VALDOSTA — With South Georgia Medical Center’s accreditation in question, an industry consultant was asked what would be the worst that could happen.

“Most hospitals would not be open after the denial (of accreditation),” said Troy Lair, principal consultant for Ambulatory Accreditation Consultants of Los Angeles.

The Joint Commission, which accredits and certifies about 21,000 hospitals and health-care organizations across the U.S., announced Sept. 17 it was issuing a “preliminary denial of accreditation” to SGMC following an on-site survey three days earlier, citing “a condition, which in the Joint Commission’s view, poses a threat to patients or other individuals served.” Neither the hospital nor the commission have revealed the stated condition.

Out of 3,958 facilities on a Joint Commission list, only 21 were labeled “preliminary denial of accreditation.” SGMC’s laboratory services, which are surveyed by the commission separately, remains accredited.

SGMC was given up to 45 days to tackle the Joint Commission’s concerns, said Sam Allen, chairman of the Hospital Authority of Valdosta and Lowndes County.

If the accreditation denial is made permanent after the deadline, the hospital would face a crippling financial situation, said Lair, who advises hospitals on accreditation problems but is not involved in the SGMC case.

For starters, Medicare would stop paying the hospital, he said. In 2016, 49 percent of SGMC patients were on Medicare, according to a study commissioned by the hospital. In Georgia, hospitals which meet Joint Commission standards are regarded as meeting all Medicare requirements, according to the Georgia Department of Community Health. 

On top of that, private insurers would refuse to pay claims for the hospital’s services, Lair said.

“Insurance companies will do anything in the world to deny payments anyway,” he said.

A hospital with no accreditation could still technically admit patients as long as it had a state license, but there would be no way to collect payment, Lair said.

Patients now in SGMC wouldn’t need to worry, as they have already been cleared by insurance or Medicare for treatment, he said.

When a hospital gets a preliminary denial, state authorities are alerted, which means a state investigation often follows, Lair said.

In addition, any satellite facilities owned and operated by a hospital without accreditation could be in trouble as well, he said. SGMC operates two smaller hospitals, in Berrien and Lanier counties, but those facilities are not affected by the current accreditation trouble because they are surveyed by the Joint Commission separately, said Richard Huth, administrator for the two facilities.

Given South Georgia Medical Center’s position as the only hospital in Lowndes County, it’s possible the state and the Joint Commission would hold off on doing anything that would close its doors, Lair said.

“Most places in this situation put together a team, bring in consulting firms, do whatever it takes to get their accreditation straightened out,” he said. 

According to a prepared statement from SGMC, the authority board said it is taking actions to address the items identified in the Joint Commission survey and will implement work plans to ensure there are no disruptions to services. However, the statement failed to identify the areas of concern.

Sam Allen, chairman of the Hospital Authority of Valdosta and Lowndes County, said he is confident SGMC will beat the 45-day deadline. 

 

Terry Richards is senior reporter at The Valdosta Daily Times.