CMS penalties: what enforcement actually looks like

The formula

Hospitals with 30 beds or fewer face a flat $300 per day for noncompliance. Larger hospitals face $10 per bed per day, capped at $5,500 per day. Sustained over a full year, that caps out around $2 million for the largest facilities.

The pace is accelerating

CMS issued 10 civil monetary penalties in 2025, roughly double the prior year's pace, with individual fines ranging from $32,000 to $871,000. Of the 3,764 hospitals CMS reviewed, 65 percent had already received a warning or a corrective action request.

The new incentive to settle

The CY2026 rule adds a 35 percent reduction in the civil monetary penalty for hospitals that waive their right to an ALJ hearing. That is a deliberate structural push toward faster settlements, and it means enforcement actions are likely to keep showing up in the news at a steady clip through 2026.

What this means practically

A single avoided penalty day, at the maximum $5,500 rate, is worth roughly 18 months of a Pro-tier monitoring subscription. The math favors catching a broken file before CMS does, not after.

See a specific hospital's exact daily exposure with the penalty calculator.