JCAHO and HCFA standards come together
Hospitals will find and fix problems a la JCAHO
The new revised conditions of Medicare participation (COPs) shift the oversight focus toward patient health outcomes and away from burdensome and costly procedural requirements.
"It’s inevitable that federal regulations and JCAHO accreditation requirements will eventually dovetail," says Robert Pollack, MD, director of Professional Quality Analysts in Casselberry, FL. "There are definite similarities."
"A quick glance at the proposed rules shows reference in several places to the Joint Commission," says Janet McIntyre, spokes woman for the Joint Commission. "We’re pleased with that. HCFA seems to have moved from a prescriptive stance to one that’s more performance-based, and that’s compatible with what we’ve done."
Accreditation of hospitals by the Joint Commission has been around longer than Medicare. At first, HCFA’s requirements were very close to the accrediting agency’s. As the years went by, however, the rules became increasingly dissimilar. HCFA’s became more and more structure- and process-oriented, while the Joint Commission’s stayed in the outcomes mode. It remains to be seen whether this new focus on quality will downplay a continuing need for Joint Commission accreditation.
"The new Medicare COPs will not be exactly the same as Joint Commission requirements, but they’re along the same vein," explains Rachael Weinstein, RN, senior health insurance specialist at HCFA. The COPs have to be included in the Joint Commission’s requirements by virtue of its deemed status. So hospitals going through accreditation are automatically subject to HCFA’s requirements as well as to the standards of the accrediting body. Nonaccredited facilities are surveyed directly by their state survey agencies under an agreement with Medicare, and as such they too are subject to the COPs.
"If there were any differences between Joint Commission standards and ours," continues Weinstein, "it’s the Joint Commission that would have to revise its standards. A couple of years ago, for example, we added discharge planning and HIV look-back provisions, and the Joint Commission had to pick up those pieces."
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