Hospital record · FY2026CCN 010061

1Hospital

Highlands Medical Center

2Location

Scottsboro, AL (Alabama’s hospitals on the map and in the table) 35768

Jackson County

3Type

Not a teaching hospital · 170 beds · Government · Rural · Sole community hospital

4Care Compare stars

3 of 5 stars

Overall rating, CMS Care Compare data of July 22, 2026
Open on Care Compare (opens in a new tab)

5Total HAC Score

0.5781

As CMS reports it

6Payment reduction

1% cut

CMS’s value: Yes

7Estimated cut

$59K estimate

Likely $42⁠–⁠66K; about $111 per traditional Medicare stay

Cut 1%

$59K

cut from its FY2026 Medicare inpatient payments, this site estimates estimate

For fiscal year 2026, CMS reports a Total HAC Score of 0.5781 for Highlands Medical Center and a payment reduction decision of Yes.

That is 1% of about $5.9M, this site’s estimate of what traditional Medicare pays it for inpatient stays in a year: about $111 per traditional Medicare stay.

Likely range $42–66K

Its score was above CMS’s line, so CMS cut its Medicare inpatient payments by 1% for the year. The score compares hospitals with each other; it is not a grade of the quality of care.

CMS cut scores of 0.3799 and above.

Each year CMS cuts the hospitals with the highest quarter of scores, those above the 75th percentile, so the line moves with other hospitals’ scores.

Higher than 83% of the other 2,928 scores CMS published (higher is worse).

Its record, fiscal years 2015 to 2026 Cut in 8 of 11 years

15Cut
16No
17No
18Cut
19Cut
20Cut
21Cut
22No
23—
24Cut
25Cut
26Cut

Where the score came from

CMS scored this hospital on 3 of the 6 measures. On every measure a lower value is better. Each row puts the hospital among every hospital with a value: the gray columns are those hospitals, the tall tick is the national median, and the hatched ends score the same as CMS’s floor or cap.

Bringing CAUTI down to the national median (0.489) would lower the score the most: by 0.4443, to 0.1338. That change alone would put the score under CMS’s line. Try it in the what-if

Figure 1. Of its 3 measures with a value, this hospital is above the national median on 3; CAUTI added the most to its score.

This hospital
National median
Scores the same as CMS’s floor or cap

PSI 90 (what it counts)
Safety problems such as serious bedsores, falls that break a bone and blood clots after surgery, found by CMS in traditional Medicare claims. A value of 1 matches the national composite value.
Patient safety and adverse events composite
Worse than 66% of the other 2,808 hospitals
estimate

This site recomputes this measure’s z‑score from CMS’s published value. The recompute can differ from CMS’s z‑score by up to 0.0021. How this site estimates

CMS value1.0015

Z-score0.0907

Part of score+0.0302
CLABSI (what it counts)
Bloodstream infections tied to a central line, a tube often placed in a large vein in the neck, chest or groin. Hospitals report them to the CDC’s National Healthcare Safety Network. A value of 1.0 means as many infections as the CDC’s model predicted.
Central line–associated bloodstream infections
Not scored on this measure
CMS footnote 13: Results cannot be calculated for this reporting period.
CMS footnote 5: Results are not available for this reporting period.

CMS valueno value published

Z-scoreno value published

Part of scoreno value published
CAUTI (what it counts)
Urinary tract infections that start from a urinary catheter, a tube that drains the bladder. Hospitals report them to the CDC’s National Healthcare Safety Network. A value of 1.0 means as many infections as the CDC’s model predicted.
added the most
Catheter-associated urinary tract infections
Worse than 87% of the other 2,354 hospitals

CMS value1.042

Z-score1.1931

Part of score+0.3977
SSI (what it counts)
Deep infections at the site of colon surgery or an abdominal hysterectomy, within a month of the operation, pooled into one measure. Hospitals report them to the CDC’s National Healthcare Safety Network. A value of 1.0 means as many infections as the CDC’s model predicted.
Surgical site infections after colon surgery or abdominal hysterectomy
Not scored on this measure
CMS footnote 13: Results cannot be calculated for this reporting period.
CMS footnote 5: Results are not available for this reporting period.

CMS valueno value published

Z-scoreno value published

Part of scoreno value published
CDI (what it counts)
C. diff infections, which cause diarrhea and inflammation of the colon, found by a lab test and starting in the hospital. Hospitals report them to the CDC’s National Healthcare Safety Network. A value of 1.0 means as many infections as the CDC’s model predicted.
Clostridioides difficile (C. diff) infections
Worse than 71% of the other 2,766 hospitals
estimate

This site recomputes this measure’s z‑score from CMS’s published value. The recompute can differ from CMS’s z‑score by up to 0.0071. How this site estimates

CMS value0.494

Z-score0.4506

Part of score+0.1502
MRSA (what it counts)
Bloodstream infections with MRSA, a germ that resists several antibiotics, found by a lab test and starting in the hospital. Hospitals report them to the CDC’s National Healthcare Safety Network. A value of 1.0 means as many infections as the CDC’s model predicted.
MRSA bloodstream infections
Not scored on this measure
CMS footnote 13: Results cannot be calculated for this reporting period.
CMS footnote 5: Results are not available for this reporting period.

CMS valueno value published

Z-scoreno value published

Part of scoreno value published

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

Show table

Measure	CMS value	National median	Z-score	Part of the score	Among hospitals
PSI 90	1.0015	0.9623	0.0907	+0.0302	Worse than 66% of the other 2,808 hospitals
CLABSI	no value published	0.559	no value published	no value published	Not scored on this measure
CAUTI	1.042	0.489	1.1931	+0.3977	Worse than 87% of the other 2,354 hospitals
SSI	no value published	0.795	no value published	no value published	Not scored on this measure
CDI	0.494	0.346	0.4506	+0.1502	Worse than 71% of the other 2,766 hospitals
MRSA	no value published	0.641	no value published	no value published	Not scored on this measure

How the parts add up

CMS adds the z‑scores and divides by the number of measures scored, so each measure counts the same. Each bar below is one z‑score divided by 3; a bar right of zero raised the score and one left of zero lowered it.

(0.0907PSI 90+1.1931CAUTI+0.4506CDI)÷3measures=0.5781Total HAC Score

This hospital’s score is 0.1989 above 0.3792, the highest score CMS marked No. (This site recomputes.)

Figure 2. The parts add up to 0.5781, above CMS’s line.

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

Show table

Measure	Z-score	Part of the score	Running total
PSI 90	0.0907	+0.0302	0.0302
CAUTI	1.1931	+0.3977	0.4279
CDI	0.4506	+0.1502	0.5781
Total HAC Score			0.5781
CMS’s line		0.3792	0.3799

The money is a cliff

This program’s cut doesn’t grow with the score. Over CMS’s line, CMS cuts 1% of what traditional Medicare pays a hospital for inpatient stays that year; at or under the line, this program cuts nothing.

The chart draws what the cut would be for this hospital at any Total HAC Score, from this site’s estimate of its payments, with its own score marked.

Figure 3. The cut is a cliff, not a slope: this hospital’s score, 0.1989 over the highest score CMS didn’t cut, costs it about $59K by this site’s estimate, and at CMS’s highest score, 2.3133, the cut would be the same.

Under the axis, every Total HAC Score CMS published: 306 of the 2,929 scored within 0.1 of CMS’s line, on one side or the other.

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.

Show table

Score	Total HAC Score	Estimated HAC cut (whole dollars)
Any score up to 0.3792	0.3792	$0
Any score from 0.3799	0.3799	−$58,586
This hospital	0.5781	−$58,586
CMS’s highest score	2.3133	−$58,586

The money, line by line

This site estimates what traditional Medicare pays the hospital for a year of inpatient stays, from CMS’s FY2026 payment files, then applies Medicare’s three hospital quality programs: the readmissions and value-based adjustments to the base payment, and the HAC cut last, as the law sets.

The readmissions and value-based programs adjust only the base payment: the DRG rates times the hospital’s cases, and a Medicare-dependent hospital’s add-on. The HAC cut comes last and takes 1% of everything left, teaching, low-income-patient, outlier, capital and uncompensated care payments included.

($5,833,546payment−$789readmissions+$25,831value-based)×1%the cut=$58,586HAC cut

$58,586HAC cut÷526traditional Medicare stays=$111per traditional Medicare stay

Figure 4. This site estimates the HAC cut at $59K: 1% of the hospital’s whole inpatient payment, taken last. The readmissions and value-based adjustments, on the base alone, came to −$789 and +$26K.

Estimated Medicare inpatient payments · FY2026 estimate

What traditional Medicare pays it for inpatient stays
DRG payments at the federal rates the base	$3,943,821
Many low-income patients (disproportionate share)	$118,315
Outliers: unusually costly stays	$4,417
Low-volume adjustment	$681,133
Capital: buildings and equipment	$299,121
Uncompensated care	$786,739
Total, before the three programs	$5,833,546
The three programs: two on the base, the HAC cut last
Readmissions (HRRP) base × (0.9998 − 1)	−$789
Value-based purchasing (HVBP) base × (1.0065 − 1)	+$25,831
After these two	$5,858,588
HAC Reduction Program 1% of everything above; likely $42⁠–⁠66K	−$58,586
Net of the three programs likely −$36K to −$23K	−$33,544

Not paid to this hospital: a Medicare-dependent hospital add-on, teaching payments, and a sole community hospital rate difference.

Whole dollars, so every line adds up; the estimate is not that precise. Each likely range spans the middle 80% of the misses this site’s estimate made for similar hospitals (or for a wider group, where there were too few) when it was checked against their FY2024 cost reports: one year’s check, not a promise of how often a hospital’s actual figure lands inside.

Show table

Line	Amount (whole dollars)
DRG payments at the federal rates (the base)	$3,943,821
Many low-income patients (disproportionate share)	$118,315
Outliers: unusually costly stays	$4,417
Low-volume adjustment	$681,133
Capital: buildings and equipment	$299,121
Uncompensated care	$786,739
Total, before the three programs	$5,833,546
Readmissions (HRRP) (base × (0.9998 − 1))	−$789
Value-based purchasing (HVBP) (base × (1.0065 − 1))	+$25,831
After these two	$5,858,588
HAC Reduction Program (1% of everything above; likely $42–66K)	−$58,586
Net of the three programs (likely −$36K to −$23K)	−$33,544

What if a measure were different?

Change a measure’s value to see how this site recomputes the Total HAC Score, the payment reduction decision and, by its estimate, the money, starting from CMS’s values. The money doesn’t slide with the score: it drops off a cliff at CMS’s line.

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

Show table

	CMS reports	Hypothetical
Total HAC Score	0.5781	same
Payment reduction decision	Yes	same
Payment cut	1%	same
Estimated HAC cut estimate	$59K	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.

CMS reports a Total HAC Score of 0.5781 and a payment reduction decision of Yes.

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.

What would it take?

Getting under CMS’s line would keep about $59K, this site estimates: the whole cut, however far under the score lands.

From CMS’s values, one measure at a time, with every other measure held at CMS’s value.

Measure	Value that would read No
PSI 90	0.9159 or lower
CAUTI	0.794 or lower
CDI	0.339 or lower

Each measure weighs 1 ÷ 3 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

CMS 1.0015 · median 0.9623 · floor 0.7760 · cap 1.3482 · each 0.1 = 0.2327

Catheter-associated urinary tract infections CAUTI

CAUTI value

CMS 1.042 · median 0.489 · cap 1.537 · each 0.1 = 0.0804

Clostridioides difficile (C. diff) infections CDI

CDI value

CMS 0.494 · median 0.346 · cap 0.944 · each 0.1 = 0.1291

Have your NHSN predicted counts? (optional, stays in your browser)

Stays in your browser; never sent.

Optional: your NHSN predicted infections for CAUTI, January 1, 2023 to December 31, 2024

Optional: your NHSN predicted infections for CDI, January 1, 2023 to December 31, 2024

Figure 5. CAUTI added the most to this hospital’s Total HAC Score of 0.5781 among its measured results: +0.3977.

PSI 90 +0.0302
CAUTI +0.3977
CDI +0.1502

A measure adds its z‑score divided by 3, the number of measures scored. Bars right of the center line raise the score. Hatched: assigned by CMS.

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

Show table

Measure	Z-score	Part of the score	Hypothetical
PSI 90	0.0907	+0.0302	same
CAUTI	1.1931	+0.3977	same
CDI	0.4506	+0.1502	same

Interactive what-if at https://paidandpenalized.org/hacrp/hospital/010061/

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.

Year by year

Where this hospital’s score fell among every hospital’s, each year CMS published one. A score near the top is among the highest; the shaded band is where CMS cut. Places compare across years even where CMS changed how it builds the score.

Its longest run: cut 4 years in a row.

Figure 6. CMS cut this hospital in 8 of the 11 years it made a decision.

● Red: a year CMS cut it ○ Hollow: a year it didn’t

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

Fiscal year	Total HAC Score	Higher than this share of scores	Payment reduction
FY2015	9.3000	97.8%	cut
FY2016	3.7500	19.6%	not cut
FY2017	3.3625	18.1%	not cut
FY2018	0.6282	86.6%	cut
FY2019	0.8591	92.1%	cut
FY2020	1.4454	98.9%	cut
FY2021	0.8377	93.2%	cut
FY2022	−0.6751	12.9%	not cut
FY2023			no decision
FY2024	0.6982	86.4%	cut
FY2025	0.9465	93.1%	cut
FY2026	0.5781	83.1%	cut

Its infections, year by year

This hospital’s infection rate against prediction for each calendar year Care Compare published one, on each measure with at least two years of results (black), over the nation’s middle hospital (gray). Below the dashed line at one, fewer infections than predicted. Each year is measured against the same fixed baseline, not against other hospitals, so unlike the score they can all improve at once.

Figure 7. 1 of its 2 infection measures ended lower than they started.

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).

Show table

Calendar year	CAUTI	C. diff
2017	0.000	0.737
2018		0.784
2019		0.222
2021	4.896	0.991
2022	2.762	0.309
2023	0.000	0.989
2024		0.000

Among hospitals like it

Each row is a group this hospital belongs to, drawn from every hospital in it with a payment decision. Red columns are hospitals past CMS’s line, the ones CMS cut; the short tick is the group’s middle score.

In Alabama, its score is higher than 62% of the other 67 scored there.

Figure 8. Its score is above the middle in all 7 groups it belongs to; the share cut runs from 22% (South region) to 43% (Alabama).

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

Show table

Group	With a decision	Hospitals cut	Share cut	Middle score	Hospital higher than
All hospitals	2,886	718	25%	−0.0453	83%
South region	1,174	263	22%	−0.1056	84%
Alabama	68	29	43%	0.2561	62%
Not teaching	1,563	389	25%	−0.1053	82%
100 to 299 beds	1,193	275	23%	−0.0732	84%
Government	401	140	35%	0.1602	74%
Rural	619	196	32%	0.0229	76%
This hospital				0.5781
CMS’s line				0.3792	0.3799

The nearest hospitals

The 8 closest hospitals with a Total HAC Score, in a straight line. The squares are each hospital’s measures in order: filled, above the national median; open, at or below it; hatched, assigned by CMS; blank, not scored.

Figure 9. CMS cut 4 of the 8 nearest hospitals; the closest is 23 miles away.

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

Show table

Hospital	Miles	Score	Decision
Dekalb Regional Medical Center, Fort Payne, AL	23	0.5478	cut
Huntsville Hospital, Huntsville, AL	30	0.9199	cut
Crestwood Medical Center, Huntsville, AL	30	0.3156	not cut
Marshall Medical Centers, Boaz, AL	31	0.6065	cut
Southern Tennessee Regional Health System Winchest, Winchester, TN	36	0.1915	not cut
Floyd Cherokee Medical Center, Centre, AL	41	−1.4622	not cut
Lincoln Medical Center, Fayetteville, TN	44	−0.2274	not cut
Gadsden Regional Medical Center, Gadsden, AL	45	0.6323	cut

#	Hospital	Miles	Score	Decision	Est. cut ($, modeled)	Measures
1	Dekalb Regional Medical CenterFort Payne, AL	23	0.5478	1% cut	$65K	Above the national median on 4 of 4 measures
2	Huntsville HospitalHuntsville, AL	30	0.9199	1% cut	$1.6M	Above the national median on 5 of 6 measures
3	Crestwood Medical CenterHuntsville, AL	30	0.3156	No cut	$0	Above the national median on 2 of 6 measures
4	Marshall Medical CentersBoaz, AL	31	0.6065	1% cut	$148K	Above the national median on 5 of 6 measures
5	Southern Tennessee Regional Health System WinchestWinchester, TN	36	0.1915	No cut	$0	Above the national median on 2 of 5 measures
6	Floyd Cherokee Medical CenterCentre, AL	41	−1.4622	No cut	$0	Above the national median on 0 of 1 measures
7	Lincoln Medical CenterFayetteville, TN	44	−0.2274	No cut	$0	Above the national median on 1 of 2 measures
8	Gadsden Regional Medical CenterGadsden, AL	45	0.6323	1% cut	$219K	Above the national median on 3 of 6 measures

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

CMS’s footnotes on this page

13: Results cannot be calculated for this reporting period.
5: Results are not available for this reporting period.

How the program works, and how to find another hospital

A penalty reflects how CMS’s formula scored relative performance; it is not a verdict on the quality of care.

Cite this page

Paid & Penalized. Highlands Medical Center, Scottsboro, AL: Hospital-Acquired Conditions, FY2026. https://paidandpenalized.org/hacrp/hospital/010061/. Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.