Yet the article stated, "the joint commission's practices raise questions about potential conflicts of interest and the rigor of its hospital surveys." The article charged:
- There have been "glaring examples" of JCAHO missing important quality problems, notably at Redding Medical Center (California), Maryland General Hospital, Norwalk Hospital (Connecticut), and Palm Beach Gardens Medical Center (Florida).
- "The board of directors of the joint commission is dominated by representatives of the American Hospital Association and the American Medical Association." [The listing of the current Board of Commissioners is here. The listing does not appear to have many people with overt associations with the AHA and AMA. The web-site describes the Board as having "diverse experience in health care, business and public policy. The board consists of 29 individuals, including physicians, administrators, nurses, employers, a labor representative, health plan leaders, quality experts, ethicists, a former health insurance executive, a consumer advocate and educators."]
- "About 99 percent of the hospitals reviewed by the joint commission win accreditation...." "Some critics point to the approval rate as evidence that the joint commission is captive to hospitals."
- JCAHO sells hospitals "We Are Accredited" products, e.g. "banners, coffee mugs and enamel pins."
- JCAHO has a "subsidiary, Joint Commission Resources, [which] was established in the 1990s to consult with hospitals on how to gain accrediation and improve their performance." "Directly or indirectly, most of JCR's nearly $33 million in revenue comes from helping hospitals win the joint commission's seal of approval." JCR CEO Karen H. Timmons "said that there is a firewall between the subsidiary and the joint commission...." However, there are substantial money flows between the groups. "In the past three years, JCR has paid its parent about $10.5 million in management fees and $867,000 in royalties. And according to its 2003 tax return, JCR owes the joint commission nearly $8.4 million."