Healthcare-associated infections (HAI) are a persistent threat to patient safety. This report analyzes data from the Healthcare Cost and Utilization Project to compare local data from 38 states. A distinct set of large hospitals consistently had higher rates of HAIs compared with similar hospitals in 2019 and 2021. Of the HAIs reviewed, non-COVID associated rates of ventilator-associated pneumonia not present on admission increased by over 80%, surpassing rates of other infections.