Joint Commission Fail: On the Record

Tape recorder. Photo by darkday/Flickr

Our call to the JC Sentinel Event Hotline confirms our previous reporting about the ruse that is the Joint Commission International. “The standards are not the same. The standards are different. It’s a totally different manual.”

What’s so wrong is that the JCI cleverly set up a different set of standards than what JC hospitals are beholden to in America—a fact confirmed through our call. Read the full transcript below!

Santa Fe, New Mexico, 18 June 2015
By Dr. James Goldberg, Author of The American Medical Money Machine: The Destruction of Healthcare in America and the Rise of Medical Tourism

What if Your Life Was on the Line?

We have previously reported on the background and related matters of the Joint Commission (JCAHO or JC) which accredits medical facilities here and abroad. If you haven’t been following, please read our articles, “The Joint Commission Continues to Poison the Medical Spider Web” and “The Joint Commission’s Unpoliced Tax-Exempt Status Has a Staggering Effect on the Economics of Medicine”.

The JC’s group of interrelated organizations quietly exert enormous power over the trillions of dollars spent on healthcare in the US and abroad. They operate as a group of affiliated tax-exempt charities with 501(c)(3) designations. The tax paying public essentially gives them a free ride and indirectly pays their share of taxes which would otherwise be their responsibility.

Hiding behind the veil of being a charitable group of organizations, the hundreds of millions of dollars they generate annually pass back and forth through their web of companies, compensating their senior level executives apparently far beyond acceptable guidelines of reasonableness. Across all the JC conglomerates, at least 65 percent ($179,363,299.00) of their total revenue was spent on salaries in 2013.

Learn from History

To recap, these are the JC’s four public charities:

1. Formed in 1951: Joint Commission on Accreditation of Healthcare Organizations (EIN #: 36-2229255) dba: The Joint Commission
2. Formed in 1986: Joint Commission Resources, Inc. (EIN #: 36-3521721) dba: Joint Commission Resources International
3. Formed in 1989: JCAHO Surveyor & QHR Consultant Corporation (EIN #: 36-3673595)
4. Formed in 2008: Joint Commission Center for Transforming Healthcare (EIN #: 26-3020947) dba: Center for Transforming Healthcare

Only the first organization listed above, the JC, received authority in 1965 from the government to accredit American hospitals (limited to the US and its territories). None of the other three JC outfits existed at that time. They were all subsequently created in a type of shell game, making it very difficult to distinguish which monies flowed where and why and how much their executives actually received for running these charitable entities.

Brilliant? At Your Expense!

Please take particular note of #2, Joint Commission Resources (JCR), an educator, publisher and consulting company. Here is where the Joint Commission International (JCI) sits on their tax filings, operating as a DBA of the JCR, though in public they call their International arm a “division” of the JCR.

All four entities share logo symbols which vary only slightly. They all seem to be the same and to the uneducated eye, they all seem to bear the imprimatur of the US government, making it appear that all these organizations are blessed by the US government and carry the authority of law. But all JCs are not equal!

To generate significant additional revenue, the JC dreamed up the JCI to tap into international accrediting funds. Running slyly under the banner of the Joint Commission Resources in order to get that coveted tax-exempt charity status, they set up shop to accredit medical institutions around the world in more than 90 countries. By last account, this is more than 750 institutions and counting fast.

What’s so wrong is that the JCI cleverly set up a different set of standards than what JC hospitals are beholden to in America—a fact confirmed through our call (read transcript below). What the JCI sells to foreign hospitals seems to be a valued accreditation. World citizens are led to believe these foreign hospitals operate under the same regulations and responsibilities as JC accredited hospitals do. But that’s a fraud and fiction with serious consequences regarding patient safety.

JCI accredited foreign health care institutions appear to operate under supervision of the American-based JC. In other words, it looks as though JCI hospitals are policed by the US-designated JC in concert with the Department of Health and Human Services to receive Medicare payments—just the same way that a hospital in New York or Chicago or anywhere in the US are required by law to operate and be accountable. This is clearly a wrong assumption. International hospitals don’t need JC accreditation to take Medicare! Medicare coverage outside the US is taken in extremely limited situations (and why the AARP and UnitedHealth Group push Medigap-coverage).

You see, the JCI sells accreditation look-a-like approvals to these foreign hospitals without any obligation whatsoever for these foreign institutions to comply with the “rules” established by the JC. They only buy the JCI accreditation yearly to attract American patients who have cash or international insurance coverage. They bear no responsibility to comply with any of the “JCI rules” which they have purchased.

Sentinel Events: Matters of Life and Death

One of the key happenings which US accredited hospitals are honor bound to report are called Sentinel Events. The JC—a public charity—is all over Sentinel Events, just try a search. They are supposed to inform health care workers and the public about these events through Alerts.

A Sentinel Event is an unexpected occurrence involving death or serious physical or psychological injury or the risk thereof. Serious injury specifically includes loss of limb or function.

The phrase “or the risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome.

Such events are called “sentinel” because they signal the need for immediate investigation and response.

The JC has a Sentinel Event Hotline set up for this very special and important purpose. Is this charitable? We don’t think so since organizations which have not paid the JC do not get to report anything. Plus, reporting isn’t even required by US hospitals according to Health and Human Services!

Here is an HHS Inspector General’s report on reporting adverse events in hospitals. The Patient Safety Act requires HHS to establish a national network of Patient Safety Organizations (PSO) to accept voluntary reports of adverse events from hospitals. “Staff from 15 of the 26 States acknowledged that hospitals do not always submit reports when adverse events occur. However, staff from nearly all of these States were reluctant to estimate the extent to which adverse events go unreported, typically expressing that they could not know how many events actually occur.” The JC is once again duplicating and commingling HHS services with no charitable benefit.

Get Your Story Straight!

In late May 2015, one of our researchers called the JC Sentinel Event Hotline to ask about reporting a Sentinel Event that happened at a hospital overseas. Following is an excerpt from that conversation and you can read the entire transcript here.

Please continue reading on The American Medical Money Machine.