Health care acquired conditions, what happens in the SNF?

[mlbluvr]

PPACA doesn't allow extra payment to treat hospital caused problems, like stage 3 or 4 pressure ulcers. That's an awfully expensive situation. What happens when those patients (or those that have any other HACA, such as uncontrolled diabetes, surgical site infection, embolism, etc.) are sent to a SNF? The PPS MDS would normally capture some payment for treating such things, but if the hospital can't bill for them, it would seem logical that the payment block would be permament for the HACAs? Also, I'm wondering who and how exactly decides whether a condition is a HACA/provider preventable condition?

[mlbluvr]

As an MDS nurse, I'm trying to find out all the ways Obamacare will affect long term care. It's complicated, but I just also read that Medicaid has followed Medicare in not paying for HACA (provider preventable complications, in acute care hospitals) as of this July first. They also keep adding conditions, such as catheter induced UTI- so the question is, was it HACA, or wasn't it, and how will the treatment be paid for? Sounds like SNF admissions coordinators are going to face a lot of issues come January 1.