For fiscal year 2018, more than 740 hospitals were fined for reporting excess cases of hospital-acquired conditions (HACs), losing a total of $244.3 million in revenue. The top 25 hospitals that faced the largest penalties lost more than $42.3 million. In an effort to reduce the number of preventable illnesses and readmissions post-acute care, the Center for Medicare and Medicaid Services (CMS) launched the HAC Reduction Program as a means to incentivize hospitals to take stronger precautionary measures.
Development of HACs leads to increased healthcare spending, a higher risk of patient deaths and readmissions, longer length of stay, and other complications. CMS tracks 14 HACs across several categories, including surgical site infections, blood stream infections, and pressure ulcers. However, the HAC Reduction Program only takes 6 of these into account: Clostridium Difficile (C.Diff), Catheter-Associated Urinary Tract Infections (CAUTI), Central-Line-Associated Blood Stream Infections (CLABSI), Methicillin-resistant Staphylococcus aureus (MRSA), and Surgical Site Infections for colon surgeries and hysterectomies.
Of the hospitals facing the highest fines from the HAC Reduction Program, 7 of the top 25 are located in New York — more than any other single state. Connecticut, Florida, New Jersey, and Pennsylvania all had 2 hospitals on the list.
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| Hospital Name | FY 2018 HAC Score | Est. Revenue Loss | Number of Discharges | Explore This Dataset | |
| 1. | Yale New Haven Hospital (CT) | 0.5 | $2,877,816 | 66,291 | Explore This Profile |
| 2. | Mount Sinai Medical Center (NY) | 0.39 | $2,379,489 | 56,276 | Explore This Profile |
| 3. | NYU Langone Health Tisch Hospital (NY) | 0.45 | $2,240,566 | 56,006 | Explore This Profile |
| 4. | Stanford Hospital (CA) | 0.57 | $2,105,555 | 25,142 | Explore This Profile |
| 5. | Montefiore Hospital - Moses Campus (NY) | 0.79 | $1,899,583 | 86,865 | Explore This Profile |
| 6. | Methodist University Hospital (TN) | 0.45 | $1,857,325 | 63,220 | Explore This Profile |
| 7. | Norton Hospital (KY) | 0.88 | $1,824,781 | 72,972 | Explore This Profile |
| 8. | UCSF Helen Diller Medical Center at Parnassus Heights (CA) | 0.42 | $1,788,896 | 35,009 | Explore This Profile |
| 9. | MedStar Washington Hospital Center (DC) | 0.81 | $1,723,425 | 31,705 | Explore This Profile |
| 10. | Long Island Jewish Medical Center (NY) | 0.51 | $1,670,228 | 70,901 | Explore This Profile |
| 11. | UPMC Presbyterian (PA) | 0.45 | $1,628,905 | 52,889 | Explore This Profile |
| 12. | Hartford Hospital (CT) | 0.61 | $1,614,376 | 37,202 | Explore This Profile |
| 13. | Northwestern Memorial Hospital (IL) | 0.51 | $1,590,581 | 43,474 | Explore This Profile |
| 14. | Hackensack University Medical Center (NJ) | 0.55 | $1,583,843 | 36,668 | Explore This Profile |
| 15. | St Francis Hospital - The Heart Center (NY) | 0.44 | $1,543,217 | 17,066 | Explore This Profile |
| 16. | Lehigh Valley Hospital - Cedar Crest (PA) | 0.57 | $1,517,807 | 42,260 | Explore This Profile |
| 17. | Aurora St Lukes Medical Center (WI) | 0.43 | $1,504,874 | 42,083 | Explore This Profile |
| 18. | Stony Brook University Hospital (NY) | 0.47 | $1,497,693 | 30,709 | Explore This Profile |
| 19. | Robert Wood Johnson University Hospital - New Brunswick (NJ) | 0.83 | $1,461,538 | 33,164 | Explore This Profile |
| 20. | Carilion Roanoke Memorial Hospital (VA) | 0.6 | $1,435,679 | 37,291 | Explore This Profile |
| 21. | Baptist Memorial Hospital - Memphis (TN) | 0.51 | $1,372,177 | 34,151 | Explore This Profile |
| 22. | Baptist Medical Center Jacksonville (FL) | 0.72 | $1,345,131 | 48,645 | Explore This Profile |
| 23. | NYU Winthrop Hospital (NY) | 0.55 | $1,334,287 | 33,817 | Explore This Profile |
| 24. | University Hospital (VA) | 0.49 | $1,304,062 | 29,534 | Explore This Profile |
| 25. | Lee Memorial Hospital (FL) | 0.53 | $1,275,335 | 38,166 | Explore This Profile |
Fig 1. Data from Definitive Healthcare based on the CMS Quality Metrics Update, updated Oct 2018.