Joint Commission ends commendation award
The Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, has eliminated the "Accreditation with Commendation" category and increased the fee it charges health care providers for an on-site survey.
Accreditation with Commendation was introduced in January 1991 to recognize exemplary performance in accredited organizations at a time when performance reports — which give consumers and providers detailed information about how health care organizations compare with each other — were not available. Perform ance reports now provide up-to-date, understandable data about the performance of all health care organizations accredited by the Joint Commis sion, says Dennis O’Leary, MD, president of the Joint Commis sion.
In addition, recent experience had suggested that the Accreditation with Commendation decision category was leading organizations to place undue pressure on their senior management staff to attempt to influence surveyors not to cite them for insufficient compliance with Joint Commis sion standards. Department of Health and Human Services Inspector General June Brown Gibbs had suggested earlier this year that the decision category be made more meaningful or be done away with altogether in the report, "The External Review of Hospital Quality."
"The time for Accreditation with Commen dation has clearly passed,"O’Leary says. "We need to assure that the focus is where it belongs — on improving the safety and quality of health care across all accredited organizations."
Survey fees hiked
The Joint Commission sought input from both consumers and health care organizations earlier this year regarding the possible elimination of Accreditation with Commendation. It also announced that it is increasing the fees for its periodic full surveys by 3.25% in all but its ambulatory care and home care programs. The fee increase, which became effective Jan. 1, 2000, was approved by the Board of Commis sioners at its November 5-6 meeting. The board also acted to re-establish a $2,500 fee for follow-up focused surveys to offset the actual costs of conducting these surveys.
The Joint Commission last adopted an across-the-board survey fee increase in 1994. The overall fee for a full survey is generally derived from a base fee, a service-volume-related fee, and the application of a survey price ceiling. The price increase will apply to all of those fee components.
In 1995, the Joint Commission eliminated its separate charge for focused surveys but did not increase overall fees to cover the costs of these surveys. About 10% of accredited organizations are expected to require a focused survey next year. In reinstating a charge for those follow-up surveys, the Board of Commissioners determined that the related costs should be borne principally by those organizations requiring focused surveys, rather than spreading the costs across the fees for all accredited organizations.
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