Joint Commission is a Joke...

[Emergent]

My Hospital has been preparing for the Joint Commission inspection. Frankly, it's pathetic. No saline locks in our pockets, no IV buckets left out on counters, nothing closer than 18 inches from ceiling. And, no concern regarding nurse/patient ratios of course.

Another self-important, entrenched, bureaucratic entity, that is impeding us in our work. People who have spent their time in academia, studying theory that was developed outside of the space/time continuum, in front of a computer spreadsheet. God save us all.

[CrunchRN, ADN, RN]

I would respect it much more if it was an unannounced visit.

Janjull - a picture is worth a thousand words huh? That is pathetic.

[klone, MSN, RN]

I think what bothers me most about JC and its implementation is that so many things that are claimed to be "Joint Commission requirements" are in fact NOT.

Who here has heard "Joint Commission requires that NOTHING be stored in cabinets under sinks"? Well, guess what? They specifically state that they do NOT have any edicts regarding under-sink storage, but that common sense, infection control and OSHA safety regulations should prevail. But my clinic recently got "dinged" because an internal "mock audit" found that we had empty flower vases under the sink in the breakroom.

[llg, PhD, RN]

OK - so what's the alternative? Do you not want ANY type of mandatory criteria for hospital operations? Just imagine how that would turn out. Sheesh. CMS surveys are more exacting than JC - with much more serious consequences for any lapses in compliance. Nothing in life is ever perfect, but I believe that a more professional approach would be to recognize the gaps and shortcomings.... and work to improve them.

Is anyone involved with activities related to JC/CMS compliance?

I am. Staff Development folks get very involved. It's a pain in the neck -- but something that needs to be done. It is the equivalent of "a good house-cleaning" in which we look into all the dark corners and sort them out, clean them up, etc. That process is valuable. As dudette10 just said, " preps for a survey are probably more useful for patient safety and improvements that really matter than the survey itself."

[RNperdiem, RN]

When I worked in food service, every day was a potential inspection day. There was no "cleaned up and buffed for the inspector" and "normal operations". The things inspectors were looking for were directly relevant to public safety, good hygiene and proper cleanliness and was not difficult to achieve.

In nursing, I have worked long enough to appreciate many of the changes related to patient safety. Some of the things as we all know ,are nit-picking. I guess I have mixed feelings about this.

[elkpark]

Is anyone involved with activities related to JC/CMS compliance?

I worked for four years as a hospital surveyor for my state and CMS (all state surveyors are also contract surveyors for CMS -- instead of maintaining its own staff of surveyors, CMS contracts with each state to use the state's surveyors for CMS surveyors. So we were responsible for knowing all the state regs and all the CMS COPs). I second what Esme said -- in my state, in my branch (psychiatric hospitals), we surveyed every facility every year. The surveys were all unannounced, but the facilities knew we were coming at some point during the year. The stuff we encountered on surveys (at some facilities, certainly not all), even when they knew we were coming, would scare the bejeezus out of you. If you had any idea what surveyors see on surveys, you would agree strongly that healthcare needs more regulation and oversight, not less.

FWIW, all the state surveyors I encountered, in my state and from other states (we had to complete mandatory CMS training, which involved surveyors from all states), consider Joint Commission a joke. The state and CMS surveyors are much tougher. The administration folks at the hospitals my team surveyed used to comment that they were glad to see us arrive because that knew that, if they passed our survey, they would have no problems with Joint Commission. (Plus, we didn't charge them tens of thousands of dollars for the privilege of being surveyed ...)

[wooh, BSN, RN]

I don't think anyone complaining about TJC is saying hospitals need LESS oversight. We're saying we want genuine and effective oversight of things that actually make patients safer. We want hospitals to make changes that make the patients safer all the time. Not just making things look good for the couple of days the inspection is going on.

[ThePrincessBride, MSN, RN, NP]

In my opinion, announcing when JC is going to arrive kind of defeats the purpose of the visit anyway. And yeah, I wish they would put more effort in staff:patient ratios, but then that would cost the hospital more money.

[Rose_Queen, BSN, MSN, RN]

I used to be. I knew TJC stuff inside out and was responsible for my unit's compliance. Things got cleaned up the week of. Staffing suddenly increased so we could actually do things "right." And I knew how to make things look right even when things were oh so wrong.

Yes, hospitals need oversight. But it needs to be REAL. Surprise inspections. Looking at things that count. Like staffing. Not whether boxes are off the floor. Administration needs to be accountable for making it possible to follow the rules. Not bedside nurses being held accountable for charting that the rules were followed even when there's not time to actually follow them.

Announced inspections are an absolute joke. The week prior to ours, two big tractor trailers show up at the hospital. Everything that has been kept in the hallways magically disappears- packed into the trailers and parked at an offsite parking lot until the inspection is over. And I'm sure the JC inspectors know that facilities are finding ways to clean up and meet the requirements prior to the announced visits. Unannounced, not on any kind of routine schedule visits are needed so that the JC can be honest- and then maybe we'll see things change to how they should be year-round instead of for a single week.

Also, does anyone else's facility announce a "Good morning. (Name of facility) would like to welcome the Joint Commission inspectors this week" over the hospital-wide intercom? That's just as much of a joke- everyone knows it's not a welcome; it's a warning to shape up.

[RNperdiem, RN]

If the hospital could play the Darth Vader theme music from Star Wars over the intercom, now that would be closer to reality!

[Deepinthegame]

It is a joke ! Fear the Feds and laugh at Joint Commission

We had a hospital here in Chicago that had to be shut down by the FBI-where was Joint Commission ? Where was Magnet ? Where was etc. ? However , it took an entity outside of healthcare to shut it down. Go figure, I am sure there are other Hell hole hospitals harassing nurses about visits from the likes of above -only to really fear the feds. Furthermore, I have worked in five star dumps that clearly there was more wrong than what we were harassed about prior and during a visit . Again, where were theses "Jokes " when this happened ? To get to the point , these guys were putting tracheostomies in pts that didn't need them for profit. Chicago doctors, hospital owner arrested in an alleged kickback conspiracy | WBEZ 91.5 Chicago

Another hospital was fully accredited by Joint Commission to be shut down by the feds- Hospital shuts down services after patient safety violations - FierceHealthcare

[Esme12, ASN, BSN, RN]

It is a joke ! Fear the Feds and laugh at Joint Commission

We had a hospital here in Chicago that had to be shut down by the FBI-where was Joint Commission ? Where was Magnet ? Where was etc. ? However , it took an entity outside of healthcare to shut it down. Go figure, I am sure there are other Hell hole hospitals harassing nurses about visits from the likes of above -only to really fear the feds. Furthermore, I have worked in five star dumps that clearly there was more wrong than what we were harassed about prior and during a visit . Again, where were theses "Jokes " when this happened ? To get to the point , these guys were putting tracheostomies in pts that didn't need them for profit. Chicago doctors, hospital owner arrested in an alleged kickback conspiracy | WBEZ 91.5 Chicago

Another hospital was fully accredited by Joint Commission to be shut down by the feds- Hospital shuts down services after patient safety violations - FierceHealthcare

First, the Feds supersede the JC when there is criminal wrongdoing. The first hospital should have closed YEARS ago and was not accredited with the CEO and the physicians in jail.

Second not all facilities are accredited by the JC

St. Catherine Medical Center Fountain Springs is a non-profit acute care hospital based at 101 Broad Street in Ashland, PA. The facility is not accredited and provides emergency services.

I wouldn't laugh at the JC too hard....((WINK))

[Esme12, ASN, BSN, RN]

A jury convicted Nagelvoort in March of one count of conspiracy to violate the federal healthcare anti-kickback statute, and 11 counts of paying kickbacks for patient referrals. In addition to the prison term, U.S. District Judge Matthew F. Kennelly ordered Nagelvoort jointly liable for an $8.48 million forfeiture with his co-conspirators, EDWARD NOVAK and ROY PAYAWAL.

Novak, of Park Ridge, was the hospital's former owner and chief executive officer. He was sentenced Wednesday to 54 months in prison. Payawal, of Burr Ridge, served as the hospital's chief financial officer. Judge Kennelly sentenced Payawal on Thursday to 12 months and one day in prison. Other convicted executives, including the chief operating officer who succeeded Nagelvoort and the Vice President of Geriatrics, are awaiting sentencing.

The hospital executives are among nine defendants convicted in a multi-year investigation of Sacred Heart, a 119-bed acute care facility at 3240 West Franklin Boulevard in Chicago. From 2001 through April 2013, the executives conspired to pay kickbacks and bribes to physicians to induce them to refer patients to the hospital for services that would be reimbursed by Medicare and Medicaid. Evidence at trial revealed that hospital administrators tried to conceal the kickbacks by creating sham professional and lease agreements with doctors. The hospital closed in 2013 in the aftermath of the criminal indictments.

The Sacred Heart investigation was carried out by the Medicare Fraud Strike Force, which is part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative between the U.S. Justice Department and the U.S. Department of Health and Human Services to prevent fraud and to enforce anti-fraud laws around the country. Dozens of defendants have been charged in numerous fraud cases since the strike force began operating in Chicago in 2011.

Former Chief Operating Officer Of Sacred Heart Hospital Sentenced To 21 Months In Prison For Conspiring In Kickback Scheme | USAO-NDIL | Department of Justice