Accreditors such as The Joint Commission would have been required to post final survey reports online within 90 days of delivering them to hospitals. But it turns out federal law may prohibit such a requirement.
This article was originally published in Inside The Joint Commission, August 7, 2017.
By A.J. Plunkett
A proposal by CMS to have accrediting organizations (AO) post the details of survey reports online was withdrawn by the agency, not because of negative comments—although there were plenty—but because it might be prohibited under federal law.
CMS first made the proposal in April, tucking it into the latter pages of the long proposed changes to the Inpatient Prospective Payment System (IPPS) for the upcoming fiscal year.
The proposal was to have AOs post final survey reports online within 90 days that the same information is available to the hospital or other healthcare organization, including details of all initial and recertification surveys at that provider in the prior three years, as well as the accepted plans of correction (PoC).
AOs now post only whether an organization is accredited or not, and do not make details of findings public.
CMS argued its proposal was to promote transparency in healthcare, and noted that it posts its own survey reports online. But critics responded that the CMS reports are made available in a hard-to-read spreadsheet and that the federal agency was responsible for far fewer surveys at healthcare organizations that were often surveyed only after a complaint.
In public comments to CMS concerning the proposal, The Joint Commission said that requiring survey details be made public would have a “chilling effect” on efforts to raise standards of quality. Dr. Mark R. Chassin, Joint Commission president and CEO, wrote: “There will be a race to the bottom on quality as health care organizations seek out oversight bodies that will report on the least number of standards comparable to the Medicare requirements. This may also lead to a growth in non-accredited facilities that will then be surveyed at taxpayer expense and with fewer oversight visits.”
Other groups similarly weighed in against the proposal and offered alternatives. In the end, though, it was shot down because it might potentially be prohibited.
In the IPPS final rule published Aug. 2, CMS noted that its proposal included revising the federal regulations overseeing Medicare to incorporate the requirement for AOs to post report details publicly.
“Section 1865(b) of the Act prohibits CMS from disclosing survey reports or compelling the AOs to disclose their reports themselves. The suggestion by CMS to have the AOs post their survey reports may appear as if CMS was attempting to circumvent the provision of section 1865(b) of the Act. Therefore, this provision is effectively being withdrawn.”