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According to JC AHO, a dozen hospitals have lost accreditation nationwide since 1998. “When you lose accreditation, you can lose third-party patients and payments. The problems were severe enough that JC AHO issued a preliminary denial of accreditation.
If a hospital loses its Joint Commission accreditation, which happens only a few times each year across the country, a hospital could lose its ability to treat commercially insured patients, said Jim Lott, executive vice president of the Hospital Assn.
Medicare termination would be tantamount to closing down a hospital in most cases. In 2012, the Cleveland Clinic received 29% of all its net patient revenue from Medicare, according to audited financial statements. Although hospitals must be accredited to get paid, they don't have to do it through the Joint Commission.
Quite simply, hospitals pursue accreditation because it is required in order for their organizations to receive payment from federally funded Medicare and Medicaid programs. The Joint Commission accredits more than 4,000 facilities throughout the United States, which accounts for approximately 78 percent of hospitals.
Today, it accredits approximately 4,500 general, children's, long term acute, psychiatric, rehabilitation and surgical specialty hospitals. Approximately 82 percent of the nation's hospitals (including critical access hospitals) are currently accredited by The Joint Commission.
The WSJ investigation found that the Joint Commission, which accredits about 80% of U.S. hospitals, rarely pulls its accreditation. In 2014, the Joint Commission revoked accreditation for just 1% of facilities in 2014.
Joint Commission accreditation can be earned by many types of health care organizations, including hospitals, doctor's offices, nursing homes, office-based surgery centers, behavioral health treatment facilities, and providers of home care services.
Certification is earned by programs or services that may be based within or associated with a health care organization. Both accreditation and certification require an evaluation by The Joint Commission. The evaluation covers compliance with the standards and other requirements and verifies improvement activities.
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