Hospital audit

HAC Penalty Risk Auditor

HAC Penalty Risk Auditor

FY2026 · structural fragility of Total HAC Scores

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Hospital audit

CHI HEALTH ST. ELIZABETH

NE · Facility ID 280020 · FY2026

Total HAC Score

-0.1314

Percentile

43.8th

Displayed status

No reduction

From CMS Payment Reduction column (file).

Score vs threshold (0.3792)

Score distributionThreshold 0.3792Hospital -0.1314

Hospital score -0.1314. Penalty threshold 0.3792. Distribution of 2929 scored hospitals.

Data completeness

Reported on 6 of 6. Missing measures show N/A with the CMS footnote; footnote 18 values are imputed worst-case, not measured performance.

  • PSI-90z -1.438
  • CLABSIz 0.809
  • CAUTIz 0.533
  • SSIz -0.848
  • CDIz 0.121
  • MRSAz 0.035

Fragility

Each reported measure moves the score by 0.1667 points.

Score swing if each reported measure were at its Z floor versus Z cap, holding other measures fixed
MeasureCurrent ZScore @ floorScore @ capAbs swing
PSI-90controls fate-1.4378-0.13900.52680.6657
CAUTI0.5327-0.43990.17760.6175
MRSA0.0349-0.38010.23370.6137
CDI0.1215-0.39530.21390.6092
CLABSI0.8089-0.50060.10720.6078
SSI-0.8484-0.23270.37200.6047

Swing is a mechanics illustration: replace one reported Z with that measure’s observed floor or cap while holding others fixed. Ranked by absolute swing.

Peer context

Percentile within NE (24 scored): 47.9th

Score distributionThreshold 0.3792Hospital -0.1314

Hospital score -0.1314. Penalty threshold 0.3792. Distribution of 24 scored hospitals.

Percentile among hospitals with 6 reported measures (1940 scored): 40.9th

Score distributionThreshold 0.3792Hospital -0.1314

Hospital score -0.1314. Penalty threshold 0.3792. Distribution of 1940 scored hospitals.

Plain-language verdict

As scored, the CMS file lists no payment reduction (Total HAC Score -0.1314; threshold 0.3792).

Reported on 6 of 6 measures; each reported measure moves the equal-weighted score by 0.1667 points.

Describes scoring mechanics only. Not medical or legal advice. Any “would / would not” language is an illustration against the published threshold, not a CMS prediction.

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