By Betty Berry, Tuesday, Oct. 18, 2011

QUESTION: I’ve heard horrible stories about poor care and conditions encountered by patients in some hospitals. I’m wondering whether Medicare has any say in the standards hospitals must meet. Also, who reviews hospitals to determine whether standards are being met?

ANSWER: For a hospital to participate in the Medicare program, it must be accredited or certified. Beneficiaries would not use a hospital without one of these approvals.

Accreditation is a “seal of approval” that means a facility meets certain standards. The standards are set by private, nationally recognized groups that continually check on the quality of care.

Accreditation can be awarded by two organizations. The Joint Commission and the American Osteopathic Association check on the quality of care at health care facilities at least every three years, and most hospitals take part in this process.

When the commission reviews a facility, it looks at how well a hospital treats patients and the quality of staff and equipment. The resulting performance report includes one of six levels of accreditation awarded. The lowest is “not accredited,” and the highest is “accreditation with commendation.”

The report also includes the date the hospital was checked, a summary of key findings, results of any follow-up action, areas that need improvement and how that hospital compares with others.

You can call the Joint Commission at 630-792-5800 to check on a hospital’s level of accreditation or request the hospital’s current review report. The commission also has information at

The American Osteopathic Association also reviews hospitals’ patient care, staff and equipment quality and writes a performance report. There are several levels of accreditation — the lowest is “denial of accreditation,” and the highest is “accreditation with resurvey within three years.”

You can check on findings by calling 312-202-8258 or visiting

Certification means a hospital has passed a survey done by a state government agency. Although it is similar, it is not the same as accreditation.

In addition, some states provide report cards that can be used for comparing hospitals. These reports help potential patients choose where to receive their health care.


Oct. 26: “Medicare Part D Prescription Drug One-Stop Shop,” offering help with selecting and enrolling in a Part D Prescription Plan, Simi Valley Senior Center, 3900 Avenida Simi, Simi Valley. For details, call 477-7310.

Oct. 28: “Understanding Medicare and Changes for 2012” seminar, 1:30 to 3 p.m., Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks. For reservations, call 381-2744.

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