P&P, Paid & Penalized

Public Medicare data, made visible.

HospitalCHI St Alexius Health Estimated FY2026 net: −$401K×

Hospital record · FY2026CCN 350002

1Hospital

CHI St Alexius Health

2Location

Bismarck, ND (North Dakota’s hospitals on the map and in the table) 58501

Burleigh County

3Type

Minor teaching · 287 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

0.8100

As CMS reports it

6Payment reduction

1% cut
CMS’s value: Yes

7Estimated cut

$326K estimate
Likely $249⁠–⁠410K; about $163 per traditional Medicare stay

Cut 1%

$326K

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

For fiscal year 2026, CMS reports a Total HAC Score of 0.8100 for CHI St Alexius Health and a payment reduction decision of Yes.

That is 1% of about $32.6M, this site’s estimate of what traditional Medicare pays it for inpatient stays in a year plus the teaching payments Medicare makes on its Medicare Advantage patients’ stays: about $163 per traditional Medicare stay.

Likely range $249–410K

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 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: 0.8100 This hospital 0.8100 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: 0.8100 This hospital 0.8100

Higher than 90% of the other 2,928 scores CMS published (higher is worse).

Its record, fiscal years 2015 to 2026 Cut in 4 of 11 years

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

Where the score came from

CMS scored this hospital on all 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 PSI 90 down to the national median (0.9623) would lower the score the most: by 0.2322, to 0.5778. Try it in the what-if

Figure 1. Of its 6 measures with a value, this hospital is above the national median on 6; PSI 90 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.

    added the most

    Patient safety and adverse events composite

    Worse than 87% 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 value1.1619

    Z-score1.2107

    Part of score+0.2018

  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 86% of the other 2,181 hospitals

    CMS value1.086

    Z-score1.1128

    Part of score+0.1855

  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.

    Catheter-associated urinary tract infections

    Worse than 67% of the other 2,354 hospitals

    CMS value0.657

    Z-score0.2651

    Part of score+0.0442

  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

    Worse than 84% of the other 2,269 hospitals

    CMS value1.503

    Z-score1.1182

    Part of score+0.1864

  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 77% 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 value0.558

    Z-score0.6984

    Part of score+0.1164

  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

    Worse than 71% of the other 2,067 hospitals

    CMS value0.915

    Z-score0.4550

    Part of score+0.0758

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

Show table
MeasureCMS valueNational medianZ-scorePart of the scoreAmong hospitals
PSI 901.16190.96231.2107+0.2018Worse than 87% of the other 2,808 hospitals
CLABSI1.0860.5591.1128+0.1855Worse than 86% of the other 2,181 hospitals
CAUTI0.6570.4890.2651+0.0442Worse than 67% of the other 2,354 hospitals
SSI1.5030.7951.1182+0.1864Worse than 84% of the other 2,269 hospitals
CDI0.5580.3460.6984+0.1164Worse than 77% of the other 2,766 hospitals
MRSA0.9150.6410.4550+0.0758Worse than 71% 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 6; a bar right of zero raised the score and one left of zero lowered it.

(1.2107PSI 90+1.1128CLABSI+0.2651CAUTI+1.1182SSI+0.6984CDI+0.4550MRSA)÷6measures=0.8100Total HAC Score

This hospital’s score is 0.4308 above 0.3792, the highest score CMS marked No. (This site recomputes.)

Figure 2. The parts add up to 0.8100, above CMS’s line.
1% cut PSI 90: z‑score 1.2107 divided by 6 = +0.2018PSI 90+0.2018 CLABSI: z‑score 1.1128 divided by 6 = +0.1855CLABSI+0.1855 CAUTI: z‑score 0.2651 divided by 6 = +0.0442CAUTI+0.0442 SSI: z‑score 1.1182 divided by 6 = +0.1864SSI+0.1864 CDI: z‑score 0.6984 divided by 6 = +0.1164CDI+0.1164 MRSA: z‑score 0.4550 divided by 6 = +0.0758MRSA+0.0758 Total HAC Score: 0.8100Score0.8100 CMS’s line: between 0.3792 and 0.3799 CMS’s line 0.00.20.40.60.8 1% cut PSI 90: z‑score 1.2107 divided by 6 = +0.2018PSI 90+0.2018 CLABSI: z‑score 1.1128 divided by 6 = +0.1855CLABSI+0.1855 CAUTI: z‑score 0.2651 divided by 6 = +0.0442CAUTI+0.0442 SSI: z‑score 1.1182 divided by 6 = +0.1864SSI+0.1864 CDI: z‑score 0.6984 divided by 6 = +0.1164CDI+0.1164 MRSA: z‑score 0.4550 divided by 6 = +0.0758MRSA+0.0758 Total HAC Score: 0.8100Score0.8100 CMS’s line: between 0.3792 and 0.3799 CMS’s line 0.00.20.40.60.8

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

Show table
MeasureZ-scorePart of the scoreRunning total
PSI 901.2107+0.20180.2018
CLABSI1.1128+0.18550.3873
CAUTI0.2651+0.04420.4315
SSI1.1182+0.18640.6179
CDI0.6984+0.11640.7343
MRSA0.4550+0.07580.8101
Total HAC Score0.8100
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, and of the teaching payments Medicare makes on its Medicare Advantage stays; 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, 0.4308 over the highest score CMS didn’t cut, costs it about $326K 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 $326K at any score from 0.3799 $0at any score up to 0.3792 $326K at any score from 0.3799 −1012 CMS’s highest score: 2.3133 This hospital: 0.8100 This hospital 0.8100 CMS’s line $0 at any score up to 0.3792 $326K at any score from 0.3799 $0at any score up to 0.3792 $326Kat any score from 0.3799 −1.0−0.50.00.51.01.52.0 CMS’s highest score: 2.3133 CMS’s highest score 2.3133 This hospital: 0.8100 This hospital 0.8100

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−$326,308
This hospital0.8100−$326,308
CMS’s highest score2.3133−$326,308

The money, line by line

This site estimates what traditional Medicare pays the hospital for a year of inpatient stays, and the teaching payments Medicare makes on its Medicare Advantage patients’ 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.

($32,535,292payment+$169,799teaching, MA stays−$2,652readmissions−$71,682value-based)×1%the cut=$326,308HAC cut

$326,308HAC cut÷2,008traditional Medicare stays=$163per traditional Medicare stay

Figure 4. This site estimates the HAC cut at $326K: 1% of the hospital’s whole inpatient payment, taken last. The readmissions and value-based adjustments, on the base alone, came to −$3K and −$72K.

Estimated Medicare inpatient payments · FY2026 estimate

What traditional Medicare pays it for inpatient stays, and for teaching on Medicare Advantage stays
DRG payments at the federal rates the base $26,524,282
Teaching (indirect medical education) $388,581
Teaching on Medicare Advantage stays $169,799
Many low-income patients (disproportionate share) $344,550
Outliers: unusually costly stays $2,048,470
Capital: buildings and equipment $2,373,252
Uncompensated care $856,157
Total, before the three programs $32,705,091
The three programs: two on the base, the HAC cut last
Readmissions (HRRP) base × (0.9999 − 1) −$2,652
Value-based purchasing (HVBP) base × (0.9973 − 1) −$71,682
After these two $32,630,757
HAC Reduction Program 1% of everything above; likely $249⁠–⁠410K −$326,308
Net of the three programs likely −$471K to −$323K −$400,642

Not paid to this hospital: a Medicare-dependent hospital add-on, a sole community hospital rate difference, and a low-volume adjustment.

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)$26,524,282
Teaching (indirect medical education)$388,581
Teaching on Medicare Advantage stays$169,799
Many low-income patients (disproportionate share)$344,550
Outliers: unusually costly stays$2,048,470
Capital: buildings and equipment$2,373,252
Uncompensated care$856,157
Total, before the three programs$32,705,091
Readmissions (HRRP) (base × (0.9999 − 1))−$2,652
Value-based purchasing (HVBP) (base × (0.9973 − 1))−$71,682
After these two$32,630,757
HAC Reduction Program (1% of everything above; likely $249–410K)−$326,308
Net of the three programs (likely −$471K to −$323K)−$400,642

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 Score0.8100same
Payment reduction decisionYessame
Payment cut1%same
Estimated HAC cut estimate$326Ksame

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 0.8100 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 $326K, 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
PSI 900.7915 or lower
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 ÷ 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.

CMS 1.1619 · median 0.9623 · floor 0.7760 · cap 1.3482 · each 0.1 = 0.1164

CMS 1.086 · median 0.559 · cap 1.572 · each 0.1 = 0.0387

CMS 0.657 · median 0.489 · cap 1.537 · each 0.1 = 0.0402

CMS 1.503 · median 0.795 · cap 2.118 · each 0.1 = 0.0286

CMS 0.558 · median 0.346 · cap 0.944 · each 0.1 = 0.0645

CMS 0.915 · median 0.641 · cap 1.762 · each 0.1 = 0.0348

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Figure 5. PSI 90 added the most to this hospital’s Total HAC Score of 0.8100 among its measured results: +0.2018.
  • PSI 90 +0.2018
  • CLABSI +0.1855
  • CAUTI +0.0442
  • SSI +0.1864
  • CDI +0.1164
  • MRSA +0.0758

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.

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

Show table
MeasureZ-scorePart of the scoreHypothetical
PSI 901.2107+0.2018same
CLABSI1.1128+0.1855same
CAUTI0.2651+0.0442same
SSI1.1182+0.1864same
CDI0.6984+0.1164same
MRSA0.4550+0.0758same

Interactive what-if at https://paidandpenalized.org/hacrp/hospital/350002/

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 2 years in a row.

Figure 6. CMS cut this hospital in 4 of the 11 years it made a decision.
highest middle lowest z‑scoresequal weights no scores FY2015: score 6.0500, higher than 60% of scores; not cutFY2016: score 5.2500, higher than 45% of scores; not cutFY2017: score 5.2300, higher than 46% of scores; not cutFY2018: score 0.2035, higher than 66% of scores; not cutFY2019: score 0.573, higher than 84% of scores; cutFY2020: score 0.5180, higher than 83% of scores; cutFY2021: score 0.1594, higher than 65% of scores; not cutFY2022: score −0.3724, higher than 26% of scores; not cutFY2024: score −0.0830, higher than 46% of scores; not cutFY2025: score 0.5652, higher than 84% of scores; cutFY2026: score 0.8100, higher than 90% of scores; cut 161820222426 highest middle lowest z‑scoresequal weights no scores FY2015: score 6.0500, higher than 60% of scores; not cutFY2016: score 5.2500, higher than 45% of scores; not cutFY2017: score 5.2300, higher than 46% of scores; not cutFY2018: score 0.2035, higher than 66% of scores; not cutFY2019: score 0.573, higher than 84% of scores; cutFY2020: score 0.5180, higher than 83% of scores; cutFY2021: score 0.1594, higher than 65% of scores; not cutFY2022: score −0.3724, higher than 26% of scores; not cutFY2024: score −0.0830, higher than 46% of scores; not cutFY2025: score 0.5652, higher than 84% of scores; cutFY2026: score 0.8100, higher than 90% of scores; cut 151617181920212223242526

● 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 yearTotal HAC ScoreHigher than this share of scoresPayment reduction
FY20156.050060.8%not cut
FY20165.250045.0%not cut
FY20175.230046.5%not cut
FY20180.203566.6%not cut
FY20190.57384.3%cut
FY20200.518083.7%cut
FY20210.159465.1%not cut
FY2022−0.372426.5%not cut
FY2023no decision
FY2024−0.083046.2%not cut
FY20250.565284.1%cut
FY20260.810090.2%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. 3 of its 6 infection measures ended lower than they started.
CLABSI 0.99 → 0.48 1as predicted 0 ’18’21’24 Nation’s middle CLABSI, 2017: 0.995CLABSI, 2018: 1.203CLABSI, 2019: 0.615CLABSI, 2021: 1.096CLABSI, 2022: 0.678CLABSI, 2023: 1.596CLABSI, 2024: 0.477 CAUTI 1.65 → 0.00 1 0 ’18’21’24 CAUTI, 2017: 1.653CAUTI, 2018: 0.978CAUTI, 2019: 0.688CAUTI, 2021: 0.000CAUTI, 2022: 0.260CAUTI, 2023: 1.052CAUTI, 2024: 0.000 SSI, colon 0.44 → 0.83 1 0 ’18’21’24 SSI, colon, 2017: 0.442SSI, colon, 2018: 0.591SSI, colon, 2019: 0.495SSI, colon, 2022: 0.641SSI, colon, 2023: 1.314SSI, colon, 2024: 0.826 SSI, hysterectomy 0.00 → 0.78 1 0 ’18’21’24 SSI, hysterectomy, 2017: 0.000SSI, hysterectomy, 2018: 0.776 MRSA 0.54 → 0.61 1 0 ’18’21’24 MRSA, 2017: 0.536MRSA, 2018: 0.462MRSA, 2019: 0.363MRSA, 2021: 0.367MRSA, 2022: 0.458MRSA, 2023: 1.099MRSA, 2024: 0.608 C. diff 1.02 → 0.46 1 0 ’18’21’24 C. diff, 2017: 1.024C. diff, 2018: 1.356C. diff, 2019: 0.377C. diff, 2021: 0.389C. diff, 2022: 0.349C. diff, 2023: 0.644C. diff, 2024: 0.459 CLABSI 0.99 → 0.48 1as predicted 0 ’18’20’22’24 Nation’s middle CLABSI, 2017: 0.995CLABSI, 2018: 1.203CLABSI, 2019: 0.615CLABSI, 2021: 1.096CLABSI, 2022: 0.678CLABSI, 2023: 1.596CLABSI, 2024: 0.477 CAUTI 1.65 → 0.00 1 0 ’18’20’22’24 CAUTI, 2017: 1.653CAUTI, 2018: 0.978CAUTI, 2019: 0.688CAUTI, 2021: 0.000CAUTI, 2022: 0.260CAUTI, 2023: 1.052CAUTI, 2024: 0.000 SSI, colon 0.44 → 0.83 1 0 ’18’20’22’24 SSI, colon, 2017: 0.442SSI, colon, 2018: 0.591SSI, colon, 2019: 0.495SSI, colon, 2022: 0.641SSI, colon, 2023: 1.314SSI, colon, 2024: 0.826 SSI, hysterectomy 0.00 → 0.78 1 0 ’18’20’22’24 SSI, hysterectomy, 2017: 0.000SSI, hysterectomy, 2018: 0.776 MRSA 0.54 → 0.61 1 0 ’18’20’22’24 MRSA, 2017: 0.536MRSA, 2018: 0.462MRSA, 2019: 0.363MRSA, 2021: 0.367MRSA, 2022: 0.458MRSA, 2023: 1.099MRSA, 2024: 0.608 C. diff 1.02 → 0.46 1 0 ’18’20’22’24 C. diff, 2017: 1.024C. diff, 2018: 1.356C. diff, 2019: 0.377C. diff, 2021: 0.389C. diff, 2022: 0.349C. diff, 2023: 0.644C. diff, 2024: 0.459

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 yearCLABSICAUTISSI, colonSSI, hysterectomyMRSAC. diff
20170.9951.6530.4420.0000.5361.024
20181.2030.9780.5910.7760.4621.356
20190.6150.6880.4950.3630.377
20211.0960.0000.3670.389
20220.6780.2600.6410.4580.349
20231.5961.0521.3141.0990.644
20240.4770.0000.8260.6080.459

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 North Dakota, its score is higher than 100% of the other 5 scored there.

Figure 8. Its score is above the middle in all 7 groups it belongs to; the share cut runs from 17% (North Dakota) to 26% (Nonprofit).
All hospitals: CMS cut 718 of 2,886 (25%); middle score −0.0453All hospitals 2,886 hospitals25% cut Midwest region: CMS cut 174 of 683 (25%); middle score −0.0268Midwest region 683 hospitals25% cut North Dakota: CMS cut 1 of 6 (17%); middle score −0.2361North Dakota 6 hospitals17% cut Minor teaching: CMS cut 181 of 873 (21%); middle score −0.0567Minor teaching 873 hospitals21% 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: 0.8100 This hospital 0.8100 All hospitals: CMS cut 718 of 2,886 (25%); middle score −0.0453All hospitals2,886 hospitals25% cut Midwest region: CMS cut 174 of 683 (25%); middle score −0.0268Midwest region683 hospitals25% cut North Dakota: CMS cut 1 of 6 (17%); middle score −0.2361North Dakota6 hospitals17% cut Minor teaching: CMS cut 181 of 873 (21%); middle score −0.0567Minor teaching873 hospitals21% 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: 0.8100 This hospital 0.8100

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%−0.045390%
Midwest region68317425%−0.026890%
North Dakota6117%−0.2361100%
Minor teaching87318121%−0.056794%
100 to 299 beds1,19327523%−0.073292%
Nonprofit1,83047826%−0.013490%
Urban2,24151023%−0.057492%
This hospital0.8100
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 9. CMS cut 1 of the 8 nearest hospitals; the closest is less than a mile away.
25 mi50 mi100 mi8. Altru Hospital, Grand Forks: score −0.0753, not cut, 190 miles87. Sanford Medical Center Fargo, Fargo: score −0.3139, not cut, 189 miles76. Essentia Health, Fargo: score −0.5119, not cut, 187 miles65. Avera St Mary's Hospital, Pierre: score 1.6685, cut, 170 miles54. Sanford Medical Center Aberdeen, Aberdeen: score −0.8636, not cut, 145 miles43. Avera St Lukes, Aberdeen: score −0.3820, not cut, 144 miles32. Trinity Hospitals, Minot: score −0.3037, not cut, 101 miles21. Sanford Medical Center Bismarck, Bismarck: score −0.1685, not cut, less than a mile1This hospital: CHI St Alexius Health

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

Show table
HospitalMilesScoreDecision
Sanford Medical Center Bismarck, Bismarck, NDunder 1−0.1685not cut
Trinity Hospitals, Minot, ND101−0.3037not cut
Avera St Lukes, Aberdeen, SD144−0.3820not cut
Sanford Medical Center Aberdeen, Aberdeen, SD145−0.8636not cut
Avera St Mary's Hospital, Pierre, SD1701.6685cut
Essentia Health, Fargo, ND187−0.5119not cut
Sanford Medical Center Fargo, Fargo, ND189−0.3139not cut
Altru Hospital, Grand Forks, ND190−0.0753not cut

#HospitalMilesScoreDecisionEst. cut ($, modeled)Measures
1Sanford Medical Center BismarckBismarck, NDunder 1−0.1685No cut$0Above the national median on 3 of 6 measures
2Trinity HospitalsMinot, ND101−0.3037No cut$0Above the national median on 3 of 6 measures
3Avera St LukesAberdeen, SD144−0.3820No cut$0Above the national median on 2 of 5 measures
4Sanford Medical Center AberdeenAberdeen, SD145−0.8636No cut$0Above the national median on 0 of 2 measures
5Avera St Mary's HospitalPierre, SD1701.66851% cut$85KAbove the national median on 3 of 3 measures
6Essentia HealthFargo, ND187−0.5119No cut$0Above the national median on 1 of 6 measures
7Sanford Medical Center FargoFargo, ND189−0.3139No cut$0Above the national median on 2 of 6 measures
8Altru HospitalGrand Forks, ND190−0.0753No cut$0Above the national median on 3 of 6 measures

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

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. CHI St Alexius Health, Bismarck, ND: Hospital-Acquired Conditions, FY2026. https://paidandpenalized.org/hacrp/hospital/350002/. Source: CMS Provider Data Catalog, HACRP FY2026 (yq43-i98g), released August 13, 2026.