Methodist Hospital in Indianapolis faces $47,500 in fines for violations of state and federal regulations found during the state's annual inspection last month.
It is only the second time the Indiana State Department of Health has fined a hospital, and Methodist is the first hospital to get fined following its annual state review.
The 69-page Methodist inspection report released last week lists numerous violations in policies and procedures, ranging from shortcomings in medical record-keeping to dirty floors.
The report did not evaluate the quality of patient care at the hospital, one of the nation's largest.
"We obviously feel our findings are serious and significant enough that they require actions such as this," said D. Peter Maniago, deputy assistant commissioner at the health department.
Several of the problems were noted in past inspections but were not corrected, he said.
Methodist and other hospitals have been cutting costs and staff under pressure from insurers and employers, prompting critics to warn that the quality of care could be affected.
William J. Loveday, Methodist's chairman and chief executive officer, defended the hospital's quality of patient care. But he said the hospital is "taking the state board of health's report very seriously."
"We're going to drill down on it, and we're going to be in compliance in every way possible," Loveday said.
The fine may reflect a tougher attitude at the health department, which in the past has sought to avoid sanctioning healthcare institutions.