The FBI and other law enforcement agencies are looking into incidents in which people masquerading as unannounced inspectors were found poking around three hospitals in Boston, Detroit and Los Angeles.
In each case the impostors were stopped by security guards or hospital staff, and then either left or were expelled. No one has been arrested, and neither the identity of the intruders nor their motives are known.
"There is no working hypothesis. It could be any number of things, from identity theft to something more nefarious," an FBI spokesman, who declined to be named, said yesterday.
The Department of Homeland Security is also "aware of these suspicious reports," said Brian Roehrkasse, a department spokesman. He added the agency does not have "any intelligence information that indicates al Qaeda is planning an attack or targeting hospitals."
Virtually all U.S. hospitals are subject to unannounced inspections by surveyors from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The surveyors can ask to see hospital records, gain admittance to nonpublic areas, and watch people work. In all three incidents, the impostors implied or stated outright they were JCAHO surveyors.
In the past the organization has occasionally gotten reports of people falsely claiming to be its inspectors. Usually, though, they were seeking favored treatment, such as moving ahead of others in the emergency room or getting copies of a patient's medical chart. That was not the case in the recent incidents, which occurred from late February through mid-March.
"We decided that this represented a pattern of behavior that we had not seen before, and our anxiety level went up," said Joe Cappiello, JCAHO's vice president for accreditation/field operations.
In the first, a well-dressed man and woman were stopped by a security guard at a Los Angeles hospital about 2 a.m. They showed badges similar to those issued by JCAHO and asked to be let in. When the guard asked for more identification, they retreated, saying they were at the wrong hospital.
The second incident occurred three days later at a hospital in Boston. A well-dressed man described as being 35 to 40 and of South Asian or Middle Eastern descent was stopped about 3 a.m.
"He seemed to have some authority about him, and again when pressed for identification that person fled the medical center," Cappiello said.
About a week later, a woman was found in the maternity ward of a Detroit hospital. She identified herself as a Joint Commission surveyor but fled when staff members asked more questions.
A fourth incident, which occurred in daylight hours on March 27 at a hospital in Sussex County, N.J., was deemed unrelated to the others. In that one, three men told a security guard they were doctors, and asked for a hospital directory and information about bed capacity and services. They did not mention JCAHO.
It is unclear whether any of the impostors in the three incidents participated in more than one. An FBI spokesman said he was "not going to get into any specifics."
Neither JCAHO nor the FBI would identify the hospitals, and officials at the hospital associations in California, Massachusetts and Michigan said they did not know.
The Joint Commission sent two security alerts to the 5,000 medical institutions it accredits, describing the incidents and warning the hospitals to be on the lookout for suspicious activities.
"It might all be coincidence," Cappiello said. Although hospitals have been named as possible terrorist targets, he noted they also may be attractive to people wanting to steal drugs, expensive equipment or identity information.
JCAHO surveyors go to about 1,700 hospitals a year, with about 300 of the visits unannounced. Only a few are done outside usual work hours, and those are usually to investigate complaints made about specific night-shift activities.
In response to the three incidents, the organization said that all unannounced surveyors will now carry a letter signed by its executive vice president.
Ron Czajkowski, vice president of the New Jersey Hospital Association, said his organization used to post on its Web site the names of Joint Commission surveyors working in the state. It stopped that practice two weeks ago.