After a successful effort to expand its accreditation of Medicare HMOs in March, the Joint Commission on Accreditation of Healthcare Organizations last week announced that the Centers for Medicare and Medicaid Services has granted it deeming authority for critical-access hospitals, effective Nov. 21.
The CMS designation means the JCAHO's standards for critical-access hospitals meet or exceed those established by the Medicare program, and that critical-access hospitals accredited by the JCAHO will be considered to have met Medicare certification requirements to receive cost-based reimbursements.
More than 650 rural U.S. hospitals are certified as critical-access facilities, which provide essential services in medically underserved communities. To qualify as a critical-access facility, the hospital must have an average daily patient census below 25.
"These hospitals play a vital role in meeting the healthcare needs of America's citizens," JCAHO President Dennis O'Leary, M.D., said in a written statement. He said the JCAHO is "very pleased to receive this recognition of its accreditation process for critical-access hospitals."
The Oakbrook Terrace, Ill.-based JCAHO becomes the second organization to be recognized by the CMS as a voluntary deeming authority for the rural facilities. In September 2001, the CMS granted deeming authority to the American Osteopathic Association's Healthcare Facilities Accreditation Program for the hospitals. The JCAHO has accredited 36 critical-access hospitals since November 2001, when it began surveying the special category of rural facilities, a spokesman said.
Alan Morgan, vice president of government affairs and policy at the National Rural Health Association, said the Washington-based advocacy group doesn't have a formal position on the JCAHO's authorization by the CMS.
"Certainly with the JCAHO as an option, it will be helpful," Morgan said. "It's an issue that the NRHA will closely monitor as it evolves. The key question from a quality standpoint is what is needed and what is appropriate."
Morgan said rural hospitals largely have been exempted from national discussions on quality led by the Institute of Medicine and the Leapfrog Group, a coalition of Fortune 500 employers pushing providers to adopt certain safety standards.
"Rural hospitals have different needs," Morgan said. "An intensivist in the ER for rural sites is impractical. Even having an M.D. on call all the time in the ER-at some rural sites it's an issue."