RHIT Domain 4 – Revenue Cycle Management Practice Test

The identification of stage III or IV pressure ulcers as a hospital-acquired condition under the inpatient prospective payment system is based on the criteria established by the Centers for Medicare & Medicaid Services (CMS). Hospital-acquired conditions (HACs) are significant complications or conditions that are not present upon a patient’s admission and arise during their hospital stay.

Stage III or IV pressure ulcers qualify as HACs because they are serious deteriorations of a patient’s condition that are considered preventable through proper care and monitoring. Their occurrence in the hospital suggests a failure in the patient care process, specifically in the areas of risk assessment, skin care, and mobility assistance. Hence, hospitals are financially penalized when these conditions develop, emphasizing the importance of maintaining high-quality care standards.

In contrast, while postoperative infections can also be serious, they do not automatically fall under the HAC definition, as they can be part of the expected complications of surgery. Pneumonia can occur for various reasons and is not solely indicative of hospital-acquired conditions unless specifically linked to factors that could be controlled within the hospital setting. Readmissions of patients, while significant, are typically a reflection of the overall quality of care rather than a specific condition and do not qualify as a specific HAC under the