Johns Hopkins Hospital, a world-renowned health care center and one of Baltimore’s largest employers, is at risk of losing its accreditation because monitors in August discovered something that “poses a threat to patients or other individuals served.”

Surveyors identified two areas of concern, Liz Vandendriessche, a spokesperson for the hospital, said in a statement.

They flagged problems in the medical center’s food preparation facilities, primarily the kitchen in one of the hospital’s original buildings, and pointed out various pieces of furniture in need of repair. She declined to say more about what exactly the monitors found or share a copy of a report summarizing their findings. On Sunday, she said the problems stemmed from a routine check, and noted that this was the first time the institution’s accreditation had been threatened.

Vandendriessche stressed that the hospital has already acted to address the problems and voluntarily closed its aging kitchen, which was previously scheduled for a significant renovation. And many hospitals correct problems before they result in lost accreditation or closure. But even the threat of lost accreditation is a black eye and should raise concern for one of the nation’s best-known and sought-after medical centers, those familiar with hospital accreditation said.

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“The Johns Hopkins Hospital took these findings very seriously, and we acted immediately to address the concerns,” Vandendriessche said. “It is important to note that there were no reports of food-borne illness among patients or staff members. We also inventoried hundreds of furniture items across our campus, and repaired or replaced items as needed.”

Maureen Lyons, a spokesperson for the accreditor, an organization called the Joint Commission, said she couldn’t disclose any details about the preliminary denial of accreditation decision the commission made on Aug. 12 because the move to seek her organization’s endorsement is voluntary.

However, Maryland requires hospitals, residential treatment centers and related institutions to be accredited to qualify for licenses. That means if Hopkins Hospital lost its accreditation, it could lose its state license to operate — and with no license, it would be barred from treating patients.

Denise Anthony, chair of the Department of Health Management and Policy at the University of Michigan’s School of Public Health, said she would not have expected to see a hospital of Hopkins’ prominence at risk of losing its accreditation. But without more information on the commission’s findings, there’s no way to assess the severity of the risk to patient safety.

“Finding a broken piece of furniture in a waiting room could be considered a dangerous thing,” Anthony said. “But there could be a whole range of furniture problems that are much more serious, like broken equipment in an operating room or ICU.

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“Which is it?” she wondered. “It’s hard to tell.”

Carolyn Jacobs, a Baltimore lawyer who specializes in health care matters, described accreditation as the “proxy” that enables health care organizations to be licensed and qualified to provide vital services such as the ability to treat Medicare patients. “So, having accreditation from the Joint Commission is really key,” she said.

Jacobs, who has no connection to Hopkins Hospital’s case and spoke generally of the accreditation process, said a preliminary denial is just that, preliminary, and that most organizations avoid being sanctioned by correcting the concerns during an appeal process.

Even if surveyors wound up removing the accreditation, Jacobs said, it is not likely that any Maryland hospital would shut down. “I would think they are far from that process.”

Vandendriessche said a surveyor returned to the hospital on Sept. 6 to assess the actions taken since the August visit and was “complimentary of our progress.” She added that the commission is scheduled to meet this week to review the results of the “re-survey” and reconsider its initial finding.

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The Joint Commission uses its so-called gold seal of approval as a way to track compliance. Accreditation for most organizations runs for three-year terms, according to the commission’s website. Surveyors’ visits and reviews are unannounced and generally incorporate feedback from randomly selected patients.

Lyons, of the commission, declined to say how often hospitals receive a preliminary denial of accreditation decision or see the commission’s endorsement revoked entirely. The organization is the accrediting body for almost 80% of U.S. hospitals, according to a 2017 Wall Street Journal article.

A preliminary decision to pull a hospital’s accreditation is subject to review and appeal before the commission can make a final determination.

In the latest round of annual U.S. News and World Report rankings, Hopkins Hospital ranked No. 5, falling one position from a year earlier. In the patient experience category, which combines 10 metrics, it earned four out of five possible stars overall, scoring just two stars for satisfaction with staff responsiveness and three stars for satisfaction with efforts to reduce medication harm and satisfaction with hospital room cleanliness.

U.S. News also found the share of Black patients treated at Hopkins Hospital is substantially lower than the proportion of Black residents in the greater Baltimore community the medical center serves.

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The subhead in this story was corrected to say the Joint Commission revisited Hopkins Hospital to reinspect changes made to address problems that threatened patient safety.

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