Hospitals May Get Accredited Even With Poor, Unsafe Care

10/4/2017, noon | Updated on 10/4/2017, noon
Increasingly, it’s becoming clear there are few places patients and their families can turn for help in avoiding bad care ...
Trudy Lieberman

By Trudy Lieberman, Rural Health News Service

Earlier this year an Illinois woman sent an email telling me of the poor care her husband received at a large Chicago hospital. After six weeks of fighting for his life, he died. “I wish you could see his records and all the infections and surgeries he had,” she told me. “I’ve been wanting to do something about the care he got and just didn’t know who to go to.”

I return to this topic from time to time because everyone

is vulnerable to hospital mistakes. Most people think of hospitals as safe, loving places that advertise their miracle

cures on TV and build new wings to house the latest technology. How can things go wrong? But they do, and

readers of this column have been eager to share their


Increasingly, it’s becoming clear there are few places

patients and their families can turn for help in avoiding bad

care and equally important there’s almost no guidance from

state or the federal regulators. When news outlets try to write about unsafe hospitals, they run into a “veil of secrecy that protects the industry” as one reporter in Michigan put it.

The Wall Street Journal has just published a fine story

that begins to lift that veil. Not many Americans know that the federal government has turned over the task of accrediting most of the nation’s hospitals to a private organization called the Joint Commission, which is funded by

hospitals and governed by a board of directors some of whom are executives in the health systems it accredits.

Medicare requires hospitals to comply with safety

standards, and they can use state inspections or hire a government-approved accrediting body to show they are in

compliance. Most have chosen the latter.

Hospitals have a lot of skin in this game paying the Commission an annual fee between $1,500 and $37,000

depending on how big they are, the Journal reported. They

also pay for the inspections, which in 2015 cost on average


The Joint Commission awards a “Gold Seal of Approval”

to those facilities that meet its standards. Maybe you’ve seen

them when you’ve visited a hospital. It encourages hospitals

to use those accreditations in their marketing activities, even

providing them with a publicity kit. The Commission has also created a patient brochure with this reassuring message, “Whenever and wherever you receive health care, look for The Joint Commission Gold Seal of Approval.”

However, the Journal found that those seals of approval

can be misleading. Using information from inspection records, reporters found that in 2014 some 350 hospitals had Joint Commission accreditation even though they were in violation of Medicare safety requirements, and 60 percent of them had safety violations in the preceding three years.

It seems that most patients facing an operation or a

hospital stay would want to know that. Dr. Mark Chassin,

president and chief executive of the Joint Commission, told

the Journal that his organization doesn’t routinely withdraw

accreditation of hospitals with safety problems because