Hospital Administration

TUI University

Module 5 Case

MIH 535 Hospital Administration

Introduction

Accreditation by The Joint Commission is a recognized seal of approval for many institutions in the United States. It is needed by the hospitals to become providers in the Medicare program. In order to receive payment from the Centers for Medicare and Medicaid Services (CMS), hospitals are required to meet a set of minimum requirements called conditions of participation. There are three organizations that can accredit hospitals based on the participation requirements– the Joint Commission, the American Osteopathic Association (AOA), or the state certification agencies (Sprague 2005). More than 80% hospitals in the country voluntarily use the Joint Commission for accreditation purposes.

Role of Accreditation

The majority of US hospitals use The Joint Commission because if hospitals want to be reimbursed for care given to Medicare covered patients, then they are required to have The Joint Commission accreditation for reimbursement. Medicaid is state funded but has federal mandates. The Joint Commission accreditation pretty much covers all ground in ensuring that all federal or state paying entities will honor reimbursement (Centers for Medicare and Medicaid Services. 2009). However survey and Accreditation by The Joint Commission is voluntary. Several states such as Oklahoma do not use The Joint Commission but instead use standards set forth by the state.

Traditionally, Joint Commission reviews hospitals every three years on a scheduled basis. A team consisting of at least a physician, a registered nurse, and a hospital administrator conduct a full survey of each participating medical facility. There are several hundred-performance standards that investigators use to evaluate compliance. Each performance area receives a score of 1 to 5. A score of 1 indicates full compliance with the standards of that performance area. The minimum acceptable score is a 2. A score of 3, 4, or...