Top 25 Hospitals by HAC Penalty

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.

25 Hospitals with the Greatest Revenue Loss from 2018 HAC Penalties

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25 Hospitals with the Greatest Revenue Loss from 2018 HAC Penalties