Accreditation program for critical access hospitals
First surveys were conducted at end of 2001
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has launched a new accreditation program for critical access hospitals, with the first surveys conducted at the end of 2001. The Joint Commission is seeking deemed status for the program from the Center for Medicare & Medicaid Services (CMS).
Critical access hospitals, as outlined in the Balanced Budget Act of 1997, are designed to provide limited but essential health services to rural communities. These small facilities, with a patient census of less than 25, are certified by the secretary of the Department of Health and Human Services as eligible for cost-based reimbursement from the Medicare program. More than 400 existing hospitals nationwide already have converted to critical access hospital status, and as many as 1,100 organizations may be eligible for this designation.
The new accreditation program is designed to meet the performance improvement and business needs of these particular hospitals, many of which currently are accredited by the Joint Commission as acute care hospitals, says Kurt Patton, executive director of hospital accreditation services for the Joint Commission.
Critical access hospitals will be surveyed for compliance with standards specifically adapted for these organizations and that are in conformance with the Medicare requirements for these special hospitals. JCAHO also developed a cost-effective survey process based on the pre-survey review of relevant information and a focused on-site review of compliance with standards.
"JCAHO is sensitive to the special issues of critical access hospitals," Patton says. "We are also mindful that most critical access hospitals will likely seek insurance reimbursement from sources other than the Medicare program. JCAHO accreditation can be a tremendous asset in that process."
The new accreditation program is based on the Joint Commission’s own experience in evaluating small and rural hospitals and on extensive field input and test surveys. JCAHO also sought feedback from its Hospital Professional and Technical Advisory Committee and the Work Group on Accreditation Issues for Small and Rural Hospitals. Critical access hospitals must meet a specific set of federal Conditions of Participation in order to participate in and receive payment from the Medicare program.
National accrediting bodies, such as the Joint Commission, which successfully demonstrate to CMS that they are meeting requirements comparable to the federal Conditions of Participation, may be granted "deeming" authority.
If the Joint Commission is successful in achieving deeming authority for critical access hospitals, such Joint Commission-accredited hospitals would not be subject to the Medicare survey and certification process. The Joint Commission has had deeming authority for hospitals since the inception of the Medicare program in the 1960s.
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