Proposed Rule Would Make Hospital Inspections More Transparent

Hospital inspection reports concerning errors and violations have long been kept confidential, but a new proposed rule by the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) may change that.

The proposed rule would establish new requirements that private health-care accreditors (the bodies that usually conduct and report on these incidents) publicly detail medical errors found in hospitals, as well as steps taken to resolve them. 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.

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.

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.”

CMS proposed this regulation in response to concerns about private accreditors missing major problems at health-care facilities. CMS conducts an annual sample inspection to validate the work of private accreditors. In the 2014 inspection of 103 acute-care hospitals, state inspectors found 41 serious deficiencies, 39 of which were missed by private inspectors.

“This disparity raises serious concerns regarding the [accrediting organizations’] ability to appropriately identify and cite health and safety deficiencies,” the agency wrote in the draft regulation announcing the proposed rule. Notably, nearly nine in 10 hospitals are directly overseen by private accreditors rather than state officials.

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