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The HAC reduction program examines hospitals' performance on safety indicators and hospital‐acquired infections. Safety indicators are based on physician, advanced practice registered nurse, and physician assistant documentation. The coded data are then analyzed as part of the Agency for Healthcare Research and Quality Patient Safety Indicators (PSI‐90). For hospital‐acquired infections, hospitals are required to submit their data on central line‐associated bloodstream infections, CAUTI, surgical site infections for colon and hysterectomy surgeries; methicillin‐resistant Staphylococcus aureus bacteremia, and Clostridium difficile infections to the Center for Disease Control and Prevention National Healthcare Safety Network (NHSN) databases. Each hospital's performance is compared to the mean. Poor performing hospitals receive a 1 % penalty (Centers for Medicare and Medicaid, 2018).

CMS publicly reports each hospital's performance on these measures. In addition, many states require health care organizations to report specific adverse events and safety, quality, and staffing indicators. These indicators are available to the public at state websites.