Joint Commission accreditation impacts Medicare reimbursement in many hospitals.
Formerly known as JCAHO, the Joint Commission is a not-for-profit organization that sets quality standards in health care. Hospitals, doctors' offices and other health care facilities follow these standards in their delivery of patient care. Those facilities that are evaluated by the Joint Commission and found to be exhibiting quality care can receive accreditation in one of seven categories. Accreditation is granted or denied on the basis of information collected by Joint Commission staff members during unannounced surveys of the facility.
Hospitals
Hospitals can receive Joint Commission accreditation by demonstrating patient quality and safety in areas consisting of emergency management, infection control, medical staffing, nursing, medication management and information management. During a Joint Commission survey, hospitals must provide requested documentation about their processes and procedures. Surveyors will also interview staff and patients, conduct observations and trace the patient and operational experience. Once a hospital receives accreditation, they must go through the survey process again every 18 to 39 months.
Critical Access Hospitals
Critical Access Hospital (CAH) is a designation given to smaller, rural hospitals by the Centers for Medicare and Medicaid (CMS). A CAH has less than 25 beds and keeps patients for less than 96 hours. CAHs are assessed by standards similar to other hospitals and must also submit information pertaining to six performance measures of their choosing. During a Joint Commission visit, surveyors will evaluate a CAH's inpatient and outpatient facilities and operations at one time. A CAH that receives accreditation will be surveyed every 18 to 39 months from then on.
Ambulatory Care
Ambulatory care refers to care that is delivered in an outpatient setting such as care at a doctor's office, outpatient surgical center, imaging center or urgent care center. These facilities are surveyed using the same standards as hospitals, but medical staff and nursing staff are not included. Surveyors look at the patient experience and operational systems in each case. Ambulatory care facilities are surveyed every three years after initial accreditation.
Behavioral Health Care
Types of behavioral health care programs that are eligible to receive Joint Commission accreditation include addiction programs, group homes, foster care and rehabilitation programs. The standards the Joint Commission uses to evaluate behavioral health care facilities is similar to that of hospitals. However, programs or facilities that provide recovery-oriented programs must demonstrate compliance with additional standards. Behavioral health care facilities are surveyed every three years after their initial accreditation.
Laboratory
Laboratories, including those connected to hospitals or clinics as well as freestanding laboratories, can receive Joint Commission accreditation. Surveyors follow a lab specimen from the time it is collected to the time the report is put together to determine if correct quality and safety measures were taken. Labs must also enroll in a proficiency testing program approved by CMS. Lab surveys follow a two-year cycle after accreditation is initially granted.
Home Care
Hospice facilities, home care facilities, pharmacies and personal care programs can all receive Joint Commission accreditation as home care organizations. Surveyors will trace a patient's experience and review operational systems to determine compliance. Home care organizations are surveyed every 18 to 30 months after their first accreditation.
Long-term Care
Health care organizations that provide beds for long-term patients like nursing homes and skilled nursing facilities are eligible to receive Joint Commission accreditation in two categories. The Joint Commission can grant a traditional long-term care accreditation or a Medicare/Medicaid certificate-based accreditation depending on the requirements that are met. During the Joint Commission survey, the resident's experience will be looked at as well as the facility's operational systems. Long-term care facilities must go through the survey process every three years.
