Joint Commission Accreditation

Key facts

Accrediting body

The Joint Commission, an independent nonprofit organization

Founded

1951, as the Joint Commission on Accreditation of Hospitals

Former name

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

Medicare role

CMS-approved accrediting organization that can grant deemed status

Deeming authority

Section 1865 of the Social Security Act

What is Joint Commission accreditation?

The Joint Commission evaluates organizations against its published standards, including National Patient Safety Goals, through on-site surveys. It accredits hospitals, Critical Access Hospitals, ambulatory care and surgery centers, behavioral health programs, home care and hospice providers, laboratories and nursing care centers, and it offers disease-specific certifications such as stroke center certification.

Accreditation is voluntary, but for hospitals it is closely tied to Medicare. Under Section 1865 of the Social Security Act, CMS can deem a provider accredited by an approved accrediting organization to meet Medicare Conditions of Participation without a routine state agency survey. The Joint Commission once held statutory deeming authority for hospitals; the Medicare Improvements for Patients and Providers Act of 2008 removed it, so The Joint Commission now needs CMS approval like other accreditors.

How accreditation and deemed status work

The process combines private surveys with federal oversight:

• Surveys are generally unannounced and use tracer methodology, following individual patients through the organization to test compliance in practice.
• Organizations must correct findings within set timeframes to keep accreditation.
• Hospitals seeking deemed status are surveyed against standards that CMS has found to meet or exceed the Conditions of Participation.
• CMS oversees accreditors through validation surveys by state agencies and can authorize complaint investigations of deemed hospitals.
• CMS has approved other hospital accrediting organizations, so a hospital without Joint Commission accreditation is not necessarily unaccredited or uncertified.

Why accreditation status matters

Accreditation is a common screen for quality, capability and risk:

• Specialty certifications, such as comprehensive stroke center status, help device and pharma teams identify hospitals equipped for advanced procedures.
• Payers often require facility accreditation as part of credentialing and network participation.
• Accreditation status and any loss of accreditation are due diligence signals before acquisitions or partnerships.
• Because accreditors and state agencies both survey facilities, quality analysis should combine accreditation status with CMS survey deficiency data.