JCAHO Raises Threshold for Punishment for Violations
The Joint Commission on Accreditation of Healthcare Organizations is defending a decision last month to raise the number of allowable deficiencies a hospital can receive before being punished, as lawmakers and others say the change could decrease quality of care, the Los Angeles Times reports.
Under the old rules, large hospitals could be downgraded to conditional accreditation if inspectors found the hospitals had violated 10 standards and could lose accreditation if they violated 15. Small hospitals received conditional accreditation for 10 violations and loss of accreditation for 15.
Under the new rules, large hospitals can have 14 violations to receive conditional accreditation and 20 violations to lose accreditation. Small hospitals can have 11 violations for conditional accreditation and 16 to lose accreditation. In addition, punishment is not automatic and must be approved by an accreditation committee.
Critics, including several lawmakers, have said the change is a "step back," adding that JCAHO seems "more eager to please hospitals than protect patients," the Times reports.
Rep. Pete Stark (D-Calif.) said, "I don't know how far below zero they intend to go. They're not doing the job of making sure that hospitals are delivering quality, safe care."
Senate Finance Committee Chair Chuck Grassley (R-Iowa) said the changes were "puzzling," adding, "Government investigators already have documented that the Joint Commission misses too many serious problems and rarely drops any hospital's accreditation. This move to weaken standards seems to be going in the opposite direction of what makes sense for quality of care."
Joseph Cappiello, vice president of accreditation field operations for JCAHO, said inspections are better used as a "catalyst for improvement" than a punishment, adding, "We shouldn't deny accreditation to 10% or 15% or 20% of all the hospitals" in the U.S.
JCAHO President Dennis O'Leary said the changes were made because the commission believed too many well-run hospitals were being punished for violations this year (Ornstein/Weber, Los Angeles Times, 4/6).