The Joint Commission on Accreditation of Healthcare Organizations has hired an Ohio hospital executive to fill its top post in the division of accreditation services, the commission's largest operating unit.
The executive-level position had been vacant for seven months during a critical transition to a new survey process based on performance-focused standards. The internal re-engineering and higher workload involved in that transition has created a backlog of surveys and a slowdown in survey revenues that the JCAHO is trying to get under control.
In a summary of the commission's May board meeting, a synopsis of financial affairs documented a deficit in revenues for the first two months of 1994, compared with budget projections. "The current budget shortfall, primarily related to survey fees, is expected to worsen in the near term but be eradicated before the end of the year," the report said.
The size of the budget shortfall wasn't disclosed.
Karen Timmons, JCAHO's chief operating officer, said that "at the beginning of the year we did have a small backlog" in accreditation surveys, which she said was caused by a revamped application form that launched the new approach to accreditation.
The application processing required a "strong learning curve" at the JCAHO's Oakbrook Terrace, Ill., headquarters, which turned out to be more difficult than anticipated, Ms. Timmons said. Since the applications had to be processed before surveys could be scheduled, the scheduling got behind, she said.
Amid the changeover in January, the vice president for accreditation services, Kenneth Hermann, resigned.
On Sept. 6, that post will be filled by Charles H. Bair, 52, president and chief executive officer of Upper Valley Medical Center in Miami County, Ohio.
As the survey backlog built up, the JCAHO was hiring additional surveyors and training its survey force to conduct the refocused surveys, Ms. Timmons said.
The commission began sending out employees from its home office to conduct follow-up visits at previously surveyed organizations requiring corrective action, she said. That freed its existing survey force for the main business of conducting the mounting schedule of surveys, but it brought in people whose main duties did not involve field work.
Ms. Timmons said the headquarters-based employees are physicians, nurses and other healthcare professionals who were surveyors at one time and are teaching the new standards and survey methods to the surveyors. She said it wasn't the first time they'd been called on to supplement the survey force.
As for the survey backlog, she predicted the commission would end up doing more surveys than last year among all the types of organizations the JCAHO accredits. She said some of the survey load this year is due to an increase in requests by nonhospital organizations such as home-care agencies and ambulatory facilities.
The commission also has yet to fill directorship positions for two of those nonhospital areas-ambulatory care and the new expansion into healthcare networks-but Ms. Timmons said decisions on final candidates were deliberately held back until Mr. Bair takes over the accreditation division.
He will oversee the commission's seven accreditation programs and also guide accreditation decision processing, scheduling and field operations.
As Upper Valley's president and CEO, he oversaw an organization of two acute-care hospitals, four long-term-care facilities, a psychiatric specialty hospital, three community health centers, a physician-hospital organization, a home-care organization, a dialysis center, retirement community and insurance company.