The Joint Commission: Pay Us Or ELSE!


Something from the Medical Marijuana Advocates, er-um, Joint Commission arrived in my mailbox recently.

I am now the proud owner of the Spring 2008 Joint Commission Resources Solutions Catalog – a brochure full of all kinds of products you can purchase from the Joint Commission so that you too can learn how to be in compliance.

Ever try to find Joint Commission “standards” online? You can’t. You have to buy them. If they change their missives, guess what … you have to buy them again. If you don’t buy updates, then you risk not being in “compliance” and losing your accreditation.

So TJC (which is an unapproved abbreviation because it can be confused with “THC“) gains a financial advantage by creating frequent changes in their “standards.”

Just in case you want to learn how to pass your Joint Commission inspection, Joint Commission Resources has all kinds of information they will sell you about how to get in line with their secret directives.

You can buy a manual of Accreditation Standards for $135. Then you can purchase 9 other “Additional Accreditation Standards” for only $110 each.

They have seven different “Comprehensive Accreditation Manuals” covering areas such as ambulatory care, home health, long term care, point of care testing, etc. that sell for $265 each.

Then … you can get any or all of six “Accreditation Manager Plus” modules that range in price from $2,400 to $3,895 each.

If you’re still confused, you can purchase a site license to “The Source” newsletter for a $995 per year. Individuals can get a subscription for a mere $299.

Go look at all this stuff at the “JCR Web store.” All you have to do is cough up about $20,000 and you’ll know everything you need to know to pass your inspection with flying colors.

Isn’t this kind of like some state forcing you to purchase a book of laws you have to follow, making you renew your purchase every year, and subjecting you to arrest if you can’t afford the book?

Or is it more like the cartoon below?


  1. With all the pain TJC accreditation afflicts on hospitals to become or stay accredited. why do hospitals pursue this?? Seriously, does anyone know why? I don’t think patients care one bit as to who TJC is or about hospital accreditation. What if all the hospitals just said no and didn’t get accredited and didn’t buy all the TJC stuff?

  2. We each have little pocket-sized 3-ring manuals that we are supposed to put in our pockets should the inspectors show up which answer the FAQs for nurses. *Sigh*

    Incidentally, I was the nurse they pulled aside when we were getting eval’d for something last time. It’s, shall we say, extremely intimidating to be surrounded by no fewer than 15 clipboard nurses, inspectors, administrators etc etc. Awhile later, the eval came back and I was mentioned specifically as having a lot of knowledge on the area being evaluated. Good thing I skimmed the “manual” on what to say 15 minutes before they showed up in our dept…

  3. Accreditation is an issue of both public perception (i.e. similar to physicians who are not “board certified” ) and of payments. In order to receive payment from the government, you have to abide by their “Conditions of Participation.” Many insurance companies have also jumped on that bandwagon.
    To prove that they are in compliance with the Conditions of Participation, hospitals can be surveyed by any accrediting agency such as the Medical Marijuana Advocates, state surveyors, or the American Osteopathic Association. An oversimplified view is that if you pass, you get your money. If you don’t pass, you may get a chance to redeem yourself, but after that, you’re considered to be defrauding the government if you attempt to bill them for your services.
    The only way to get around this silliness is to stop accepting Medicare as a payment. Because many people over 65 don’t have secondary insurance or a means to pay for high-cost care, the economic choice for hospitals is to stop participating in Medicare and bill patients directly (in which case the patients would likely go to another hospital that does participate in Medicare), or take some payment for treating all the Medicare patients in exchange for reams of paperwork, delays, and more and more regulations.
    So, for the most part, it’s all about the Benjamins.

  4. From the perspective of a medical transcription service, JCAHO are a huge pain. Hospitals facing upcoming accreditation visits panic as the date of the visit approaches, and dump 300% of their normal volumes of dictation on the unsuspecting transcription service. All documentation must be up to date before the visit or the hospital receives a strong reprimand and consequences from JCAHO. One hospital administrator once mentioned that a JCAHO visit feels like 4 visits to the dentist, all in the same day…

  5. At what point does it become economical to avoid all of the costs associated with receiving medicare payments, bill the patients, only receive a little money, but have more satisfied staff and the ability to provide safer care?

    Eventually, all of the requirements to receive money from medicare have to exceed the amount of money you actually receive. Interest charges, since they are not prompt in paying and sometimes will threaten fraud charges, just to blackmail you into accepting a small fraction of what was billed months, or years ago. TJC charges – no benefit, but high cost. Other government regulations that can be forced on you as a result of receiving government money, . . . .

  6. WhiteCoat—I thought CMS was the accreditation agency for Medicaid and Medicare and JCAHO was something different entirely…So if you’re not accredited by JCAHO, you can still receive payment for Medicare, but you can’t if you are not approved by CMS…

  7. Griffin3 – Since doctors are independent contractors, it violates anti-collusion laws for them to organize a union.

  8. Same thing with accounting – if you want the FASB (financial accounting standards board) pronouncements you have to BUY them and if you are not in compliance you can lose your CPA license.

  9. Joint Commission visits are a joke; the units are made to look the way JCAHO WANTS them to look, and then when they are gone, everything gets back to normal. Our clinic had an inspection once, and they cited us for having a dead bug in a ceiling light; because they couldn’t find anything else. Of course, if they came in 2 weeks later, they would have had a field day. And they have the testicles to charge for their standards?

  10. Hi I am just a lurker who got here via I am actually very curious about your personal opinion on Medical “Mary Jane”

    Ummm … it is against federal law, so I can’t really say that I wholeheartedly endorse it. As long as you don’t end up like Spicoli, I don’t have problems with people that use it.
    Besides, there are prescription compounds containing its active ingredients that are legal if you *really* want it for medicinal purposes.
    Wonder what “Tier” it is…

  11. Pingback: Yes, This IS A Joke « WhiteCoat’s Call Room

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