Despite ongoing safety issues, API receives renewed psychiatric care accreditation

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ANCHORAGE, Alaska (KTUU) — Despite a recent Ombudsman's investigation detailing violence, sexual assault, and a dangerous environment for employees and patients, a national healthcare accreditation body has renewed Alaska Psychiatric Institute's accreditation for psychiatric care.

In a press release trumpeting the renewed accreditation by The Joint Commission — a private, non-profit organization — Department of Health and Social Services acting Commissioner Adam Crum said the renewal of accreditation is evidence of improving conditions at API.

“I am very pleased that API has once again received its Behavioral Health Care Accreditation from The Joint Commission as we were in imminent danger of losing that accreditation," Crum said. "This provides further evidence that the actions we’ve taken over the last few months are making positive improvements for our patients and staff.”

The accreditation, which retroactively took effect on Dec. 15, 2018, signals that API is in compliance with safety requirements necessary for receiving Medicare and Medicaid funds.

DHSS says the renewal follows an on-site inspection in December, 2018, which identified two areas for improvement — "medical staff and physical environment."

The two page Joint Commission report includes no specific information regarding those two findings or recommendations for improvement.

In February, the state handed over management of API to Wellpath Recovery Solutions, a national, for-profit company.

DHSS says the deficiencies defined in the initial inspection were "successfully addressed by API and Wellpath" and that compliance was confirmed by subsequent on-site inspections and review of supporting documentation.

Crum says that although the renewal is a step in the right direction, more work remains to be done to ensure a safe environment for patients and staff.

“While this accreditation is a step in the right direction we continue to work daily to improve patient and staff safety as well as striving towards receiving continued federal certification and full licensure from the State of Alaska,” Crum said in the statement.

While the accreditation may allow much-needed federal dollars to keep flowing to Alaska's only psychiatric facility — which is facing a 25% cut in Gov. Dunleavy's proposed FY2020 austerity budget after years of flat funding — the implications of the TJC stamp of approval on staff and patient safety is less clear.

A 2017 Wall Street Journal investigation found that The Joint Commission "revoked the accreditation of less than 1% of the hospitals that were out of Medicare compliance in 2014," and that "in more than 30 instances, hospitals retained their full accreditation although their violations were deemed by CMS so significant they caused, or were likely to cause, a risk of serious injury or death to patients."

CMS refers to the Centers for Medicare and Medicaid Services, the federal agency responsible for administering federal Medicare and Medicaid funding.

In response to the WSJ report, Sen. Charles Grassley, R - IA, said "it’s unclear what rock bottom a hospital would have to hit before losing accreditation.”

Ashish Jha, a health policy researcher at Harvard University and co-author of a 2018 study on patient outcomes and accreditation in U.S. hospitals echoed Grassley's sentiments, saying "accreditation is basically meaningless—it doesn’t mean a hospital is safe.”

Jha's 2018 study similarly found no evidence "to indicate that patients choosing a hospital accredited by The Joint Commission confer any healthcare benefits over choosing a hospital accredited by another independent accrediting organization."

The WSJ report also found at the time that 20 of TJC's 32 board members "are executives at health systems it accredits or else work at parent organizations of such health systems," and that other board members had ties to healthcare lobbying groups.

In a written statement, Wellpath congratulated DHSS for the accreditation renewal.

“This is a huge achievement for the Department, the staff, and, above all, the patients at API,” said Jeremy Barr, division director at Wellpath. “We appreciate the hard work that went into addressing API’s short-term challenges, and have been proud to partner with the DHSS as they worked through them. Earning reaccreditation from The Joint Commission is no easy feat, and represents hundreds of hours of effort. This is the first of many steps required to get API back to full capacity, and we look forward to continuing to improve the quality of care available at API.”

Requests for additional comment from DHSS were not returned before deadline.