Hospital inspections from accrediting organizations could become public

Tucked away in the proposed inpatient payment rule for 2018 from CMS is a provision that would radically change what information from hospital inspections is made available to the public.

Located more than 1,400 pages into the regulation, the provision means CMS would require the private health care accreditors it approves, such as the Joint Commission, to publicly release survey reports of hospitals, detailing problems they find during what have been confidential inspections, as well as the corrective actions taken afterwards.

The major change is necessary, according to CMS, because of what those private organizations have missed, with disparities as high a 39 percent between accrediting organization (AO) and state regulator inspections of hospitals.

“Therefore, we believe that posting AO survey reports and acceptable [plans of correction] would address some of the concerns of reporting hospital information from both CMS and AOs, as well as the disparity between serious deficiency findings, and provide a more comprehensive picture to health care consumers and the public in general,” CMS said in the regulation.

Under the proposed regulation, any organization applying or re-applying for CMS approval of its Medicare provider or supplier accreditation program has to make its reports publicly available on their websites within 90 days of when the facilities received the information.

The agency makes available its own survey reports and corrective plans, like Form-2567 survey reports based on complaint investigations for short-term acute care hospitals and critical access hospitals (CAHs). News organizations like the Association for Health Care Journalists have turned that information into searchable databases.

However, that data offers only a “subset" of complaint activity. The regulation also notes that 89 percent of hospitals and psychiatric hospitals participate in Medicare based on their accreditation status, meaning most surveys of healthcare facilities can’t be viewed by consumers when they’re making a selection on where to receive care.

“Expanding these requirements through the posting of all survey reports and acceptable [plans of correction] would allow for a more comprehensive way to show a provider’s or supplier’s compliance with all health and safety requirements,” the regulation said.

The same would be asked of AOs covering advanced diagnostic imaging, as suppliers of those services are not evaluated on technical components by state agencies. 

The American Hospital Association didn't argue with the goal of additional transparency surrounding hospital inspections, but told HealthExec these survey reports may be too "long and detailed" to be understood by people without "deep expertise in healthcare."

"A more useful approach might be to provide an accurate summary that would tell people in a page or two what the key takeaways are from the survey and why they are important," said Nancy Foster, AHA's vice president of safety and quality. "This summary could also draw from the plan of correction the hospital creates and summarize how the hospital plans to address the findings."