Table 1

Comparison of Regulatory/Monitoring Bodies

Monitoring Agency	CMS^{^a}	TJC^{^b}	DOJ^{^c}
Investigation triggered by a Sentinel Event	Sometimes	Sometimes	Always
Routine and ongoing survey as part of conditions of participation	Yes	Yes	No
Compliance with federal regulatory standards for hospitals	Sets and ensures compliance with conditions of participation	Meets or exceeds CMS conditions of participation through establishment of elements of performance	Establishes own standards
Participation	Voluntary	Voluntary	Involuntary
Effect of hospital’s certification	Deems hospital eligible to receive Medicare and Medicaid reimbursements	Deems hospital eligible to receive Medicare and Medicaid reimbursements	Prevents closure of hospital
Hospital Expenses	No payment for regulation	Pays TJC a fee to be included in the survey process	Pays DOJ consultants for ongoing monitoring of process until compliance with settlement agreement is reached
Regulatory or survey process	Collaborative	Collaborative	Adversarial
Attorneys as part of team of investigators/surveyors	No	No	Yes
Investigation or survey based on court order or settlement agreement	No	No	Yes
Finite period of investigation or survey known at start	Yes	Yes	Yes
State and privately owned hospitals affected	Yes	Yes	No (only state hospitals)
Survey initiated as a result of a complaint	Yes	Yes	Yes