The many rural hospitals that are designated "critical access" are not subject to the penalties. Neither are "specialized hospitals, such as those that treat psychiatric patients, veterans and children," Rau notes. "Of the remaining hospitals, the Affordable Care Act requires that Medicare penalize the 25 percent that perform the worst on these measures, even if they have reduced infection rates from previous years." The list of penalized hospitals is here; it's also available are a PDF or in a sortable Excel file.
The federal Agency for Healthcare Research and Quality "estimates there were 3.8 million hospital injuries last year, which translates to 115 injuries during every 1,000 patient hospital stays," Rau writes. "Each year, at least 2 million people become infected with bacteria that are resistant to antibiotics, including nearly a quarter million cases in hospitals. The Centers for Disease Control and Prevention estimates 23,000 people die from them. Infection experts fear that soon patients may face new strains of germs that are resistant to all existing antibiotics. Between 20 and 50 percent of all antibiotics prescribed in hospitals are either not needed or inappropriate, studies have found. Their proliferation — inside the hospital, in doctor’s prescriptions and in farm animals sold for food — have hastened new strains of bacteria that are resistant to many drugs."