The Facebook page for Dr. Rim Marcinkus’ Desert Plastic Surgery Center in Rancho Mirage is packed with images of patients. Each is photographed twice: First, before a nose job or facelift and second, good as new, after the face has healed.

Dr. Marcinkus, on the other hand, has some scars to show.

A February 2016 accusation filed against the physician by the Medical Board of California alleges Dr. Marcinkus “committed gross negligence” in the treatment of two patients in 2011 and 2012 – including that a doctor at his surgery center used general anesthesia during a breast augmentation surgery even though the center wasn’t accredited until 2013.

But about a week before the state accused Dr. Marcinkus of gross negligence and incompetence, a surgery center he owned in Rancho Mirage at the same address as Desert Plastic Surgery Center, Eurolift Med Inc., had its medical accreditation renewed by a private, state-approved agency, San Francisco-based Institute for Medical Quality.

SIGN UP FOR FACEBOOK NEWS ALERTS: Message us here to get started

Eurolift Med remained accredited for nearly a year after the state complaint, according to a database maintained by the Medical Board of California.

Dr. Marcinkus is not an anomaly. An investigation by Kaiser Health News found California is the only state in the country that has given private accreditors like the Institute for Medical Quality a lead role in overseeing more than 1,000 surgery centers – an approach to oversight that has resulted in laxity.

The investigation found California-approved accreditation agencies awarded gold seals of approval to surgery centers even as federal or state authorities waved red flags.

In one case not related to the Rancho Mirage doctor, the investigation found a doctor accused of “gross negligence” in connection with two patient deaths in 2014 and 2015 still received approval of a surgery center from an accreditor in 2016.

California handed oversight of surgery centers over to private agencies after a physician challenged the need for both his surgery center and he to maintain a license. The doctor prevailed in court – and in 2012, the state medical board was mandated to approve private accreditors of surgery centers instead, the Kaiser Health News investigation found. Ambulatory surgical centers can also operate with just approval from the Center for Medicare and Medicaid Services.

INVESTIGATION:California surgery center accreditation leads to patterns of lax oversight

RELATED:This small office in Indian Wells is at the center of a $14M fraud, SEC says

RELATED: Transportation access for Riverside County communities can be difference between life of pain or comfort

The private accreditation agencies today have the power to grant or deny surgery centers, as well as to inspect them. Their new role gives the agencies a guaranteed income stream from the surgery centers. The centers pay their accrediting agency around $15,000 every three years, reporting by Kaiser Health found. In exchange, the accreditors began to open their inspection reportsto public review.

The reports show accreditors and other officials didn’t always come to the same conclusion.

In a Feb. 16, 2016 report, for example, the Institute for Medical Quality evaluated Eurolift Med. The report turned up three areas in which Eurolift Med had partially met IMQ’s standards for accreditation and one area in which the center had not met the standards.

But according to an IMQ report, all of IMQ’s requirements had been met by Eurolift Med as of a note dated July 2016 – even as Dr. Marcinkus stood accused of “gross negligence” by the state medical board, charges that included allegedly prescribing an antibiotic after one patient informed him they were allergic to the treatment.

Eurolift Med’s accreditation was revoked in February 2017, according to state surgery center records. No records were immediately available to show why the accreditation was revoked.

The Medical Board of California put Dr. Marcinkus on three years' probation in August 2017. The board technically revoked Dr. Marcinkus' physician's and surgeon's certificate, but stayed the revocation and placed him on probation, so long as he completes educational courses and other requirements.

When The Desert Sun reached Dr. Marcinkus’ office seeking comment for this story, a clerk said he was not available. The doctor was in surgery. Subsequent messages to Dr. Marcinkus’ office were not returned.

But Dr. Marcinkus has responded to a previous accusation of medical malpractice in at least one court case. In 2012, a patient fitting the description of one of the cases noted by the medical board sued Dr. Marcinkus for medical malpractice. In an answer to the complaint filed in court, Dr. Marcinkus denied the patient had been "damaged" and said her claims against him were "frivolous and malicious." The patient later dismissed the complaint.

The medical board probation was not the first time Dr. Marcinkus has been sanctioned by government authorities for conduct as a physician.

Dr. Marcinkus was convicted in 2008 of a misdemeanor after allegedly injecting patients with a Botox alternative that had been labeled "not for human use" and "for research purposes only." He was placed on probation for 12 months.

Victoria Samper of IMQ did not immediately reply to an inquiry for this story. Samper told Kaiser Health News she could not comment on a specific center, but said state law requires accreditation agencies to “conduct a reasonable investigation” into a surgery center’s past owners and history. The law defines the check as ensuring a doctor has a license to practice.

Amy DiPierro covers business and real estate for The Desert Sun in Palm Springs. Reach her at amy.dipierro@desertsun.com or 760-218-2359. Follow her on Twitter @amydipierro.