In a collaboration with the Association of Health Care Journalists (AHJC), the Centers for Medicare & Medicaid Services (CMS) has launched a national, searchable database that contains federal safety rule violations at approximately 1,000 hospitals across the country. The data only includes violations found since January 2011, but it represents another step toward greater transparency in regulatory actions and affords consumers much more substantive information about hospitals in their location. As noted by a CMS spokeswoman, CMS released the information to “promote an informed citizenry, patient engagement in healthcare, quality improvement on the part of providers, and transparency in government.”
The documents, called “2567s,” are the written findings from federally authorized complaint investigations and detail the deficiencies found—or not—as a result of the investigation. These documents were previously available through the Freedom of Information Act or a state public records request if the particular state did not publish the information. AHJC has organized the documents on a searchable website at www.hospitalinspections.org.
The database has its limitations. First, it does not include the “Plans of Correction” that are submitted by the hospital in order to continue to receive Medicare reimbursement. These detail the steps taken to insure the deficiency is corrected and will not reoccur. Second, the database only includes complaint investigations and does not include the routine inspections that are done to insure ongoing adherence to Medicare’s Conditions of Compliance. These inspections often reveal deficiencies—some life threatening—and could be of interest to consumers comparing facilities.
Not everyone is happy with the release of the information. The American Hospital Association was not told in advance by CMS that it was releasing the database of 2567s. The AHA minimizes the value of having the documents readily accessible to the public. “Despite our hope that these data would help inform the public, the public hasn’t found the data as useful as anticipated.. it is hard even for a seasoned healthcare policy maker to understand the CMS documents or thoughtfully apply them to making informed decisions,” said Nancy Foster, Vice President for Quality and Safety for the AHA.
In Florida, the public has long had access to the 2567s for hospitals and other health care facilities. The Agency for Health Care Administration (AHCA) maintains its data—which is much more extensive that the new federal database at http://www.fdhc.state.fl.us. Users need to go to the Division of Health Quality Assurance homepage to access the various databases available. AHCA’s database includes both complaint and routine inspection findings as well as follow up inspections to insure corrections were made.
Whether all of this access to data has any effect on consumers remains to be seen. A Pew Research Center survey found that only 14 percent of internet users consult online rankings and reviews of hospitals and other facilities. A Tufts University Professor, Dr. Peter Lindenauer, comments that “the limited research on rankings suggests they have very little impact on patient behavior.”