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What are Hospital-Acquired Conditions?

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Medical malpractice can take a number of forms including carelessness, negligence, and hospital-acquired conditions.

You might now be wondering what hospital-acquired conditions (HACs) are. This term refers to when patients in a hospital contract a medical condition due to time spent in a hospital. Like other types of medical malpractice, hospital-acquired conditions often result in victims facing numerous complications including lost wages and medical bills.

To make matters worse, hospital-acquired conditions strike at an unfortunate time. Patients go to hospitals hoping to recover from an illness, but hospital-acquired conditions can leave a person worse than when they entered the medical facility.

Recognized Hospital-Acquired Conditions

There are a limited number of hospital-acquired conditions. In 2005, Congress passed the Deficit Reduction Act, whose Section 5001 required the Secretary of Health and Human Services to list hospital-acquired conditions. 

The Deficit Reduction Act also required hospitals to report secondary diagnoses that are present on admission. Furthermore, the Centers for Medicare and Medicaid Services were required to select at least two-hospital-acquired conditions that are high-cost and/or high-volume, resulting in the assignment of a case to a Diagnostic Related Group (DRG) that has a higher payment when present as a secondary diagnosis, and could reasonably be prevented through adherence to evidence-based guidelines.

In 2008, the Centers for Medicare and Medicaid Services created a list of 10 conditions that conform with this description. In 2013, this list of 10 conditions was expanded to 14. 

The Centers for Medicare and Medicaid Services created a list of hospital-acquired conditions to penalize medical facilities that have an inordinate number of conditions. Hospital-acquired conditions make up just one of many Medicare Diagnosis-Related (MS-DRG) used for the purposes of Medicare reimbursement.

In July 2008, the Centers for Medicare & Medicaid Services selected for the fiscal year 2009 final, 10 categories of conditions for an HAC payment provision.

For discharges that occurred on or after October 1, 2008, hospitals no longer receive payment for cases in which selected conditions were not present at the time of a patient’s admission. As a result, reimbursement no longer occurs as if the secondary diagnosis were not present.

The 14 Hospital-Acquired Conditions

The 14 hospital-acquired conditions on the Centers for Medicare and Medicaid Services’ expanded list in 2014 include the following:

  • Air embolisms
  • Blood incompatibility
  • Catheter-associated urinary tract infections
  • Deep vein thrombosis/pulmonary embolism following certain procedures
  • Falls and traumas
  • Foreign objects retained after surgery
  • Iatrogenic pneumothorax with venous catheterization
  • Manifestations of poor glycemic control
  • Stage III and IV pressure ulcers
  • Surgical site infection following bariatric surgery
  • Surgical site infection following cardiac implantable electronic device
  • Surgical site infection following certain orthopedic procedures
  • Vascular catheter-associated infections

Contact a Compassionate Medical Malpractice Attorney

If you or a loved one faces a hospital-acquired condition, you should not hesitate to speak with a medical malpractice attorney. At Ferrara Law, we understand just how devastating the effects of medical malpractice can be. As a result, we remain committed to fighting tirelessly for the results that victims deserve.

The Ferrara Law Firm
Mr. Ferrara is the owner of The Ferrara Law Firm L.L.C. and is admitted to practice before the U.S. Supreme Court, the New Jersey Supreme Court, the Pennsylvania Supreme Court and the Federal Courts.
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