Technical issues also surround some of the finer points of the for-profit certification process established by McDonough and Braungart.
The watches are COSC-certified, a process that adds a few thousand to the price and basically means that the watch has been tested at the Contrôle Officiel Suisse des Chronomètres, a non-profit certification organization.
He is earning his teaching certificate through an online, for-profit alternative certification program, a nontraditional route to teaching that is becoming more common in Texas.
While virtually all paths to the classroom have seen declines since 2003, according to Mr. Fuller's analysis, for-profit alternative certification programs have grown by 23 percent.
Then, the state "didn't regulate who was operating private programs, and people saw that was a way to make a fast buck," said Rae Queen, the president of the Texas Alternative Certification Association, who also runs a for-profit alternative certification program in San Antonio.
The finding that size, length of Medicare certification, and profit status are associated with provision of radiotherapy services lends credence to suggestions that current reimbursement practices discourage the use of PRT in hospice care, particularly for low-volume hospices.
The company has put an undisclosed amount of seed funding into the Center for Resource Solutions so the non-profit can launch renewable certification programs in Asia.
ACE is the largest non-profit health and fitness certification organization in the world, and it has certified more than 60,000 fitness professionals since its inception in 1985.
IteachTexas, begun in 2003, is the first for-profit, non-university based alternative certification program to expand across state lines, with the newly created iteachU.S. operating programs in Louisiana and Tennessee.
Provision of radiotherapy services was associated with larger size (measured by total number of hospice days reported in the HCRIS), longer length of Medicare certification, not-for-profit status, and a higher proportion of patients surviving more than seven days after admission.
Princeton Review was also accused of having employees forge signatures, falsify sign-in sheets and create fake certifications to "deceitfully profit from a well-meaning program," the U.S. attorney Preet Bharara said in a statement at the time.
