An inspector for a private accreditation group was the first person to raise concerns about sanitation procedures at dental clinics in Galveston and Texas City during a routine survey February.
On March 23, Galveston County Health District officials cited an audit report conducted by the Joint Commission as one of the reasons the district would warn 9,500 former Coastal Health & Wellness clinic patients of their possible exposure to diseases like hepatitis C and HIV.
But while the audit’s finding prompted the public health warnings, the actual document is shielded from public information laws. Some consumer groups, and at least on U.S. Senator, thinks that should change.
The Joint Commission group in February identified 11 threat-to-life violations at Coastal Health & Wellness clinics in Texas City and Galveston, officials said.
The finding prompted the health district to temporarily close the two clinics. And in the two months since, at least two top clinic officials have resigned, clinic staff have been retrained on infection control practices and the clinic facilities have been cleaned and renovated.
While local health officials have spoken in detail about the concerns found in the Joint Commission’s report, the actual document outlining the agency’s findings has not been released.
Both the commission and the Galveston County Health District declined to share the audit with The Daily News.
That’s not unusual, one consumer advocate group said. While the commission plays a significant role in monitoring health care facilities across the country, it releases little information to the public about its findings, said Lisa McGiffert, the director of the Consumers Union’s Safe Patient Project.
The Joint Commission argues it is not a public institution and therefore not required to release its work publicly, a spokeswoman said.
By keeping the public in the dark about its work, the commission fails to act as a real watchdog of medical facilities, McGiffert said.
“This has been going on for a long time,” McGiffert said. “These accrediting agencies could reveal these reports if they wanted to, and we feel they include really important information about safety.”
The Joint Commission is an independent, non-profit organization that certifies nearly 21,000 health care organization and programs in the United States, according to its website. It offers three-year accreditation certificates.
Its accreditation allows health care facilities to receive Medicaid and Medicare reimbursements, officials said. It’s one of several accreditation services health providers can use.
The Coastal Health and Wellness Clinic accepts both Medicare and Medicaid, as well as private insurance. The clinic is the only in the county to serve people who cannot pay for medical services elsewhere.
A health district spokeswoman said on Friday that Coastal Health & Wellness did not lose its accreditation following the failed February inspection. The clinic was last accredited in 2015. The joint commission’s website, qualitycheck.org, lists the clinic’s status as having a “Preliminary Denial of Accreditation.”
“Upon its most recent site review in February this year, the Joint Commission issued a preliminary denial of accreditation, but no final action has been taken,” health district spokeswoman Ashley Tompkins said.
“The clinic has not lost its ability to receive Medicare or Medicaid reimbursement,” she said.
The commission had returned to the clinic again March 5 to conduct an abatement survey and determine if threat-to-life concerns had been addressed, she said. The commission found the issues had been addressed, she said.
The health district announced Thursday the Coastal Health and Wellness dental clinic in Texas City would reopen Monday. The dental clinic in Galveston is still closed, and the clinic’s medical clinic is not conducting invasive medical procedures that require sterile instruments, officials said.
A spokeswoman from the Joint Commission said the group does not release its full reports to the public.
“We are not a public or regulatory agency,” Joint Commission spokeswoman Katie Looze Bronk said. “We do not provide public reports. We provide survey reports to the organization surveyed, which they can choose to release or discuss.”
But groups like the Consumers Union argue the Joint Commission essentially fills a federal role because of its connection to a federal benefits program. While some information the Joint Commission identified at Coastal Health & Wellness became public, similar concerns at other local health facilities may be going under-reported, McGiffert said.
“Federal laws sort of defer to accreditation organizations to inspect these health care facilities,” McGiffert said. “It was originally created because it was going to be difficult for the federal government to inspect all theses things.
The union and other groups have pushed for years for the commission to be required to make their reports public, she said.
Last fall, U.S. Sen. Chuck Grassley, an Iowa Republican, pressed federal agencies, including the Centers for Medicare and Medicaid Services, to identify federal rules preventing commission reports from being made public and to develop ways to remove those barriers.
“The Joint Commission appears to be unable to aggressively enforce the necessary standards on all facilities,” Grassley said. “Making facility inspections reports public may go a long way to providing the necessary additional information for patients and their families to make informed decisions about where to seek care.”
There’s been no legislation proposed to remove those barriers since Grassley’s request.