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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.

25 Hospitals with the Greatest Revenue Loss from 2018 HAC Penalties

 

Hospital Name

FY 2018 HAC Score

Est. Revenue Loss

Number of Discharges

1.

Yale New Haven Hospital (CT)

0.5

$2,877,816

66,291

2.

Mount Sinai Medical Center (NY)

0.39

$2,379,489

56,276

3.

NYU Langone Health Tisch Hospital (NY)

0.45

$2,240,566

56,006

4.

Stanford Hospital (CA)

0.57

$2,105,555

25,142

5.

Montefiore Hospital - Moses Campus (NY)

0.79

$1,899,583

86,865

6.

Methodist University Hospital (TN)

0.45

$1,857,325

63,220

7.

Norton Hospital (KY)

0.88

$1,824,781

72,972

8.

UCSF Helen Diller Medical Center at Parnassus Heights (CA)

0.42

$1,788,896

35,009

9.

MedStar Washington Hospital Center (DC)

0.81

$1,723,425

31,705

10.

Long Island Jewish Medical Center (NY)

0.51

$1,670,228

70,901

11.

UPMC Presbyterian (PA)

0.45

$1,628,905

52,889

12.

Hartford Hospital (CT)

0.61

$1,614,376

37,202

13.

Northwestern Memorial Hospital (IL)

0.51

$1,590,581

43,474

14.

Hackensack University Medical Center (NJ)

0.55

$1,583,843

36,668

15.

St Francis Hospital - The Heart Center (NY)

0.44

$1,543,217

17,066

16.

Lehigh Valley Hospital - Cedar Crest (PA)

0.57

$1,517,807

42,260

17.

Aurora St Lukes Medical Center (WI)

0.43

$1,504,874

42,083

18.

Stony Brook University Hospital (NY)

0.47

$1,497,693

30,709

19.

Robert Wood Johnson University Hospital - New Brunswick (NJ)

0.83

$1,461,538

33,164

20.

Carilion Roanoke Memorial Hospital (VA)

0.6

$1,435,679

37,291

21.

Baptist Memorial Hospital - Memphis (TN)

0.51

$1,372,177

34,151

22.

Baptist Medical Center Jacksonville (FL)

0.72

$1,345,131

48,645

23.

NYU Winthrop Hospital (NY)

0.55

$1,334,287

33,817

24.

University Hospital (VA)

0.49

$1,304,062

29,534

25.

Lee Memorial Hospital (FL)

0.53

$1,275,335

38,166

Fig 1. Data from Definitive Healthcare based on the CMS Quality Metrics Update, updated Oct 2018.