What the Joint Commission will tell you:
This Joint compliance standard is robust: it includes internal reporting requirements and follow up.
This standard has been approved by the CMS.
Equipment not located for inspections must be reported to affected departments and include follow up to assure completion of periodic maintenance inspections.
This policy rewards departments for their efforts in complying, recognizing that different institutions present a range of obstacles that are typically found in healthcare.
The surveyor always has the authority to drill down and follow wherever the evidence leads.
However, survey organizations, including The Joint, will not explain or acknowledge the following.
Focusing compliance on adherence to a schedule, rather than numbers of devices actually inspected on time, enables care facilities to budget maintenance departments (“Biomed”) more stress-free: reporting real numbers can make an administration look bad, lending support to an increase in funding for maintenance – not a position administrations want to be in. This is one reason hospitals prefer a standard that enables an easier 100% compliance. And a Biomed administrator can more easily demand that their staff meet a schedule than they can demand technicians increase the number of devices inspected in an hour.
I can fully appreciate how difficult it is to challenge The Joint: in some cases, your job may even be at stake. I understand, I’ve been there.