The effort began with his March, 2010 letter to CMS Acting Administrator Charlene Frizzera, in which he proposed "An AHCJ-led initiative" that would "put online CMS 2567s" dating to 2005, starting with 340 hospitals with two or more violations of Medicare's conditions of participation.
But there was a delay. The administration was then focused on implementing the newly passed Patient Protection and Affordable Care Act. "It took time to get their attention and show them how this fit with the administration's promise and pledge of transparency." It took time to get attention from the right people, he said.
In March of 2011, after many e-mails and calls, Ornstein met with acting CMS administrator Don Berwick. Later he met with Berwick's successor, acting CMS administrator Marilyn Tavenner.
Top level CMS officials gave excuses why they couldn't move forward. One was that investigations of complaints about many hospitals are performed not by CMS or its designated state agencies, but by accreditation organizations such as The Joint Commission, whose resulting survey documents CMS does not have. Ornstein says he is working on getting those documents.
Another problem: the hospitals' plans of correction—required in each survey document—aren't yet in an electronic database.
The tipping point came in October, 2012, when Tavenner and CMS chief medical officer Patrick Conway, MD, "made it clear they had crossed the hurdle," Ornstein said. AHCJ would get the electronic database with reports dating to January, 2011, without the plans of corrections and of course, without any violation reports performed by accrediting organizations like TJC.
The journalism group used funds from the Ethics and Excellence in Journalism Foundation, and hired an application developer to build a user interface that allows users to search by state, city, or by keyword.