This study aims to identify the level of capability of the information and technology governance process at a hospital. The identification of IT governance carried out in this study uses the COBIT 2019 framework in mapping the processes to be assessed. There were five domains tested in this study: Evaluate, Direct & Monitor (EDM); Align, Plan, and Organize (APO); Build, Acquire & Implement (BAI); Deliver, Service & Support (DSS); and Monitor, Evaluate & Assess (MEA) with 40 IT governance process objectives. Data were obtained through unstructured interviews, which were conducted to obtain information related to the 2019 COBIT IT governance design factors at the hospital. Data were analyzed through two stages: identification of IT Governance design factors and process capability level identification. The identification process is carried out by mapping the data related to organizations with IT governance design factors based on the COBIT 2019 toolkit. The result found that there are two highest score processes found in design factor analysis, namely APO08 (managed relationship) and BAI08 (managed knowledge). The results of identifying the capability level of the three processes are at level 4. It means that the activities carried out in implementing Hospital Management Information Systems in terms of APO08 and BAI08 at the hospital have achieved their objectives and are well-defined. However, EDM3 (Ensured Risk Optimization) and APO06 (Managed Budget and Cost) at the hospital still need improvement. The findings contribute to literature related to Management Information Systems and Accounting Information Systems.