Medicare is cutting payments to 800 hospitals around the country for having relatively high rates of infections and injuries among their patients, according to an analysis by Kaiser Health News. That’s the highest number of penalties in the five years that the federal government has handed them out.

Penalized hospitals will see a one-percent cut to payments for Medicare patients discharged between October 2018 and September 2019. The penalties are the result of an annual assessment set up by the 2014 Hospital-Acquired Condition Reduction Program, which was created under the Affordable Care Act. The program ranks all hospitals based on their rates of specific infections and in-hospital injuries. From there, Medicare penalizes the bottom quarter or subsection—the threshold varies from year to year based on the data. So far, 800 is the highest number penalized, seconded by 769 two years ago.

The infection rates that the program looks at are those linked to urinary tract catheters, colon surgeries, hysterectomies, plus blood infections from central lines. The program also tallies infections from the dreaded Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile, which causes intractable and sometimes life-threatening diarrhea. The injuries assessed include bedsores, in-hospital falls that cause hip fractures, wounds that burst open after surgery, blood clots, and kidney injuries after surgery.

The hospital industry has balked at the penalties, arguing that the cut-off for being in the penalized subsection is arbitrary and the rates are calculated unfairly, favoring smaller hospitals that are less rigorous in testing for infections. Proponents are dismissive of the concerns, arguing that pitting hospitals against each other can boost overall quality of care. Additionally, there are clear strategies for hospitals to avoid injuries and infections. “There’s a lot of really strong, good best practices to getting to zero on these infections,” Missy Danforth told KHN. She’s the vice president of health care ratings at the Leapfrog Group, a nonprofit devoted to patient safety.

As part of their analysis, KHN created a tool to look up how individual hospitals across the country fared in the latest Medicare penalties over safety. KHN also included additional cuts that hospitals face for having high rates of patients being re-admitted to the hospital. You can find the tool here.

Leapfrog also offers an online tool to look up and compare how hospitals fare on a range of safety measures and best practices. You can find that here.