Many hospital patients will tell you they didn’t really feelsafe until they were discharged from care. And now Medicare is onthe case. As reports of in-hospital infections, sepsis andcomplications from treatment grow, Medicare is holding healthorganizations accountable for their performance in this area.

In its latest report on the largest hospital safety offenders,Medicare counted 758 hospitals on its list of miscreants.Medicare reduces its payments to these organizations, so it’s nosmall matter. And despite several years of this punitive treatmentof treatment centers, more hospitals were on this list this yearthan last, when 721 were punished.

The payment reduction doesn’t seem like much on the faceof it: 1 percent for those on this list. But it adds up. Overall,those being “fined” will lose $364 million.

Among those on the list are some prestigious players: theCleveland Clinic, the Mayo Clinic, Stanford Health Care and CancerTreatment Centers of America. And about half on this year’s listmade last year’s Nightmare Team.

Representatives of several of the penalized hospitals complainedto Kaiser Health News that the penalties don’t take into accountthe complexities of treatment programs, which vary fromhospital to hospital, nor efforts to improve. But others were more public relations savvy.

Typical was the statement from Dr. Brian Whited, vice chair ofoperations at Mayo. Two Mayo hospitals were on the list. He saidMayo Clinic supports the effort to clean up hospitals.

“As an organization, we’re not satisfied with these results andunderstand we have work to do to reduce hospital-acquiredconditions,” Whited said. “We support the objectives of theHospital-Acquired Condition Reduction Program, and all ourpractices have been developing improvement strategies and otherchanges to reduce those conditions.”