Accreditation Association
for Ambulatory Health Care, Inc.

March 15, 2004
Jerry Stem, MD
Commonwealth Endoscopy Center, Inc.
120 West Center Street Suite 1
West Bridgewater, MA 02379-1600

Dear Dr. Stern;
It is our pleasure to inform you that Commonwealth Endoscopy Center, Inc. has been accredited for a term of three years by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC). Your accreditation Is effective as of January 6, 2004. In making this accreditation decision, AAAHC applied not only the accreditation standards generally applicable to all organizations, but also all additional Medicare-related criteria required for accreditation in the Medicare deemed status program as a Medicare-related ambulatory surgical center.
The dedication and effort necessary for an organization to be accredited is substantial and your organization is to be commended for this accomplishment. Granting accreditation reflects our confidence, based on evidence from your recent survey, that you meet, and will continue to demonstrate throughout the accreditation term, the attributes of an accreditation organization as outlined by the standards In the Accreditation Handbook for Ambulatory Health Care'. The spirit of those standards implies a commitment to continual self-evaluation and improvement.

We encourage your organization to carefully review the enclosed Survey Report as a guide to the ongoing process of self-evaluation. "Recommendations Made to the Organization Regarding Standards" are directly related to the standards and require corrective action Therefore, subsequent surveys by the AAAHC will seek evidence that recommendations from this survey have been addressed without serious delay and that the attributes expressed in the standards have been continuously evident during the term of accreditation. Statements in the "Consultative Comments" section of the report are part of the "consultative" portion of the survey, do not affect the accreditation decision, and therefore are not considered deficiencies.
To maintain your accredited status, the AAAHC will notify you several months prior to the expiration date of your current term of accreditation. Please note that all Medicare surveys are conducted on an unannounced basis.

March 15,2004 Jerry Stem, MD Page 2
It is our sincere hope that you will continue to find the accreditation experience worthwhile, not only from the recognition that your participation in this survey process brings,, but also from the benefit of having carefully reviewed your own operation.

If you have any questions or comments about any portion of the accreditation process, please contact AAAHC
at (847) 853-6060.

Sincerely,
Gerald G. Edds, MD, FACS
President
Accreditation Association for
Ambulatory Health Care, Inc.