scores the same
SSI	any value: every SSI value past the cap (2.118) scores the same
CDI	any value: every CDI value past the cap (0.944) scores the same
MRSA	any value: every MRSA value past the cap (1.762) scores the same

Each measure weighs 1 ÷ 6 of the score.

Measure values

SIR 1.0 = as many infections as predicted · Lower is better

On each track the tick is the national median; shaded values score the same as the floor or cap, as this site fits them to CMS’s values.

Patient safety and adverse events composite PSI 90

PSI 90 value

median 0.9623 · floor 0.7760 · cap 1.3482 · each 0.1 = 0.1164

Central line–associated bloodstream infections CLABSI

CLABSI value

median 0.559 · cap 1.572 · each 0.1 = 0.0387

Catheter-associated urinary tract infections CAUTI

CAUTI value

median 0.489 · cap 1.537 · each 0.1 = 0.0402

Surgical site infections after colon surgery or abdominal hysterectomy SSI

SSI value

median 0.795 · cap 2.118 · each 0.1 = 0.0286

Clostridioides difficile (C. diff) infections CDI

CDI value

median 0.346 · cap 0.944 · each 0.1 = 0.0645

MRSA bloodstream infections MRSA

MRSA value

median 0.641 · cap 1.762 · each 0.1 = 0.0348

Each measure’s part of the score

PSI 90 −0.0305
CLABSI −0.0183
CAUTI −0.0233
SSI −0.0158
CDI −0.0204
MRSA −0.0196

A measure adds its z‑score divided by 6, the number of measures scored. Bars right of the center line raise the score. Hatched: assigned by CMS.

Interactive what-if at https://paidandpenalized.org/hacrp/

Among hospitals with a Yes or No payment decision, CMS cut those with a published Total HAC Score of 0.3799 or higher and none at 0.3792 or lower. Maryland’s hospitals are scored but not subject to the reduction.

Held fixed: every other hospital’s results, CMS’s line, and each measure’s mean, spread, floor and cap as this site fits them to CMS’s published values.

Part 2

The fiscal year 2026 picture

Who landed past CMS’s line, and on which measures. Every chart here is drawn from CMS’s file; pick, hover or tap to look closer.

Every hospital, one dot each

Each dot is a hospital with a payment decision, placed by its Total HAC Score; each column holds the hospitals with nearly the same score. CMS cut the ones past its line. Pick a kind of hospital to lift it out of the crowd; hover or tap a dot to see the hospital.

Not shown: Maryland’s 43 scored hospitals. 13 of them scored at or above the lowest score CMS cut elsewhere, and none were cut.

Figure 6. CMS cut 718 of the 2,886 hospitals with a payment decision; just 0.0007 separates the highest score it didn’t cut from the lowest it did.

Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Score from	to	Hospitals	CMS’s decision
−1.5201	−1.4201	40	No
−1.4201	−1.3201	5	No
−1.3201	−1.2201	11	No
−1.2201	−1.1201	22	No
−1.1201	−1.0201	27	No
−1.0201	−0.9201	45	No
−0.9201	−0.8201	82	No
−0.8201	−0.7201	124	No
−0.7201	−0.6201	78	No
−0.6201	−0.5201	125	No
−0.5201	−0.4201	166	No
−0.4201	−0.3201	175	No
−0.3201	−0.2201	182	No
−0.2201	−0.1201	208	No
−0.1201	−0.0201	202	No
−0.0201	0.0799	181	No
0.0799	0.1799	160	No
0.1799	0.2799	161	No
0.2799	0.3799	174	No
0.3799	0.4799	128	Yes
0.4799	0.5799	109	Yes
0.5799	0.6799	103	Yes
0.6799	0.7799	70	Yes
0.7799	0.8799	68	Yes
0.8799	0.9799	49	Yes
0.9799	1.0799	59	Yes
1.0799	1.1799	32	Yes
1.1799	1.2799	17	Yes
1.2799	1.3799	12	Yes
1.3799	1.4799	13	Yes
1.4799	1.5799	8	Yes
1.5799	1.6799	6	Yes
1.6799	1.7799	4	Yes
1.7799	1.8799	2	Yes
1.8799	1.9799	1	Yes
1.9799	2.0799	3	Yes
2.0799	2.1799	10	Yes
2.1799	2.2799	23	Yes
2.2799	2.3799	1	Yes

Who lands past the line

If the cut fell on hospitals at random, every kind of hospital would sit near the national share, 24.9%. Some sit far from it. A stem to the right of the dashed line marks a group cut more often than hospitals overall.

The size of each dot is the number of hospitals in the group; a stem is red only where a group sits more than 2 points past the national share. These are differences in who was cut, not explanations of why. Each hospital’s kind is as CMS’s newest files list it.

Figure 7. Government hospitals were cut most often (35%); For-profit hospitals, least (15%). Nationally: 24.9%.

Dot size: hospitals in the group. Red: more than 2 points above the reference.

Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Group	With a decision	Hospitals cut	Share cut
Teaching: Major teaching	424	136	32.1%
Teaching: Minor teaching	873	181	20.7%
Teaching: Not teaching	1,563	389	24.9%
Beds: Fewer than 100 beds	805	225	28.0%
Beds: 100 to 299 beds	1,193	275	23.1%
Beds: 300 to 499 beds	523	113	21.6%
Beds: 500 beds and up	365	105	28.8%
Ownership: Nonprofit	1,830	478	26.1%
Ownership: For-profit	651	98	15.1%
Ownership: Government	401	140	34.9%
Location: Urban	2,241	510	22.8%
Location: Rural	619	196	31.7%
Special status: Sole community	405	120	29.6%
Special status: Medicare-dependent	153	51	33.3%
Special status: Rural referral center	1,031	257	24.9%

Fewer measures, wider swings

A hospital scored on a single measure has a Total HAC Score that is that measure’s z‑score; one scored on all 6 averages 6 of them. An average varies less than the numbers in it, so the fewer measures a hospital has, the further its score can land from the middle, either way.

Which measure a hospital has alone matters too. Of 101 hospitals scored only on PSI 90, CMS cut 3. Of 68 scored only on CDI, it cut 26.

Figure 8. Scores of hospitals with one measure spread 2.2 times as wide as those with all 6 (a standard deviation of 1.11 against 0.50).

Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Measures scored	With a decision	Hospitals cut	Median score	Standard deviation
1	181	39	−0.1532	1.11
2	252	65	−0.2930	0.81
3	194	54	−0.0948	0.75
4	138	41	0.0088	0.69
5	219	71	−0.0214	0.75
6	1,902	448	−0.0124	0.50

The measures barely agree

If a hospital that does badly on one measure did badly on the others, the measures would rank hospitals alike. They mostly don’t. Each square is a pair of measures, sized by how alike they rank hospitals (rank correlation: zero is no relation, one is the same order).

Pick a pair to see every hospital with both: a dot on the diagonal ranks the same on both.

Figure 9. The closest pair, CLABSI and CAUTI, has a rank correlation of only 0.25; CLABSI and SSI, 0.24.

This site recomputes · Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Pair	Rank correlation	Hospitals with both
CLABSI + CAUTI	0.246	2,169
CLABSI + SSI	0.241	2,042
CAUTI + CDI	0.228	2,342
CAUTI + SSI	0.211	2,128
CLABSI + MRSA	0.190	2,017
PSI 90 + CDI	0.131	2,673
PSI 90 + CLABSI	0.126	2,175
CLABSI + CDI	0.107	2,172
SSI + CDI	0.099	2,252
CDI + MRSA	0.096	2,068
PSI 90 + CAUTI	0.095	2,343
CAUTI + MRSA	0.084	2,048
PSI 90 + MRSA	0.083	2,056
PSI 90 + SSI	0.062	2,266
SSI + MRSA	0.007	1,968

One measure from the line

For each hospital CMS cut, this site moved its one costliest measured result to the national median and recomputed its score, holding everything else fixed. Most land under the line. A cut often rests on one measure.

Which measure added the most to a cut hospital’s score varies: no single measure drives the cuts.

Figure 10. The measure that added most to each cut hospital’s score: PSI 90 for 168 of 718, MRSA for 85.

Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Measure	Hospitals
PSI 90	168
CDI	143
CAUTI	130
SSI	99
CLABSI	93
MRSA	85

Figure 11. 475 of the 718 hospitals CMS cut would have been under its line had their costliest measure been at the national median.

29 with no measured result above the median

Hypothetical · Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Cut hospitals	Hospitals
Under the line	475
Still past it	214

Scored without data

A hospital that doesn’t submit an infection measure gets CMS’s worst z‑score on it, not a gap. One such measure can carry a score past the line.

Each card is one hospital: a box per measure, filled for a measured result, hatched where CMS assigned its worst score. A red frame: CMS cut it.

Figure 12. CMS assigned 52 hospitals its worst score on at least one measure and cut 44 of them, including all 23 with no measured result at all.

Boxes, left to right: PSI 90 · CLABSI · CAUTI · SSI · CDI · MRSA.

Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

Hospitals with an assigned score	Hospitals
With a decision	52
Hospitals cut	44

Part 3

The money

This site estimates the FY2026 cut at about $306M (likely $299–312M), from 709 of the 718 hospitals CMS cut; CMS’s impact file, which the estimate is built from, has no usable row for the other 9. The cut is 1% of what traditional Medicare pays a hospital for inpatient stays and, at teaching hospitals, of the teaching payments Medicare makes on Medicare Advantage stays, so it lands hardest where those payments are largest.

Who carries the cut

Each hospital CMS cut that this site could estimate is a tile, its area this site’s estimate of its cut, grouped by teaching status. Point at or tap a tile for the hospital.

A few large hospitals carry much of the money: the cut is a share of a payment, and their payments are large.

Figure 13. The largest tenth of the cuts, 71 hospitals, are 44% of the $306M this site estimates the program took.

Teaching status: this site’s grouping of the resident-to-bed ratio in CMS’s impact file: major at 0.25 or more, minor above zero, none at zero. The hospital master has none for 5 of the cut hospitals ($244K), the group too small to label.

Estimate · Source: this site’s arithmetic on CMS’s FY2026 IPPS final rule files (the impact file, the rate tables and the value-based factors), its FY2026 HRRP supplemental file and HACRP FY2026 (yq43-i98g), released August 13, 2026.

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Group	Cut hospitals estimated	Estimated cut (whole dollars)	Share of the hospitals	Share of the money
Major teaching	136	$146,960,360	19.2%	48.0%
Minor teaching	181	$91,337,284	25.5%	29.8%
Not teaching	387	$67,563,801	54.6%	22.1%
Teaching status unknown	5	$244,251	0.7%	0.1%

Across the line

Each hospital within 0.05 of CMS’s line that this site could estimate, each dot as large as the cut it took, or would have taken, by this site’s estimate. Point at or tap a dot for the hospital.

A hair apart in score, the two sides are all or nothing in money.

Figure 14. Of the hospitals this site estimates within 0.05 of CMS’s line, CMS cut 59 hospitals, about $29.8M; the 82 just under it had about $52.8M at stake.

3 more within 0.05 have no estimate, and Maryland’s 2 are exempt.

Show table

Side of the line	Hospitals	Estimated cut, taken or not (whole dollars)
Under the line: not cut	82	$52,846,861
Over the line: cut	59	$29,847,503

The same hospitals, a different share of the money

For each kind of hospital: its share of the cut hospitals this site estimates, and its share of the dollars this site estimates they were cut.

Figure 15. Hospitals of 500 beds and up are 15% of the cut hospitals this site estimates, and 50% of the money it estimates.

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Group	Cut hospitals estimated	Estimated cut (whole dollars)	Share of the hospitals	Share of the money
Teaching: Major teaching	136	$146,960,360	19.2%	48.0%
Teaching: Minor teaching	181	$91,337,284	25.5%	29.8%
Teaching: Not teaching	387	$67,563,801	54.6%	22.1%
Beds: Fewer than 100 beds	218	$17,089,264	30.7%	5.6%
Beds: 100 to 299 beds	273	$70,221,326	38.5%	22.9%
Beds: 300 to 499 beds	113	$66,215,465	15.9%	21.6%
Beds: 500 beds and up	105	$152,579,641	14.8%	49.8%
Ownership: Nonprofit	475	$227,659,455	67.0%	74.4%
Ownership: For-profit	96	$18,211,944	13.5%	5.9%
Ownership: Government	136	$60,161,683	19.2%	19.7%
Location: Urban	509	$278,710,453	71.8%	91.1%
Location: Rural	195	$27,150,992	27.5%	8.9%

Where the money comes from

Each state’s circle is as large as this site’s estimate of its hospitals’ cuts. Switch to the cut per traditional Medicare stay to compare states of different sizes: the dollars over every traditional Medicare stay at the state’s hospitals with a decision.

Figure 16. By state, this site’s estimate of the cut ran from $27K to $36.5M; per traditional Medicare stay, from $1 to $184.

States whose hospitals CMS didn’t cut, and Maryland, have no circle.

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State	Cut hospitals estimated	Estimated cut (whole dollars)	Traditional Medicare stays	Per traditional Medicare stay
Alaska	4	$2,419,053	15,006	$161
Alabama	29	$6,676,685	96,540	$69
Arkansas	14	$4,781,033	75,639	$63
Arizona	12	$4,973,732	132,885	$37
California	75	$36,508,033	625,181	$58
Colorado	7	$2,072,503	73,272	$28
Connecticut	3	$1,971,581	72,283	$27
District of Columbia	1	$389,825	21,009	$19
Florida	17	$9,236,750	567,277	$16
Georgia	27	$14,300,738	176,812	$81
Hawaii	7	$2,853,950	16,748	$170
Iowa	16	$5,321,381	63,462	$84
Idaho	2	$320,956	26,110	$12
Illinois	31	$11,178,680	290,780	$38
Indiana	10	$2,989,354	151,911	$20
Kansas	10	$1,802,120	71,497	$25
Kentucky	21	$8,839,384	100,434	$88
Louisiana	25	$4,836,122	89,943	$54
Massachusetts	20	$15,027,767	221,877	$68
Maine	4	$362,278	20,532	$18
Michigan	30	$12,017,014	183,949	$65
Minnesota	11	$1,492,068	98,791	$15
Missouri	9	$7,458,185	144,733	$52
Mississippi	18	$5,810,050	76,221	$76
Montana	4	$1,088,515	23,879	$46
North Carolina	20	$6,422,512	194,576	$33
North Dakota	1	$326,308	22,026	$15
Nebraska	6	$1,762,672	46,414	$38
New Hampshire	5	$3,691,833	35,740	$103
New Jersey	5	$4,169,557	221,501	$19
New Mexico	10	$3,131,543	29,457	$106
Nevada	3	$1,510,499	56,215	$27
New York	44	$33,407,783	410,054	$81
Ohio	31	$18,266,823	241,008	$76
Oklahoma	14	$4,518,188	95,361	$47
Oregon	13	$5,279,487	55,977	$94
Pennsylvania	35	$15,771,015	303,977	$52
Rhode Island	2	$653,957	19,570	$33
South Carolina	12	$4,562,318	122,226	$37
South Dakota	3	$262,033	28,230	$9
Tennessee	14	$7,211,571	152,718	$47
Texas	30	$10,386,145	455,392	$23
Utah	1	$26,506	36,871	$1
Virginia	5	$720,801	197,373	$4
Vermont	4	$2,338,274	12,720	$184
Washington	12	$6,706,645	114,336	$59
Wisconsin	16	$4,270,532	99,779	$43
West Virginia	12	$5,472,945	50,077	$109
Wyoming	4	$507,992	9,724	$52

Three programs, three shapes

Medicare’s three hospital quality programs move money in three ways. The readmissions program cuts hospitals by factors of their own and never adds to a payment; the value-based program pays some hospitals a bonus and cuts others; this program is a cliff.

Figure 17. Readmissions cuts spread from 0% to 3.0% of the base payment and total about $336M by this site’s estimate; value-based adjustments run from −2.0% to +4.5% and net −$3.2M; the HAC cut is 0% or 1%, about $306M in all.

Readmissions

−$336M

a sliding scale

Cut, share of the base payment

Value-based purchasing

−$3.2M

a seesaw · $217M paid in bonuses, $221M taken in cuts

Adjustment, share of the base payment

HAC Reduction Program

−$306M

a cliff

Cut, share of the whole payment

Hospitals each file lists; the readmissions and value-based adjustments are shares of the base payment, the HAC cut of the whole payment. The totals add up the 2,871 hospitals this program scored that this site estimates. The front page adds up all 2,971 hospitals this site estimates, so its totals differ slightly.

Show table

Program	Hospitals adjusted	Net estimated dollars (whole dollars)
Readmissions	2,269	−$336,437,747
Value-based purchasing	2,444	−$3,186,997
HAC Reduction Program	709	−$306,105,696

Part 4

Where the cuts land

Pick a state to see its hospitals, or go down from a region to a state and a metro area.

Figure 18. Nationally, CMS cut payments to 24.9% of hospitals with a payment decision; by state, the share ran from 0.0% to 66.7%.

Cut
Not cut
Not subject (Maryland) or no score

Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.

Show table

State	Hospitals cut	With a decision	Share cut
AK	4	8	50.0%
AL	29	68	42.6%
AR	14	39	35.9%
AZ	12	61	19.7%
CA	76	277	27.4%
CO	7	49	14.3%
CT	3	25	12.0%
DC	1	6	16.7%
DE	0	6	0.0%
FL	18	165	10.9%
GA	27	89	30.3%
HI	7	11	63.6%
IA	16	30	53.3%
ID	2	15	13.3%
IL	31	112	27.7%
IN	10	80	12.5%
KS	10	44	22.7%
KY	21	56	37.5%
LA	25	76	32.9%
MA	20	52	38.5%
MD	0	0	—
ME	4	13	30.8%
MI	30	88	34.1%
MN	11	45	24.4%
MO	9	62	14.5%
MS	18	50	36.0%
MT	4	10	40.0%
NC	20	79	25.3%
ND	1	6	16.7%
NE	6	24	25.0%
NH	5	13	38.5%
NJ	5	61	8.2%
NM	11	26	42.3%
NV	4	19	21.1%
NY	45	126	35.7%
OH	31	114	27.2%
OK	15	68	22.1%
OR	13	32	40.6%
PA	36	130	27.7%
RI	2	10	20.0%
SC	12	51	23.5%
SD	3	16	18.8%
TN	14	73	19.2%
TX	32	255	12.5%
UT	1	31	3.2%
VA	5	70	7.1%
VT	4	6	66.7%
WA	12	46	26.1%
WI	16	62	25.8%
WV	12	23	52.2%
WY	4	8	50.0%

Every hospital in CMS’s file

The sortable table of every hospital needs JavaScript; the CSV file holds the same values.

Sorted by state, then name. Sort by any column, pick a state, or search by name, city or CCN.

State

Name, city or CCN contains

Sort by

Every hospital in CMS’s file, with its Total HAC Score and payment reduction decision as CMS reports them, and this site’s estimate of the cut in dollars

Download all hospitals’ data (CSV) · Data dictionary · CMS’s dataset page

Part 5

12 years, 11 rounds of cuts

Every year but one since fiscal year 2015, CMS has cut about a quarter of hospitals. Never the same quarter: 73% of hospitals have been cut at least once. And not at random either: a hospital cut one year is cut again the next far more often than chance would have it.

Every hospital, every year

Each sliver is one hospital, each row one fiscal year. Red: CMS cut it that year; gray: it didn’t; blank: no decision that year (not in that year’s file, not scored, in Maryland, or the year CMS scored no one).

Hospitals are lined up by the first year CMS cut them, so the red steps down and to the right as each year adds hospitals that had never been cut before. The gray block at the right is every hospital never cut at all.

Why fiscal year 2016’s count differs from CMS’s fact sheet

Figure 19. 2,556 of the 3,494 hospitals with a payment decision since fiscal year 2015 have been cut at least once; 938 never have.

Source: CMS, HACRP hospital files for fiscal years 2015 to 2026 (Provider Data Catalog, its archives and, for the oldest years, the Internet Archive’s copies), and CMS’s cut lists for FY2015 and FY2016.

Show table

Fiscal year	Hospitals with a decision	Cut	Cut for the first time	Ever cut, by then
FY2015	3,300	724	724	724
FY2016	3,208	750	341	1,065
FY2017	3,202	768	305	1,370
FY2018	3,170	749	241	1,611
FY2019	3,204	800	200	1,811
FY2020	3,149	786	145	1,956
FY2021	3,105	774	139	2,095
FY2022	3,060	764	104	2,199
FY2023	0	0	0	2,199
FY2024	2,928	728	202	2,401
FY2025	2,922	724	76	2,477
FY2026	2,886	718	79	2,556

A quarter at a time

The red is each year’s cut: about a quarter of hospitals, by design, in every year CMS cut anyone. The taller column behind it is every hospital cut at least once by that year. One grows; the other doesn’t.

Figure 20. CMS cut about a quarter of hospitals in each year it cut anyone, but by fiscal year 2026, 2,556 different hospitals (73% of all with a decision) had been cut at least once.

Show table

Fiscal year	Cut that year	Ever cut by then
FY2015	724	724
FY2016	750	1,065
FY2017	768	1,370
FY2018	749	1,611
FY2019	800	1,811
FY2020	786	1,956
FY2021	774	2,095
FY2022	764	2,199
FY2023	0	2,199
FY2024	728	2,401
FY2025	724	2,477
FY2026	718	2,556

Watch it spread

Every hospital with a payment decision in any year, one dot each, where it stands. Pick a year, or press play: red is that year’s cut; pale red, a hospital cut in an earlier year; gray, one not cut so far.

Each year’s red is about the same size. The pale red is not: it spreads year after year until most of the map has been cut at least once.

Figure 21. By fiscal year 2026, 2,556 hospitals (73% of all with a decision) had been cut at least once.

Cut that year
Cut in an earlier year
Not cut so far

FY2026: 718 cut that year; 2,556 cut at least once so far

516 hospitals CMS no longer lists have no place on the map; the table counts them.

Show table

Fiscal year	Cut that year	Ever cut by then
FY2015	724	724
FY2016	750	1,065
FY2017	768	1,370
FY2018	749	1,611
FY2019	800	1,811
FY2020	786	1,956
FY2021	774	2,095
FY2022	764	2,199
FY2023	0	2,199
FY2024	728	2,401
FY2025	724	2,477
FY2026	718	2,556

Fewer infections, the same quarter cut

The lines are the nation’s infection rates, each calendar year Care Compare published one: the infections of every hospital Care Compare lists, critical access and other hospitals outside this program included, added up over the number CDC’s model predicted. Below the dashed line, fewer infections than predicted.

Most fell, one by more than half, though most rose in 2021, the pandemic’s second year. The cut did not shrink with them: in every year CMS cut anyone, the rule took the quarter of hospitals with the highest scores, however much every hospital improved.

Figure 22. From 2017 to 2024, the nation’s C. diff rate fell 54% and its catheter urinary infection (CAUTI) rate 41%; in every year CMS cut anyone, it cut about a quarter of hospitals all the same.

Share of hospitals CMS cut, each fiscal year

1522%
1623%
1724%
1824%
1925%
2025%
2125%
2225%
23—
2425%
2525%
2625%

Infections ÷ predicted, the nation, by calendar year

No point for 2020: CMS excused hospitals from reporting infections for the first half of that year and published none of that half’s data, so no file covers the full year.

This site recomputes · Source: CMS Care Compare, healthcare-associated infections by hospital, calendar years 2017 to 2024 (Provider Data Catalog archives; the oldest year through the Internet Archive’s copy); CMS HACRP files for the shares cut.

Show table

Calendar year	CLABSI	CAUTI	SSI, colon	SSI, hysterectomy	MRSA	C. diff
2017	0.813	0.873	0.908	0.863	0.867	0.804
2018	0.742	0.801	0.895	0.902	0.848	0.710
2019	0.685	0.717	0.866	0.929	0.821	0.580
2021	0.985	0.793	0.845	0.983	1.089	0.498
2022	0.844	0.670	0.877	0.934	0.907	0.482
2023	0.717	0.584	0.899	1.047	0.752	0.416
2024	0.638	0.516	0.867	1.124	0.701	0.372

Stickier than chance

Take the hospitals CMS made a decision on every year it cut anyone. If each year’s cut fell on them at random, at that year’s share, most would have been cut a few times and almost none every year: the hollow dots. The solid dots are what happened.

Chance makes a hill in the middle; the record starts high at none and falls away. More hospitals than chance were never cut, and far more were cut nearly every year. Hospitals cut a few times are fewer than chance would give.

Figure 23. Of the 2,676 hospitals with a decision in all 11 years CMS cut anyone, 558 were never cut (chance: about 125) and 23 were cut every one of those years (chance: one in 2,162).

● What happened ○ If each year’s cut fell at random. Up the side: hospitals.

This site recomputes · Source: CMS, HACRP hospital files for fiscal years 2015 to 2026 (Provider Data Catalog, its archives and, for the oldest years, the Internet Archive’s copies), and CMS’s cut lists for FY2015 and FY2016.

Show table

Years cut	Hospitals	By chance
0	558	125
1	446	442
2	438	710
3	390	683
4	295	439
5	180	197
6	137	63
7	96	14
8	63	2
9	32	one in 4
10	18	one in 63
11	23	one in 2,162

How long a cut follows a hospital

For every pair of years, how often a hospital cut in the first was cut again in the second (black), against how often one not cut was (gray), by how many years apart they are.

One year apart, the gap is widest, but those years share data: in every such pair here, a year of infection reports counts in both, and in most a year of claims does too. Two years apart, with no data in common, a cut still more than doubles the chance of another. A decade on, the gap is down to a few points.

Figure 24. A hospital cut one year was cut the next 62% of the time (12% for the rest); two years later 43% (19%); 11 years later 28% (24%).

Pairs touching fiscal year 2023, when CMS cut no one, are left out.

Show table

Years apart	Cut again, after a cut	Cut, after no cut	Hospital pairs of years
1	62.4%	12.4%	27,604
2	43.3%	18.6%	24,254
3	37.5%	20.5%	21,070
4	35.6%	21.4%	20,717
5	33.2%	22.1%	17,586
6	32.2%	22.4%	14,454
7	30.6%	22.9%	11,415
8	29.4%	23.1%	8,390
9	27.9%	23.7%	8,380
10	28.3%	23.8%	5,549
11	28.1%	24.0%	2,755

Who keeps getting cut

Each panel is one kind of hospital: its share cut each year (black) against every hospital’s (gray). The corner counts the years it sat above.

Major teaching and government hospitals sat above the nation in every year CMS cut anyone; for-profit hospitals, below. Rural and small hospitals flipped: cut less often than the nation in the program’s early years, more often every year since fiscal year 2024. Kinds are today’s: hospitals no longer in CMS’s files are left out, and a hospital’s kind may have changed.

Figure 25. Rural hospitals flipped: in fiscal year 2015, CMS cut 14% of them against 22% of all hospitals; in fiscal year 2026, 32% against 25%.

Show table

Fiscal year	All hospitals	Major teaching	Minor teaching	Not teaching	Fewer than 100 beds	100 to 299 beds	300 to 499 beds	500 beds and up	Nonprofit	For-profit	Government	Urban	Rural	Sole community	Medicare-dependent	Rural referral center
FY2015	21.9%	42.9%	23.9%	16.5%	14.4%	19.0%	29.8%	41.4%	23.2%	18.8%	26.1%	25.5%	13.6%	16.7%	10.8%	27.4%
FY2016	23.4%	41.8%	25.7%	17.6%	17.9%	19.6%	29.2%	40.3%	25.4%	18.5%	24.1%	25.9%	16.4%	19.1%	18.2%	27.0%
FY2017	24.0%	46.4%	27.2%	17.4%	14.5%	21.7%	35.0%	41.9%	26.9%	19.0%	24.2%	28.2%	13.0%	14.3%	12.7%	30.9%
FY2018	23.6%	34.4%	22.8%	21.4%	21.4%	22.6%	25.5%	31.0%	23.1%	21.7%	30.2%	24.2%	22.4%	21.0%	21.3%	25.5%
FY2019	25.0%	36.7%	24.8%	22.0%	22.4%	23.6%	26.2%	34.2%	24.7%	24.1%	28.4%	25.9%	22.1%	20.2%	26.5%	25.8%
FY2020	25.0%	38.9%	24.1%	21.7%	22.3%	22.5%	27.2%	36.4%	25.0%	21.1%	31.5%	25.5%	23.4%	22.3%	24.7%	28.2%
FY2021	24.9%	39.8%	24.7%	20.8%	19.4%	24.2%	26.0%	36.4%	25.0%	17.7%	34.7%	25.5%	22.5%	22.8%	21.1%	28.8%
FY2022	25.0%	40.9%	23.4%	21.9%	21.3%	24.1%	26.6%	34.5%	26.9%	14.3%	33.9%	25.4%	24.3%	25.9%	19.9%	27.9%
FY2023
FY2024	24.9%	30.0%	18.3%	26.0%	28.2%	24.6%	18.4%	23.8%	24.9%	18.0%	32.5%	21.8%	33.1%	31.3%	31.1%	25.2%
FY2025	24.8%	33.5%	18.0%	25.8%	27.7%	23.7%	19.7%	27.9%	25.7%	15.8%	34.3%	23.0%	30.0%	26.7%	31.2%	26.2%
FY2026	24.9%	32.1%	20.7%	24.9%	28.0%	23.1%	21.6%	28.8%	26.1%	15.1%	34.9%	22.8%	31.7%	29.6%	33.3%	24.9%

What CMS scores you on

A hospital is scored on the measures it has enough data for. One scored on PSI 90 alone is almost never cut; one with infections but no PSI 90 score is cut about half the time.

A single infection measure, with its small counts, swings a score far more than six measures averaged; the year’s picture shows the same spread; here it is over every year.

Figure 26. From fiscal year 2018 to 2026, hospitals scored on PSI 90 alone were cut 3% of the time; hospitals with no PSI 90 score, 53%.

Show table

Scored on	Hospital-years	Cut	Share cut
Every hospital	24,424	6,043	24.7%
Every measure	14,891	3,819	25.6%
PSI 90 only	1,554	46	3.0%
Infections only	429	226	52.7%

The map, year by year

Each small map is one fiscal year, each square a state, shaded by the share of its hospitals CMS cut (key above the maps). Some states keep their shade year after year.

Figure 27. Among states with at least 10 hospitals every year, New York was cut above the nation’s share in 11 of the 11 years CMS cut anyone; Texas, below it in 11.

0% to 10%
10% to 20%
20% to 30%
30% to 40%
40% and up
None cut
No decision
Outlined: New York and Texas

FY2015

FY2016

FY2017

FY2018

FY2019

FY2020

FY2021

FY2022

FY2023

FY2024

FY2025

FY2026

Show table

Fiscal year	State not given	AK	AL	AR	AZ	CA	CO	CT	DC	DE	FL	GA	HI	IA	ID	IL	IN	KS	KY	LA	MA	ME	MI	MN	MO	MS	MT	NC	ND	NE	NH	NJ	NM	NV	NY	OH	OK	OR	PA	RI	SC	SD	TN	TX	UT	VA	VT	WA	WI	WV	WY
FY2015	16.9%	22.2%	13.3%	18.2%	21.3%	26.7%	32.6%	46.7%	71.4%	33.3%	18.8%	26.7%	0.0%	8.8%	21.4%	21.6%	14.9%	21.6%	15.4%	11.8%	21.1%	33.3%	22.3%	24.0%	25.3%	19.7%	23.1%	20.2%	14.3%	29.2%	23.1%	36.5%	34.4%	37.5%	26.0%	17.3%	13.2%	27.3%	25.7%	36.4%	23.6%	14.3%	15.2%	14.0%	50.0%	20.5%	0.0%	35.4%	27.7%	21.4%	30.0%
FY2016		33.3%	8.5%	20.5%	26.2%	29.9%	15.6%	60.0%	71.4%	16.7%	18.1%	28.7%	25.0%	17.6%	38.5%	18.4%	23.0%	19.2%	13.8%	22.2%	21.1%	44.4%	26.1%	34.7%	21.9%	15.0%	38.5%	17.9%	16.7%	37.5%	15.4%	32.8%	20.7%	54.2%	30.5%	13.3%	15.9%	26.5%	25.8%	63.6%	28.6%	10.5%	17.6%	18.3%	35.5%	19.2%	33.3%	33.3%	23.1%	14.3%	20.0%
FY2017		25.0%	9.9%	11.6%	24.6%	33.0%	20.0%	46.7%	28.6%	50.0%	24.4%	30.4%	8.3%	20.6%	15.4%	22.4%	16.7%	11.5%	17.2%	24.7%	28.1%	17.6%	28.7%	14.3%	16.4%	23.3%	0.0%	22.6%	14.3%	16.7%	30.8%	40.6%	24.1%	42.9%	43.7%	12.6%	18.6%	17.6%	26.0%	36.4%	30.8%	20.0%	14.3%	20.9%	24.2%	25.3%	16.7%	30.6%	16.7%	24.1%	0.0%
FY2018		25.0%	18.4%	20.9%	23.3%	29.9%	32.6%	50.0%	42.9%	50.0%	27.4%	35.4%	8.3%	20.6%	7.1%	16.8%	20.7%	13.7%	26.6%	28.1%	16.1%	18.8%	20.2%	14.3%	12.5%	30.6%	7.7%	23.5%	12.5%	21.1%	15.4%	23.4%	19.4%	42.9%	42.4%	14.6%	19.8%	14.7%	22.4%	36.4%	26.9%	20.0%	27.0%	17.2%	16.1%	20.0%	16.7%	20.8%	19.7%	32.1%	10.0%
FY2019		37.5%	15.5%	22.7%	24.6%	33.7%	35.6%	50.0%	42.9%	33.3%	23.2%	27.3%	16.7%	29.4%	21.4%	21.6%	25.9%	13.7%	29.7%	30.7%	20.0%	23.5%	25.5%	24.5%	23.6%	27.4%	15.4%	25.0%	50.0%	17.4%	38.5%	29.7%	19.4%	45.5%	38.7%	15.7%	20.7%	14.7%	16.0%	60.0%	25.9%	15.8%	22.7%	19.7%	19.4%	24.3%	33.3%	19.1%	22.7%	27.6%	9.1%
FY2020		62.5%	19.8%	22.2%	18.6%	32.7%	35.6%	46.7%	50.0%	33.3%	22.3%	26.3%	8.3%	35.3%	14.3%	25.6%	29.3%	20.0%	28.1%	32.5%	23.6%	23.5%	20.4%	22.4%	27.1%	21.3%	7.1%	25.0%	37.5%	13.0%	38.5%	31.3%	16.1%	45.5%	38.1%	18.0%	16.9%	11.8%	14.5%	70.0%	35.8%	16.7%	25.0%	18.2%	19.4%	20.3%	33.3%	14.6%	28.6%	25.0%	30.0%
FY2021		75.0%	22.2%	22.7%	16.9%	27.1%	20.8%	20.7%	50.0%	0.0%	26.7%	18.4%	8.3%	30.3%	0.0%	29.3%	19.8%	22.0%	19.4%	30.9%	32.7%	52.9%	25.8%	22.9%	27.5%	32.2%	15.4%	31.0%	28.6%	13.0%	30.8%	33.3%	28.1%	60.9%	38.8%	21.3%	16.9%	14.7%	21.8%	60.0%	37.7%	16.7%	26.2%	16.8%	12.5%	19.2%	33.3%	12.5%	20.3%	38.5%	30.0%
FY2022		62.5%	23.8%	30.2%	18.3%	28.6%	22.9%	27.6%	50.0%	33.3%	24.4%	21.6%	0.0%	21.2%	0.0%	29.2%	24.7%	25.5%	32.8%	18.5%	30.9%	52.9%	32.6%	25.0%	23.5%	30.0%	25.0%	28.6%	28.6%	13.0%	46.2%	28.6%	43.3%	31.8%	38.5%	19.0%	15.6%	14.7%	27.5%	70.0%	38.5%	16.7%	13.8%	14.5%	18.8%	16.4%	33.3%	10.6%	23.4%	41.7%	30.0%
FY2023
FY2024		25.0%	26.2%	33.3%	16.7%	24.0%	16.3%	17.9%	16.7%	0.0%	9.8%	32.6%	25.0%	19.4%	6.7%	28.7%	28.8%	17.8%	36.7%	29.5%	35.2%	52.9%	33.3%	24.4%	24.2%	32.0%	18.2%	29.6%	0.0%	16.7%	7.7%	20.6%	59.3%	30.0%	35.4%	23.9%	34.3%	36.4%	19.2%	30.0%	26.0%	25.0%	20.5%	18.0%	15.6%	14.3%	50.0%	11.1%	27.0%	65.2%	40.0%
FY2025		25.0%	35.7%	28.2%	14.5%	26.8%	16.3%	11.5%	16.7%	0.0%	11.0%	38.0%	66.7%	43.3%	6.7%	27.2%	16.3%	22.7%	35.6%	35.9%	35.8%	43.8%	39.1%	23.9%	20.6%	22.0%	10.0%	28.8%	14.3%	16.7%	15.4%	11.5%	36.0%	23.8%	38.6%	27.4%	26.5%	36.4%	24.2%	0.0%	21.6%	18.8%	21.1%	13.6%	10.0%	8.5%	66.7%	17.4%	28.6%	66.7%	30.0%
FY2026		50.0%	42.6%	35.9%	19.7%	27.4%	14.3%	12.0%	16.7%	0.0%	10.9%	30.3%	63.6%	53.3%	13.3%	27.7%	12.5%	22.7%	37.5%	32.9%	38.5%	30.8%	34.1%	24.4%	14.5%	36.0%	40.0%	25.3%	16.7%	25.0%	38.5%	8.2%	42.3%	21.1%	35.7%	27.2%	22.1%	40.6%	27.7%	20.0%	23.5%	18.8%	19.2%	12.5%	3.2%	7.1%	66.7%	26.1%	25.8%	52.2%	50.0%

Sources and related sites

Medicare Care Compare CMS’s own site for comparing hospitals.
Leapfrog Hospital Safety Grade Related, different: a separate rating with its own method.

Download all hospitals’ data (CSV) · Data dictionary · CMS’s dataset page

Cite this page

Paid & Penalized. Hospital-Acquired Conditions (HACRP), FY2026. https://paidandpenalized.org/hacrp/. Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.