Moghadamyeghaneh Z, et al. - Because Medicare/Medicaid Services use never events (NE) and hospital-acquired conditions (HACs) to define hospital performance measures that dictate payments/penalties, researchers investigated the influence of pre-operative patient comorbidity on HAC development. They assessed 8,118,615 patients from the NIS database (2002–2012) who underwent upper/lower gastrointestinal and/or hepatopancreatobiliary procedures, and identified the highest HAC incidence among patients with severe comorbid conditions. Although increased HACs were evident in correlation with small, non-teaching, and for-profit hospitals, the strongest HAC risks included non-modifiable patient factors (preoperative loss function, diabetes, paraplegia, advanced age, etc). As hospitals caring for these complex patients would be unduly penalized, they do not support using HAC as hospital performance measures. Hence, researchers recommend CMS considering patient comorbidity as a crucial factor influencing HAC development.