The nation's largest healthcare union has aimed its legal and public relations artillery at a new target: the Joint Commission on Accreditation of Healthcare Organizations.
In a letter to HHS' inspector general's office, Andrew Stern, president of the 1.1 million-member Service Employees International Union, said last week that the healthcare accrediting agency should forfeit its "deemed" status with the Medicare program and many state Medicaid programs.
That status allows accredited hospitals and other healthcare facilities to automatically qualify for Medicare and many Medicaid programs.
Stern's criticisms were endorsed in a statement by Rep. Fortney "Pete" Stark (D-Calif.), who said he plans to introduce legislation to make the JCAHO more accountable to consumers and give them more control over the organization's operations.
In a simultaneous letter to JCAHO President Dennis O'Leary, M.D., Stern listed a series of reforms he said would make the JCAHO more responsive to consumers and remove potential conflicts of interest.
O'Leary bristled when informed of the SEIU's broadside, but conceded that some of the unions's points were well-taken and should be pursued. Others, he said, were not well-informed.
The SEIU's crusade against the JCAHO was prompted by what it called a suspect accreditation survey at Columbia Sunrise Hospital and Medical Center in Las Vegas, a hospital the SEIU is trying to unionize (Nov. 4, 1996, p. 14).
Last week, the SEIU recommended:
The JCAHO disclose all payments it receives from accredited healthcare facilities.
The agency scrutinize all provider advertising claims about JCAHO data and impose sanctions on those providers that misuse accreditation information.
Employee interviews conducted as part of the accreditation process be done without the presence of supervisors and under the assurance of confidentiality.
Accredited healthcare facilities maintain a file for public inspection of "all internal communications detailing actions employees have been asked to take to prepare" for an accreditation survey.
"If you want to know how much an organization paid us, why don't you ask them?" O'Leary responded. "We don't have a policy on whether it's confidential or not. Maybe we should write a policy and codify that. We will raise it with our board."
He dismissed the "broader inference" that organizations can buy their accreditation.
On advertising, O'Leary said the JCAHO has strict guidelines on how accreditation data may be reported and reacts promptly to any misrepresentations.
With reference to the agency's deemed status for Medicare and Medicaid, O'Leary said the SEIU had made no allegations about the quality of its evaluations, "which is what the whole deemed status relationship is based on."