You asked whether the Veterans Home and Hospital's decision not to seek reaccreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) would jeopardize its eligibility for Medicare reimbursement.

The Veterans Home and Hospital's decision not to seek JCAHO reaccreditation should not affect its eligibility to receive Medicare reimbursement.

In order to receive Medicare reimbursement, hospitals (and other healthcare facilities) must be certified by the federal Centers for Medicare and Medicaid Services (CMS, formerly the Health Care Finance Administration, HCFA). They can take two paths toward certification according to Kate Lucas, certification director at CMS' Boston regional office: JCAHO accreditation or a survey by the state survey agency. JCAHO accreditation gives them "deemed" status for CMS certification. (JCAHO is an independent, nonprofit organization that evaluates and accredits health care organizations, including hospitals, which also support it with membership fees. )

The Department of Public Health (DPH) is Connecticut' state survey agency. Wendy Furniss, manager for DPH's Health Systems Regulation Division, reports that DPH survey staff is paid by CMS and follows its certification rules. DPH surveys focus on site visits that stress patient care delivery and outcomes. Furniss contrasted this approach with JCAHO's, which she characterized as more paper-oriented, focusing on policies and procedures, manuals, and staff credentials. Furniss also noted that JCAHO has no enforcement authority, which means that if it reports a deficiency to CMS, CMS refers the matter to DPH for follow-up.

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