CHARLOTTE — The commission that gave a “Gold Seal of Approval” to the VA hospital in Salisbury has questions following disclosure of suspicious deaths at the medical center.

The Joint Commission accredits most U.S. hospitals, but gave its approval to the Salisbury center without knowing about death and allegations of poor care.

“That has given us a lot of fodder for discussion with the VA,” said Joe Cappiello, the commission vice president who heads inspection operations. “The public should be able to rely on the accreditation certificate to have value and meaning.”

The commission didn’t ask about those potential problems and the VA didn’t disclose them. Instead, the commission learned about the problems at Salisbury as well as the Asheville VA center, from The Charlotte Observer.

Commission team have signed off on the Salisbury hospital for several year and didn’t know the hospital’s managers had been told about problems by independent consultants and VA investigators.

Congressional hearing are scheduled April 19 on the Salisbury hospital.

Healthcare advocates say consumers need stronger oversight of hospitals.

“Everyone in the industry knows, you scramble when (the commission) is coming, make yourself look great and then go back to normal,” said Lisa McGiffert, a Consumers Union patient advocate. “Who’s there to make sure hospitals are safe?”

In the meantime, the commission has asked both hospitals to respond to points raised in the Observer’s stories and Cappiello said the commission could conduct surprise inspections.

The commission grants accreditation, which in many states fulfills licensing requirements, to some 15,000 health care groups. Although VA hospitals have sought the group’s approval, although they don’t have to have it, to build credibility.

“Accreditation provides independent, external confirmation that a hospital is meeting high performance standards,” said Adrien Creecy-Starks, a VA spokeswoman in Washington. “It is an important part of VA’s commitment to quality.”