Hospital audit

HAC Penalty Risk Auditor

HAC Penalty Risk Auditor

FY2026 · structural fragility of Total HAC Scores

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Hospital audit

ASANTE THREE RIVERS MEDICAL CENTER

OR · Facility ID 380002 · FY2026

Total HAC Score

-0.0837

Percentile

47.3th

Displayed status

No reduction

From CMS Payment Reduction column (file).

Score vs threshold (0.3792)

Score distributionThreshold 0.3792Hospital -0.0837

Hospital score -0.0837. 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 -1.248
  • CLABSIz -0.796
  • CAUTIz 2.386
  • SSIz -0.345
  • CDIz -0.564
  • MRSAz 0.064

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-1.2481-0.12300.54280.6658
CAUTI2.3863-0.7012-0.08380.6175
MRSA0.0642-0.33730.27640.6137
CDI-0.5638-0.23350.37570.6092
CLABSI-0.7964-0.18540.42240.6078
SSI-0.3447-0.26910.33560.6047

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 OR (32 scored): 32.8th

Score distributionThreshold 0.3792Hospital -0.0837

Hospital score -0.0837. Penalty threshold 0.3792. Distribution of 32 scored hospitals.

Percentile among hospitals with 6 reported measures (1940 scored): 44.5th

Score distributionThreshold 0.3792Hospital -0.0837

Hospital score -0.0837. Penalty threshold 0.3792. Distribution of 1940 scored hospitals.

Plain-language verdict

As scored, the CMS file lists no payment reduction (Total HAC Score -0.0837; 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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