Summary: Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) survey process, focusing on HCFA problems in comparing its survey results with those of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
GAO found that: (1) since HCFA did not have an accurate basis to compare its findings with JCAHO, HCFA could not effectively determine whether a hospital receiving JCAHO accreditation met Medicare health and safety requirements; (2) there were differences in the deficiencies that state survey agencies and JCAHO identified, primarily due to differences in the scope and content of Medicare participation conditions and JCAHO standards; (3) because of differing survey criteria, HCFA could not assess the significance and cause of differences in survey findings; (4) in fiscal year (FY) 1988, 14 of 61 HCFA validation surveys relating to Medicare conditions of participation were different from state agency and JCAHO findings; and (5) the process HCFA used to assess the JCAHO accreditation process was not an effective validation process.
