Which statement best describes hospital-acquired conditions (HAC) as defined by CMS?

Which statement best describes hospital-acquired conditions (HAC) as defined by CMS?

• A. They are conditions that must be present on admission
• B. They are conditions not present on admission that occur during hospitalization
• C. They are always related to surgical procedures
• D. They are conditions excluded from payment always

Answer: (B)

Hospital-acquired conditions are problems that arise after a patient is admitted and were not present when they arrived at the hospital. This is why the statement describing HAC as conditions not present on admission that occur during hospitalization is the best fit for CMS definitions. The distinction between what the patient already had on arrival and what develops during the stay is central to how CMS uses POA indicators to classify events for potential nonpayment under HAC rules. HAC can include a range of medical complications, not just surgical issues. And while CMS has nonpayment policies for HAC, saying they are always excluded from payment is too absolute—there are nuances and exceptions depending on the program and context.

Hospital-acquired conditions are problems that arise after a patient is admitted and were not present when they arrived at the hospital. This is why the statement describing HAC as conditions not present on admission that occur during hospitalization is the best fit for CMS definitions. The distinction between what the patient already had on arrival and what develops during the stay is central to how CMS uses POA indicators to classify events for potential nonpayment under HAC rules. HAC can include a range of medical complications, not just surgical issues. And while CMS has nonpayment policies for HAC, saying they are always excluded from payment is too absolute—there are nuances and exceptions depending on the program and context.