Data · Hospital patient safety
Hospital patient-safety ratings by state and county
Where Medicare's Care Compare rates hospitals worse than the national benchmark on patient safety and on hospital-acquired infections, state by state and county by county. The figures are CMS's own ratings, and no hospital is named.
What is in this dataset?
How Medicare's Care Compare rates hospitals on patient safety, for each state, DC and territory and for each county with at least three hospitals: how many hospitals are rated worse, the same or better than the national benchmark on the PSI 90 patient-safety and adverse-events composite (claims July 2022 to June 2024), and on the six healthcare-associated infection ratios (October 2024 to September 2025), with each state's own infection ratios and confidence limits as CMS prints them. Counties with fewer than three hospitals are combined. Hospital names are not kept. A figure CMS does not print is left out.
Use it to see where hospitals rate worse than the national benchmark on patient safety and infections, as context for hospital-injury and healthcare-quality work and for marketing in a state or county. Agents can look up a state, compare several, or search by county or measure.
- Records
- 473
- Look up by
- 56
- state
- Primary-source records
- 473
The letters are explained in what P, S, D and U mean.
Where does the data come from?
The Provider Data Catalog of the Centers for Medicare & Medicaid Services publishes four Care Compare files (hospital and state files for complications and deaths, and for healthcare-associated infections). The state files are read as printed. From the hospital files only counts are kept: hospitals per county and how many CMS rates worse, the same or better than the national benchmark on PSI 90 and on the six infection ratios; names, addresses and phone numbers are dropped. A gate re-downloads the four files and compares every figure.
- Period covered
- July 1, 2022 to September 30, 2025
- Places
- States and counties
- How often we refresh it
- Every quarter
- Records read
- October 30, 2026
Official sources
- Centers for Medicare & Medicaid Services, by bulk download. A work of the U.S. government (17 U.S.C. 105), published as open files in the CMS Provider Data Catalog, which states no license; no login or access restriction.
The sources the records cite most
What does a record look like?
-
Texas: 406 hospitals in Care Compare; on the PSI 90 patient-safety composite CMS rates 6 hospitals worse and 7 better than the national benchmark (243 no different); statewide infection ratios against the national benchmark of 1.0: central line 0.484, urinary catheter 0.353, MRSA 0.602, C. difficile 0.238.
Status P · checked October 30, 2026 · source: CMS Care Compare, Complications and Deaths and Healthcare Associated Infections (Provider Data Catalog)
-
California: 337 hospitals in Care Compare; on the PSI 90 patient-safety composite CMS rates 8 hospitals worse and 7 better than the national benchmark (267 no different); statewide infection ratios against the national benchmark of 1.0: central line 0.595, urinary catheter 0.537, MRSA 0.696, C. difficile 0.369.
Status P · checked October 30, 2026 · source: CMS Care Compare, Complications and Deaths and Healthcare Associated Infections (Provider Data Catalog)
-
New York: 163 hospitals in Care Compare; on the PSI 90 patient-safety composite CMS rates 20 hospitals worse and 4 better than the national benchmark (110 no different); statewide infection ratios against the national benchmark of 1.0: central line 0.547, urinary catheter 0.441, MRSA 0.679, C. difficile 0.328.
Status P · checked October 30, 2026 · source: CMS Care Compare, Complications and Deaths and Healthcare Associated Infections (Provider Data Catalog)
The full records add the dates, the quoted source text and every field in the CSV and JSON files below.
What each of the 28 main columns means
jurisdiction- Two-letter state or territory code
level- state, county or small-counties
county- Five-digit county FIPS code
countyName- County name
status- P: CMS's own published figure
value- Hospitals in Care Compare (the same as hospitals)
hospitals- Hospitals in the CMS Care Compare hospital file
counties- On small-counties records: the number of counties combined
psi90_rated- Hospitals with a PSI 90 rating against the national benchmark
psi90_worse- Hospitals rated worse than the national benchmark on PSI 90
psi90_same- Hospitals rated no different on PSI 90
psi90_better- Hospitals rated better on PSI 90
cms_psi90_worse- State records: CMS's own state count of hospitals worse on PSI 90
cms_psi90_same- State records: CMS's state count no different
cms_psi90_better- State records: CMS's state count better
cms_psi90_too_few- State records: CMS's state count with too few cases
hai_rated- Hospital infection ratings (six measures) against the national benchmark
hai_worse- Hospital infection ratings worse than the benchmark
hai_same- Hospital infection ratings no different
hai_better- Hospital infection ratings better
hai1_sir- State standardized infection ratio, central line bloodstream infections (1.0 is the national benchmark)
hai2_sir- State ratio, catheter-associated urinary tract infections
hai3_sir- State ratio, colon surgery site infections
hai4_sir- State ratio, abdominal hysterectomy site infections
hai5_sir- State ratio, MRSA bloodstream infections
hai6_sir- State ratio, C. difficile infections
hai1_lower- Lower 95% confidence limit of the ratio (hai2 to hai6 likewise)
hai1_upper- Upper 95% confidence limit of the ratio (hai2 to hai6 likewise)
How do I use it in my own tools?
hospitalsafety_lookup- For one two-letter state or territory code: CMS's PSI 90 counts, the state's infection ratios, hospital counts rated worse or better, and every county with three or more hospitals.
hospitalsafety_compare- The records of up to 10 states or territories side by side: PSI 90 counts, infection ratios and hospitals rated worse or better, with their counties.
hospitalsafety_search- Records whose text matches the words given, such as a county name ("Harris County") or a state.
How to cite this dataset
You can reuse, adapt and republish this data, including commercially, under the Creative Commons Attribution 4.0 license (CC BY 4.0). The only condition is that you credit Probative and link to the source.
- Version
- 1.0.0, released October 30, 2026
- Every version
- 10.5281/zenodo.23792820 (always points to the newest)
- License
- CC BY 4.0
Download the data
- CSV: hospital-safety.csv 289 KB · one row per record (columns in README.txt)
- JSON: hospital-safety.json 684 KB · every record with its sources
Free, no email or login. The files are hosted on this site and Zenodo, a public research archive.
Suggested citation
Probative. (2026). Hospital patient-safety ratings by state and county: PSI 90 and healthcare-associated infections (CMS Care Compare) (Version 1.0.0) [Data set]. Zenodo. https://doi.org/10.5281/zenodo.23792821
Credit line for a chart, table or article
Source: Probative, Hospital patient-safety ratings by state and county: PSI 90 and healthcare-associated infections (CMS Care Compare), version 1.0.0, https://doi.org/10.5281/zenodo.23792821, licensed CC BY 4.0.
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Not legal advice. These are CMS ratings of hospitals against a national benchmark, computed from claims and infection reports. They are not findings about the care any patient received, and a rating of worse than the benchmark does not mean an error occurred. Claims and deadlines for a hospital injury are for your own counsel.
What changed recently?
- 2026-10-30 · CMS Care Compare patient-safety composite (PSI 90) and healthcare-associated infection ratios for 4,790 hospitals in 56 states and territories, by state and county. (source)
The full log is in changes.json.
What are the limits?
- These are CMS ratings against a national benchmark. They are not findings about the care any patient received, and a hospital rated worse than the benchmark has not necessarily made an error.
- PSI 90 is a composite of claims-based patient-safety indicators for Medicare patients over two years; the infection ratios compare the infections a hospital reported with the number expected. The two measures cover different periods.
- Many hospitals have too few cases to be rated, so the hospitals rated are fewer than the hospitals listed.
- Counties with fewer than three hospitals are combined, so a single hospital's rating is not shown on its own.
- A figure that CMS does not print is left out of a record, so a state can carry fewer measures than another.
- Counts of hospitals are not rates: a county with more hospitals has more that can be rated worse.
- Records older than 130 days since their last check are marked
stalein the files until we re-check them. Every confirmed error we fix is listed in the data corrections log.
Found a wrong value? Report an error with the record id and the source that shows the right value.
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