CMS proposes public reporting of inspections

A Proposed Rule by the Centers for Medicare & Medicaid Services on 04/28/2017 was posted in the Federal Register us the US government.

August 15, 2017

In this post, CMS proposed "public reporting of clinical quality measure data", specifying limited criteria for each type of organization.

According to NPR Health News, April 18, 2017, "The move follows steps CMS took several years ago to post government inspection reports online for nursing homes and some hospitals."  Nursing Home Inspect at allow the public to review deficiencies.

In response, The Joint Commission responded, "The Joint Commission is opposed to the CMS proposal to make all accreditation survey reports (including statements of deficiencies) and acceptable plans of correction publicly available on the websites hosted by accreditation organizations."

We observed on the ProPublica page that the data is not shown relative to patient count, actual incidents, benchmarks or other factors.  This does support TJC arguments that it would inhibit participation and cause hospitals to seek deeming organizations that present the friendliest findings.

If the information presented is not uniform and educational, it is possible a member of the public could choose to travel 30 minutes further for a critical heart procedure because an exit door was inappropriately left open or locked according to a report.  An assortment of comments on Yelp can be very helpful when selecting a care-giver for dentistry or dermatologist.  For critical and long term care, it is good there is a healthy debate taking place about the nature of information to be reported.  Maybe the deeming agencies need to be proactive about working with AAMI and similar organizations to standardize public reporting before they are ordered to do so.

Many arguments have been made in support of "transparency."
Whatever reporting is required, the expected benefit should be supported by evidence.
According to the CMS post, these accreditation organizations are affected:

  • Accreditation Association for Ambulatory Health Care (AAAHC)
  • Accreditation Commission for Health Care, Inc. (ACHC)
  • American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)
  • American Osteopathic Association / Healthcare Facilities Accreditation Program (AOA/HFAP)
  • Community Health Accreditation Program (CHAP)
  • Center for Improvement in healthcare (CIHQ)
  • DNV GL – Healthcare (DNV GL)
  • The Compliance Team (TCT)
  • The Joint Commission (TJC)

Under CLIA (Clinical Laboratory Improvement Amendments), additional organizations are recognized:

  • AABB
  • COLA
  • American Association for Laboratory Accreditation (A2LA)
  • American Society for Histocompatibility and Immunogenetics (ASHI)
  • College of American Pathologists (CAP)

For now, the change is on hold indefinitely. posted on 8-2-1017 in a fact sheet (CMS-1677-F):
"After consideration of the public comments received, CMS decided that it would be best if the proposal was not finalized and instead, the proposal was withdrawn. CMS is committed to ensuring that patients have the ability to review the findings used to determine that a facility meets the health and safety standards required for Medicare participation. However, we believe further review, consideration, and refinement of this proposal is necessary to ensure that CMS establishes requirements, consistent with our statutory authority, that will inform patients and continue to support high quality care."

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