The group that gives a seal of approval to the nation's hospitals -- already accused of being too lenient -- now will allow medical centers to rack up more patient care lapses and other violations before sanctioning them.
The Joint Commission on Accreditation of Healthcare Organizations last month raised the number of deficiencies a hospital may accumulate during an inspection before being punished.
Critics say that the new rules are a step back for the influential group and that it may be more eager to please hospitals than protect patients.
"I don't know how far below zero they intend to go," said Rep. Pete Stark (D-Fremont), who has called for more federal oversight of the commission. "They're not doing the job of making sure that hospitals are delivering quality, safe care."
Commission accreditation is not purely symbolic; state regulators and private insurers consider it a key measure of a hospital's quality.
The commission, which accredits more than 4,500 hospitals nationwide, is private, and hospitals pay it for the cost of the inspections. It also owns a consulting business that helps hospitals prepare for its reviews.
Stark and others question whether the new standards render accreditation meaningless. If the new rules had been in place in 2004, for example, Martin Luther King Jr./Drew Medical Center in Los Angeles County would have kept its accreditation after myriad problems with care that led to some patients' deaths.
Commission officials defended their decision this week, saying the group would prefer to identify more problems and have hospitals fix them than strip more facilities of accreditation. Two major factors cited in the decision were a rise in the number of deficiencies found by better-trained inspectors and a switch this year to surprise reviews.
"We shouldn't deny accreditation to 10 or 15 or 20% of all the hospitals in the United States," said Joseph L. Cappiello, vice president of accreditation field operations. Patients are better served when the group's findings are not a punishment but a "catalyst for improvement," he said.
Dr. Dennis S. O'Leary, the commission's president, predicted that the number of hospitals sanctioned this year would actually increase from years past. O'Leary said the commission made the changes not because of outside pressure but because it found that too many decent hospitals were being referred for punishment this year.
