P&P, Paid & Penalized

Public Medicare data, made visible.

HospitalKaiser Foundation Hospital - San Marcos Estimated FY2026 net: +$12K×

Hospital record · FY2026CCN 050855

1Hospital

Kaiser Foundation Hospital - San Marcos

2Location

San Marcos, CA (California’s hospitals on the map and in the table) 92078

San Diego County

3Type

Not a teaching hospital · 168 beds · Nonprofit · Urban

4Care Compare stars

4 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

1.1604

As CMS reports it

6Payment reduction

1% cut
CMS’s value: Yes

7Estimated cut

$29K estimate
Likely $22⁠–⁠36K; about $146 per traditional Medicare stay

Cut 1%

$29K

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

For fiscal year 2026, CMS reports a Total HAC Score of 1.1604 for Kaiser Foundation Hospital - San Marcos and a payment reduction decision of Yes.

That is 1% of about $2.9M, this site’s estimate of what traditional Medicare pays it for inpatient stays in a year: about $146 per traditional Medicare stay.

Likely range $22–36K

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.

lowest −1.4728 1% cut Middle hospital: −0.0453 Middle hospital−0.0453 CMS’s line: 0.3799 and up CMS’s line0.3799 and up This hospital: 1.1604 This hospital 1.1604 lowest −1.4728 highest 2.3133 1% cut Middle hospital: −0.0453 Middle hospital−0.0453 CMS’s line: 0.3799 and up CMS’s line0.3799 and up This hospital: 1.1604 This hospital 1.1604

Higher than 96% of the other 2,928 scores CMS published (higher is worse).

Its record, fiscal years 2015 to 2026 Cut in 1 of 2 years

  1. 15—
  2. 16—
  3. 17—
  4. 18—
  5. 19—
  6. 20—
  7. 21—
  8. 22—
  9. 23—
  10. 24—
  11. 25No
  12. 26Cut

In FY2025, CMS reports a payment reduction decision for this hospital but no Total HAC Score.

Where the score came from

CMS scored this hospital on 5 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 0.5052, to 0.6552. Try it in the what-if

Figure 1. Of its 5 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
  1. 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

    Not scored on this measure

    CMS footnote 5: Results are not available for this reporting period.

    CMS valueno value published

    Z-scoreno value published

    Part of scoreno value published

  2. 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

    Worse than 97% of the other 2,181 hospitals

    CMS value1.886

    Z-score2.2402

    Part of score+0.4480

  3. 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 98% of the other 2,354 hospitals

    CMS value2.088

    Z-score2.3863

    Part of score+0.4773

  4. 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

    Better than 50% of the other 2,269 hospitals

    CMS value0.781

    Z-score−0.1186

    Part of score−0.0237

  5. 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 90% 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 value0.793

    Z-score1.6084

    Part of score+0.3217

  6. 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

    Better than 58% of the other 2,067 hospitals

    CMS value0.547

    Z-score−0.3141

    Part of score−0.0628

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

Show table
MeasureCMS valueNational medianZ-scorePart of the scoreAmong hospitals
PSI 90no value published0.9623no value publishedno value publishedNot scored on this measure
CLABSI1.8860.5592.2402+0.4480Worse than 97% of the other 2,181 hospitals
CAUTI2.0880.4892.3863+0.4773Worse than 98% of the other 2,354 hospitals
SSI0.7810.795−0.1186−0.0237Better than 50% of the other 2,269 hospitals
CDI0.7930.3461.6084+0.3217Worse than 90% of the other 2,766 hospitals
MRSA0.5470.641−0.3141−0.0628Better than 58% of the other 2,067 hospitals

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 5; a bar right of zero raised the score and one left of zero lowered it.

(2.2402CLABSI+2.3863CAUTI−0.1186SSI+1.6084CDI−0.3141MRSA)÷5measures=1.1604Total HAC Score

This hospital’s score is 0.7812 above 0.3792, the highest score CMS marked No. (This site recomputes.)

Figure 2. The parts add up to 1.1604, above CMS’s line.
1% cut CLABSI: z‑score 2.2402 divided by 5 = +0.4480CLABSI+0.4480 CAUTI: z‑score 2.3863 divided by 5 = +0.4773CAUTI+0.4773 SSI: z‑score −0.1186 divided by 5 = −0.0237SSI−0.0237 CDI: z‑score 1.6084 divided by 5 = +0.3217CDI+0.3217 MRSA: z‑score −0.3141 divided by 5 = −0.0628MRSA−0.0628 Total HAC Score: 1.1604Score1.1604 CMS’s line: between 0.3792 and 0.3799 CMS’s line 0.00.20.40.60.81.01.2 1% cut CLABSI: z‑score 2.2402 divided by 5 = +0.4480CLABSI+0.4480 CAUTI: z‑score 2.3863 divided by 5 = +0.4773CAUTI+0.4773 SSI: z‑score −0.1186 divided by 5 = −0.0237SSI−0.0237 CDI: z‑score 1.6084 divided by 5 = +0.3217CDI+0.3217 MRSA: z‑score −0.3141 divided by 5 = −0.0628MRSA−0.0628 Total HAC Score: 1.1604Score1.1604 CMS’s line: between 0.3792 and 0.3799 CMS’s line 0.00.20.40.60.81.01.2

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

Show table
MeasureZ-scorePart of the scoreRunning total
CLABSI2.2402+0.44800.4480
CAUTI2.3863+0.47730.9253
SSI−0.1186−0.02370.9016
CDI1.6084+0.32171.2233
MRSA−0.3141−0.06281.1605
Total HAC Score1.1604
CMS’s line0.37920.3799

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, 0.7812 over the highest score CMS didn’t cut, costs it about $29K by this site’s estimate, and at CMS’s highest score, 2.3133, the cut would be the same.
CMS’s line $0 at any score up to 0.3792 $29K at any score from 0.3799 $0at any score up to 0.3792 $29K at any score from 0.3799 −1012 CMS’s highest score: 2.3133 This hospital: 1.1604 This hospital 1.1604 CMS’s line $0 at any score up to 0.3792 $29K at any score from 0.3799 $0at any score up to 0.3792 $29Kat any score from 0.3799 −1.0−0.50.00.51.01.52.0 CMS’s highest score: 2.3133 This hospital: 1.1604 This hospital 1.1604

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
ScoreTotal HAC ScoreEstimated HAC cut (whole dollars)
Any score up to 0.37920.3792$0
Any score from 0.37990.3799−$29,015
This hospital1.1604−$29,015
CMS’s highest score2.3133−$29,015

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.

($2,860,562payment+$0readmissions+$40,984value-based)×1%the cut=$29,015HAC cut

$29,015HAC cut÷199traditional Medicare stays=$146per traditional Medicare stay

Figure 4. This site estimates the HAC cut at $29K: 1% of the hospital’s whole inpatient payment, taken last. The readmissions and value-based adjustments, on the base alone, came to $0 and +$41K.

Estimated Medicare inpatient payments · FY2026 estimate

What traditional Medicare pays it for inpatient stays
DRG payments at the federal rates the base $2,398,801
Outliers: unusually costly stays $254,009
Capital: buildings and equipment $207,752
Total, before the three programs $2,860,562
The three programs: two on the base, the HAC cut last
Readmissions (HRRP) base × (1.0000 − 1) $0
Value-based purchasing (HVBP) base × (1.0171 − 1) +$40,984
After these two $2,901,546
HAC Reduction Program 1% of everything above; likely $22⁠–⁠36K −$29,015
Net of the three programs likely $10⁠–⁠14K +$11,969

Not paid to this hospital: a Medicare-dependent hospital add-on, teaching payments, low-income-patient payments, a sole community hospital rate difference, a low-volume adjustment, and uncompensated care payments.

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.

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
LineAmount (whole dollars)
DRG payments at the federal rates (the base)$2,398,801
Outliers: unusually costly stays$254,009
Capital: buildings and equipment$207,752
Total, before the three programs$2,860,562
Readmissions (HRRP) (base × (1.0000 − 1))$0
Value-based purchasing (HVBP) (base × (1.0171 − 1))+$40,984
After these two$2,901,546
HAC Reduction Program (1% of everything above; likely $22–36K)−$29,015
Net of the three programs (likely $10–14K)+$11,969

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 reportsHypothetical
Total HAC Score1.1604same
Payment reduction decisionYessame
Payment cut1%same
Estimated HAC cut estimate$29Ksame

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 1.1604 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 $29K, 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.

MeasureValue that would read No
CLABSInot possible with this measure alone
CAUTInot possible with this measure alone
SSInot possible with this measure alone
CDInot possible with this measure alone
MRSAnot possible with this measure alone

Each measure weighs 1 ÷ 5 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.

CMS 1.886 · median 0.559 · cap 1.572 · each 0.1 = 0.0464

CMS 2.088 · median 0.489 · cap 1.537 · each 0.1 = 0.0482

CMS 0.781 · median 0.795 · cap 2.118 · each 0.1 = 0.0343

CMS 0.793 · median 0.346 · cap 0.944 · each 0.1 = 0.0774

CMS 0.547 · median 0.641 · cap 1.762 · each 0.1 = 0.0418

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Figure 5. CAUTI added the most to this hospital’s Total HAC Score of 1.1604 among its measured results: +0.4773.
  • CLABSI +0.4480
  • CAUTI +0.4773
  • SSI −0.0237
  • CDI +0.3217
  • MRSA −0.0628

A measure adds its z‑score divided by 5, 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
MeasureZ-scorePart of the scoreHypothetical
CLABSI2.2402+0.4480same
CAUTI2.3863+0.4773same
SSI−0.1186−0.0237same
CDI1.6084+0.3217same
MRSA−0.3141−0.0628same

Interactive what-if at https://paidandpenalized.org/hacrp/hospital/050855/

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.

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 6. 0 of its 1 infection measures ended lower than they started.
C. diff 0.27 → 0.91 1as predicted 0 ’18’21’24 Nation’s middle C. diff, 2023: 0.273C. diff, 2024: 0.908 C. diff 0.27 → 0.91 1as predicted 0 ’18’20’22’24 Nation’s middle C. diff, 2023: 0.273C. diff, 2024: 0.908

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 yearC. diff
20230.273
20240.908

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 California, its score is higher than 94% of the other 276 scored there.

In San Diego-Chula Vista-Carlsbad, CA area, its score is higher than 100% of the other 14 scored there.

Figure 7. Its score is above the middle in all 8 groups it belongs to; the share cut runs from 23% (Urban) to 40% (San Diego-Chula Vista-Carlsbad, CA area).
All hospitals: CMS cut 718 of 2,886 (25%); middle score −0.0453All hospitals 2,886 hospitals25% cut West region: CMS cut 157 of 593 (26%); middle score −0.0302West region 593 hospitals26% cut California: CMS cut 76 of 277 (27%); middle score −0.0217California 277 hospitals27% cut San Diego-Chula Vista-Carlsbad, CA area: CMS cut 6 of 15 (40%); middle score 0.2072San Diego-Chula Vista-Carlsbad, CA area15 hospitals40% cut Not teaching: CMS cut 389 of 1,563 (25%); middle score −0.1053Not teaching 1,563 hospitals25% cut 100 to 299 beds: CMS cut 275 of 1,193 (23%); middle score −0.0732100 to 299 beds 1,193 hospitals23% cut Nonprofit: CMS cut 478 of 1,830 (26%); middle score −0.0134Nonprofit 1,830 hospitals26% cut Urban: CMS cut 510 of 2,241 (23%); middle score −0.0574Urban 2,241 hospitals23% cut CMS’s line: between 0.3792 and 0.3799 CMS’s line −1012 This hospital: 1.1604 This hospital 1.1604 All hospitals: CMS cut 718 of 2,886 (25%); middle score −0.0453All hospitals2,886 hospitals25% cut West region: CMS cut 157 of 593 (26%); middle score −0.0302West region593 hospitals26% cut California: CMS cut 76 of 277 (27%); middle score −0.0217California277 hospitals27% cut San Diego-Chula Vista-Carlsbad, CA area: CMS cut 6 of 15 (40%); middle score 0.2072San Diego-Chula Vista-Carlsbad, CA area15 hospitals40% cut Not teaching: CMS cut 389 of 1,563 (25%); middle score −0.1053Not teaching1,563 hospitals25% cut 100 to 299 beds: CMS cut 275 of 1,193 (23%); middle score −0.0732100 to 299 beds1,193 hospitals23% cut Nonprofit: CMS cut 478 of 1,830 (26%); middle score −0.0134Nonprofit1,830 hospitals26% cut Urban: CMS cut 510 of 2,241 (23%); middle score −0.0574Urban2,241 hospitals23% cut CMS’s line: between 0.3792 and 0.3799 CMS’s line −1.5−1.0−0.50.00.51.01.52.0 This hospital: 1.1604 This hospital 1.1604

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

Show table
GroupWith a decisionHospitals cutShare cutMiddle scoreHospital higher than
All hospitals2,88671825%−0.045396%
West region59315726%−0.030295%
California2777627%−0.021794%
San Diego-Chula Vista-Carlsbad, CA area15640%0.2072100%
Not teaching1,56338925%−0.105395%
100 to 299 beds1,19327523%−0.073297%
Nonprofit1,83047826%−0.013497%
Urban2,24151023%−0.057497%
This hospital1.1604
CMS’s line0.37920.3799

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 8. CMS cut 3 of the 8 nearest hospitals; the closest is 5 miles away.
5 mi10 mi8. Kaiser Foundation Hospital - San Diego, San Diego: score 0.4316, cut, 24 miles87. Sharp Memorial Hospital, San Diego: score 0.4146, cut, 23 miles76. Scripps Memorial Hospital La Jolla, La Jolla: score 0.2003, not cut, 17 miles65. Scripps Green Hospital, La Jolla: score 0.3891, cut, 17 miles54. Palomar Medical Center Poway, Poway: score 0.2072, not cut, 11 miles43. Scripps Memorial Hospital - Encinitas, Encinitas: score −0.3285, not cut, 9 miles32. Tri-City Medical Center, Oceanside: score 0.3784, not cut, 9 miles21. Palomar Health Downtown Campus, Escondido: score −0.0878, not cut, 5 miles1This hospital: Kaiser Foundation Hospital - San Marcos

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

Show table
HospitalMilesScoreDecision
Palomar Health Downtown Campus, Escondido, CA5−0.0878not cut
Tri-City Medical Center, Oceanside, CA90.3784not cut
Scripps Memorial Hospital - Encinitas, Encinitas, CA9−0.3285not cut
Palomar Medical Center Poway, Poway, CA110.2072not cut
Scripps Green Hospital, La Jolla, CA170.3891cut
Scripps Memorial Hospital La Jolla, La Jolla, CA170.2003not cut
Sharp Memorial Hospital, San Diego, CA230.4146cut
Kaiser Foundation Hospital - San Diego, San Diego, CA240.4316cut

#HospitalMilesScoreDecisionEst. cut ($, modeled)Measures
1Palomar Health Downtown CampusEscondido, CA5−0.0878No cut$0Above the national median on 3 of 6 measures
2Tri-City Medical CenterOceanside, CA90.3784No cut$0Above the national median on 5 of 6 measures
3Scripps Memorial Hospital - EncinitasEncinitas, CA9−0.3285No cut$0Above the national median on 3 of 6 measures
4Palomar Medical Center PowayPoway, CA110.2072No cut$0Above the national median on 3 of 6 measures
5Scripps Green HospitalLa Jolla, CA170.38911% cut$892KAbove the national median on 4 of 6 measures
6Scripps Memorial Hospital La JollaLa Jolla, CA170.2003No cut$0Above the national median on 2 of 6 measures
7Sharp Memorial HospitalSan Diego, CA230.41461% cut$1.0MAbove the national median on 5 of 6 measures
8Kaiser Foundation Hospital - San DiegoSan Diego, CA240.43161% cut$190KAbove the national median on 4 of 6 measures

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

CMS’s footnotes on this page

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. Kaiser Foundation Hospital - San Marcos, San Marcos, CA: Hospital-Acquired Conditions, FY2026. https://paidandpenalized.org/hacrp/hospital/050855/. Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.