US politicians raise concerns about the quality of accreditation surveys for hospitals in the Medicare and Medicaid programmes
The House Energy and Commerce Committee is seeking information from Centers for Medicare and Medicaid Services (CMS) and four US hospital accreditation agencies, including The Joint Commission, asking for more information on how they conduct surveys and why there’s been a disconnect between their results and what state survey agencies find. The aim is to check that accreditation processes for hospitals in the Medicare and Medicaid programmes follow federal standards and so ensure patient safety.
Representatives sent letters to The Joint Commission, the Bureau of Healthcare Facilities Accreditation, the Centre for Improvement in Healthcare Quality and DNV GL Healthcare; “Although CMS has worked to strengthen its oversight of accrediting organizations, the committee is concerned about the adequacy of CMS oversight as well as the rigor of the survey process. For example, according to CMS’ most recent annual report to Congress in 2015, accreditors conducting hospital surveys did not report 39% of condition level deficiencies that were subsequently reported following validation surveys conducted by state survey agencies no later than 60 days following the survey.”
This follows a media report in The Wall Street Journal that claimed The Joint Commission rarely revokes its seal of approval when hospitals are not compliant with Medicare regulations. The article said that 350 Joint Commission hospitals violated Medicare requirements in 2014, and more than one third had additional violations in 2015 and 2016. More than 30 hospitals were able to keep their accreditation.
The committee is seeking information on contracts between the accreditors and CMS, complaints, correspondence about adverse events, and disparities between accreditor and state surveys, performance reviews and corrective actions. CMS oversees the private accreditors and the state survey agencies.
A total of 90% of US hospitals (3,500), are accredited by private organisations, with the Joint Commission accounting for 80%. In 2014 the Joint Commission revoked accreditation for just 1%.
Behind this investigation are concerns that accreditors do not follow up or enforce hospital failings and that there is a lack of transparency.
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