Visible Flaws: Making Healthcare Violations Public

A new federal regulation may require private accreditors to reveal the violations found to the public

Medical errors and malpractice are a leading cause of death in the United States, accounting for 9.5% of annual deaths, but how many does the public know about?

Healthcare facilities and nursing homes are given routine inspections by private accreditors, state inspectors and The Centers of Medicare and Medicaid Services (CMS). These are meant to catch and report violations, and to evaluate a facility and its quality of care. But the findings gathered are not openly reported to the public. How are we to know if the hospital or clinic we visit has more than several black marks against it, and how many are for errors and violations that could cost a patient his or her life? Now, if the CMS gets its way, the public may be soon offered a sliver of accessibility to information about the quality of healthcare they are receiving, as NPR reports.

Private accreditors often miss violations

Private healthcare accreditors currently do not make the results and findings of their inspections known to the public, and many are prone to missing crucial errors or violations. The CMS noted in a 2016 report that accrediting organizations left these unlisted. In 2014, officials of the state made the decision to inspect 103 “acute-care” hospitals that were recently looked at by accreditors. In those instances, officials were able to locate 41 serious deficiencies, and 39 of them were missed by accrediting organizations.

Both the Association of Health Care Journalists and ProPublica have taken the initiative in posting government inspection reports for both nursing homes and hospital violations online. Inspections are routine, and some (like those conducted by The Joint Commission at least once every 39 months) are done spontaneously.

In order to qualify for federal funding, medical facilities have to continuously meet certain requirements. These are commonly known as the “Medicare conditions of participation” and a failure to meet them can result in a facility losing their Medicare funding. Some of these conditions include:

• Compliance with federal, state, and local laws
• The presence of a governing body within the facility
• Medical record services
• Quality assurance
• Outpatient services (evaluated on their quality)
• Medical staff- presence physically, adhering to laws, proper patient care, accountability.

Private accreditors have pulled the wool over the public eye

The Joint Commission provides the accreditation status of healthcare facilities, but the issues that were discovered are not readily made available to the public, thus leaving them in the dark about the quality of healthcare they’re receiving. What’s worse, the same accreditation statuses being awarded and accessible to the public doesn’t always reflect the truth. According to the Chicago Tribune in 2002 article, “the nation’s most influential health-care regulator frequently serves the interest of the hospital industry over those of the public”.

The Tribune then goes on to state that patient deaths were grossly underestimated by the organization, possibly in part due to the fact that hospitals were allowed to choose the patient files that were presented for inspector review. When the Joint Commission was quoted as to saying the survey process was “not flawless” in 2002, how many flaws were being overlooked? Fortunately, tougher grading standards and more focus on patient care were introduced in a procedure overhaul scheduled for 2004. However, that was long overdue, and the cycle of a “not flawless” procedure still hangs over healthcare.

Going public means going healthy

Revealing the lower-than-desired grades of healthcare surveys to the public may be seen as a black mark against our system and its facilities, but it should be more properly viewed through the lens of progression. NPR cited the director of the Consumer Union’s Safe Patient Project as an advocate for this change, and noted that it could more properly inform the public about the quality of a hospital. Requiring private accreditors to release violations would be a huge step in securing patient trust and safety.

The quality of healthcare received by patients can sometimes mean the difference between life and death, or successful treatment and serious injury. Medical errors and malpractice occurrences are already happening frequently, and violations are found in too many facilities. Patients and their families have a right to know where a hospital or other facility stands, and how their care providers measure up to standards of care.