House committee probes CMS, Joint Commission over accreditation process

Republican members of the House Energy and Commerce Committee have launched an investigation into the hospital accreditation process following a Wall Street Journal report last year that found the Joint Commission accredited hospitals with major safety issues.

The committee sent letters to the CMS and four accreditation organizations including the Joint Commission requesting they provide detailed information about how they accredit hospitals and other facilities.

The committee wrote in the letters that it is "concerned about the adequacy of CMS' oversight" of accreditation organizations and the rigor of their survey processes. In addition to the WSJ article, the committee pointed to a 2015 congressional report that found accreditation organizations missed 39% of condition level deficiencies at hospitals that were subsequently reported by state survey agencies in validation surveys.

About 90% of U.S. hospitals—or 3,500—are accredited by private organizations. The WSJ investigation found that the Joint Commission, which accredits about 80% of U.S. hospitals, rarely pulls its accreditation. In 2014, the Joint Commission revoked accreditation for just 1% of facilities in 2014.

The committee has asked the organizations to provide copies of hospital applications for Medicare accreditation; copies of performance reviews, survey feedback, corrective action plans and responses to those plans; and any correspondence with the CMS.

In addition to the CMS and the Joint Commission, the letters were sent to the Bureau of Healthcare Facilities Accreditation, the Center for Improvement in Healthcare Quality and DNV GL Healthcare.

The Joint Commission plans to respond to the committee's request, said Kim McCullough, the commission's associate director of communications, in an email. The probe "is an opportunity to share more on the work we do to improve healthcare quality and patient safety by facilitating high reliability," she added.

In an interview with Modern Healthcare in December, Joint Commission CEO Dr. Mark Chassin said the organization views denial of accreditation as a "failure." The commission prefers to work with hospitals to help them improve on deficiencies.

The CMS, which is charged with overseeing the accreditation organizations and the state survey agencies, has been asked to provide copies of the most recent contracts with state survey agencies that detail responsibilities for the healthcare providers to comply with certification; any correspondence between state surveyor agencies and accreditation organizations; and copies of any complaints the CMS has received since fiscal 2012 that allege patient harm or misconduct in acute-care hospitals as well as actions the CMS took in response.

A CMS spokesman said in an email Tuesday afternoon that the agency will review and respond to the committee's requests.

The letters were sent by Reps. Greg Walden (R-Ore.), Gregg Harper (R-Miss.) and Michael Burgess (R-Texas). The organizations and the CMS have until March 23 to respond.

An edited version of this story can also be found in Modern Healthcare's March 19 print edition.