Accreditation 360 model launching January 1, 2026

Beginning January 1, 2026, the JC will implement its new accreditation model, Accreditation 360: The New Standard. Accreditation 360 builds on the JC’s 2023 reduction of approximately 400 standards and seeks to eliminate additional standards. For example, more than 700 additional standards will be removed from the JC’s hospital accreditation framework. While the number of standards will be reduced, the core accreditation expectations remain the same, which the JC indicates will place a stronger emphasis on outcomes-based performance.

In a significant shift from its historical approach, the JC will also make its standards publicly available without a paid subscription or purchase. Standards in place as of July 2025 are already available on its website. Electronic manuals with additional features remain available for a charge.

The JC’s focus on advancing outcomes-based performance is further supported by its efforts to present organizational survey data in a clearer, more actionable format. It has developed tailored survey experience reports designed to better identify both deficiencies and areas of excellence. As part of its Accreditation 360 initiative, the JC will continue to use the Survey Analysis for Evaluating Risk (SAFER) matrix to help hospitals understand and prioritize deficiencies identified during their surveys, but the matrix will now include topical details to aid in immediate understanding of scoring, eliminating the need for accredited organizations to track down these details.

Complementing this change, the JC will launch the Survey Analysis for Evaluating Strengths (SAFEST) program, which is intended to highlight organizational strengths, promote the sharing of leading practices, and support continuous performance improvement. Essentially, the SAFEST program will tell organizations what they are doing “right,” instead of focusing solely on areas of noncompliance. The JC will also make peer benchmarking data accessible to accredited organizations, which have long asked how they compare to peer organizations.

The JC will introduce a new chapter in its accreditation manuals titled “National Performance Goals.” These goals replace the former national patient safety goals and incorporate elements of performance that extend beyond the requirements codified in the Medicare conditions of participation (COPs). The new framework establishes 14 national performance goals for hospitals:

• Right patient, right care
• Culture of safety
• Emergency management
• Excellent health outcomes for all
• Infection prevention and control
• Pain management
• Patient rights
• Suicide risk reductions
• Safe transplant practices
• Waived testing
• Workplace and patient safety
• Staffing
• Imaging safety
• Medication management

The JC recently announced that a new accreditation model, Accreditation 360: Continuous Engagement, will also launch on January 1, 2026. The optional continuous engagement elements of this program are designed to support hospitals and critical access hospitals in ongoing quality and patient safety improvement between traditional survey cycles.

The JC has described the Continuous Engagement model as a shift away from the traditional episodic “survey-every-three-years” approach toward a continuous partnership for quality improvement. Continuous Engagement is not intended to monitor performance or compliance. Instead, it is meant to foster collaborative engagement between the JC and accredited organizations through voluntary touchpoints (either virtual or onsite) tailored to each hospital’s needs.

Nurse staffing: New national performance goal in 2026 (goal 12)

Effective January 1, 2026, the JC will designate nurse staffing as national performance goal 12, which aligns closely with the Medicare COPs while elevating the role of nurse executives in quality and compliance. The new goal places additional expectations on nursing governance, executive oversight, and staffing adequacy while building on the existing requirements identified in the Medicare COPs. The goal further emphasizes the broad role of the nurse executive working alongside other clinical leaders in hospital governance and senior leadership decisions, which may be a paradigm shift for some healthcare organizations.

Conclusion

The JC’s 2026 initiatives represent a strategic shift toward promoting transparency and continuous engagement, with an elevated focus on performance goals, including nurse staffing, as foundations of quality and compliance.

Accredited organizations should treat these changes as an opportunity to:

• Reassess accreditation readiness
• Weigh the potential benefits of participating in the continuous engagement process
• Strengthen nurse staffing policies and governance structures
• Ensure an active role for nurse executives as part of governance and decision-making
• Prepare for more dynamic engagement with the JC
• Reinforce organization-wide quality and safety systems

Early preparation and coordinated action will help organizations prepare for success under the JC’s evolving standards.