CMS Proposes Public Reporting of Medical Facility Inspections

A new rule from CMS proposes increasing transparency of the inspection process of medical facilities by requiring that private health-care accreditors (the largest of which is The Joint Commission), which usually conduct inspections, publicly report outcomes of inspections and hospitals’ plans to resolve reported problems. The reports would not specifically name staff members, but would include details about medication errors, operations on the wrong patient or body part, and patient abuse.

These reports have long been confidential, but CMS proposed the new rule to address concerns about private accreditors missing major problems at health-care facilities. Though the U.S. Department of Health and Human Services must approve accreditors, they rarely take action against the organizations.

Each year, CMS reviews a sample of hospitals and other health-care facilities accredited by private organizations to validate their findings. In the 2014 inspection of 103 acute-care hospitals, state inspectors found 41 serious deficiencies, 39 of which were missed by private inspectors. This “raises serious concerns regarding the [accrediting organizations’] ability to appropriately identify and cite health and safety deficiencies,” CMS said in a statement of the draft regulations. “We believe it is important to continue to lead the effort to make information regarding a health-care facility’s compliance with health and safety requirements.”

The proposed rule would also change regulations “relating to transparency of accrediting organization survey reports and plans of correction of providers and suppliers; electronic signature and electronic submission of the Certification and Settlement Summary page of the Medicare cost reports; and clarification of provider disposal of assets.”

In response to this draft regulation, the American Hospital Association (AHA) voiced its support for providing the public “useful information” but noted that the reports may not be interpreted easily by the general public. “It’s important that the information shared with consumers has a clear purpose, is transparent, and is readily understood by folks from all walks of life, not just those with deep expertise in health care,” said Nancy Foster, vice president for quality and patient safety at the AHA, in a statement, recommending the publication of a shorter summary document that explains key findings and significance.

The new requirements would apply to specific Medicare providers, including acute-care hospitals, Prospective Payment System-exempt cancer hospitals, long-term care hospitals, and inpatient psychiatric facilities.

Sources: NPR and ProPublica report, April 18, 2017; Federal Registrar Document 2017-07800, April 28, 2017.