Hospital audit

HAC Penalty Risk Auditor

HAC Penalty Risk Auditor

FY2026 · structural fragility of Total HAC Scores

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Hospital audit

LEHIGH VALLEY HOSPITAL - POCONO

PA · Facility ID 390201 · FY2026

Total HAC Score

-0.7709

Percentile

10.2th

Displayed status

No reduction

From CMS Payment Reduction column (file).

Score vs threshold (0.3792)

Score distributionThreshold 0.3792Hospital -0.7709

Hospital score -0.7709. 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 -0.951
  • CLABSIz -1.407
  • CAUTIz -0.270
  • SSIz -1.206
  • CDIz -0.730
  • MRSAz -0.061

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-0.9508-0.8596-0.19390.6657
CAUTI-0.2700-0.9456-0.32810.6175
MRSA-0.0612-1.0035-0.38980.6137
CDI-0.7303-0.8929-0.28360.6092
CLABSI-1.4065-0.7709-0.16310.6078
SSI-1.2064-0.8125-0.20790.6047

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 PA (130 scored): 8.8th

Score distributionThreshold 0.3792Hospital -0.7709

Hospital score -0.7709. Penalty threshold 0.3792. Distribution of 130 scored hospitals.

Percentile among hospitals with 6 reported measures (1940 scored): 5.0th

Score distributionThreshold 0.3792Hospital -0.7709

Hospital score -0.7709. Penalty threshold 0.3792. Distribution of 1940 scored hospitals.

Plain-language verdict

As scored, the CMS file lists no payment reduction (Total HAC Score -0.7709; 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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