What is Joint Commission Accreditation 360, and does it apply to ambulatory care?

Accreditation 360 is Joint Commission's rewrite of its accreditation approach, rolled out first to the Hospital and Critical Access Hospital programs in 2026, with 14 National Performance Goals replacing the National Patient Safety Goals for those programs. Ambulatory Health Care is not yet in scope and keeps its National Patient Safety Goals chapter.

What Accreditation 360 is

Joint Commission announced Accreditation 360 in June 2025.¹ For hospitals it updated the accreditation manual to separate CMS Conditions of Participation from Joint Commission's own requirements, removed more than 700 requirements from the hospital program on top of 400 removed in 2023, and organised the rest into 14 National Performance Goals.² It also added a voluntary continuous engagement model, the SAFEST program for recording strengths, and public standards for all programs.²¹

Joint Commission says Accreditation 360 is being rolled out first to the critical access hospital and hospital programs in 2026, that work has started on the remaining programs, and that their implementation dates are still to be determined.¹ Ambulatory organisations still prepare with a Survey Activity Guide, the September 2026 release for ambulatory care.³

The 14 National Performance Goals

Joint Commission lists them as Right Patient, Right Care, Culture of Safety, Emergency Management, Excellent Health Outcomes for All, Infection Prevention and Control, Pain Management, Patient Rights, Suicide Risk Reduction, Safe Transplant Practices, Waived (Point-of-Care) Testing, Workplace and Patient Safety, Planning and Evaluating Provision of Care, Imaging Safety, and Medication Management.¹ They bring together existing requirements that go beyond the CMS Conditions of Participation, with no new requirements added.⁴

1. List your programs. Separate hospital and critical access hospital accreditation from ambulatory, behavioral health and other programs.
2. Use the right guide for each. The Survey Process Guide for hospitals, the Survey Activity Guide for ambulatory care.
3. Read the disposition reports. Joint Commission publishes where each hospital requirement moved, was consolidated or was removed.
4. Keep ambulatory on the NPSGs. Clinics and surgery centres in the system keep the National Patient Safety Goals chapter until Joint Commission sets their date.
5. Watch for the next programs. Check the Accreditation 360 FAQs for implementation dates for non-acute programs.

1. Site ______ Joint Commission program ______
2. Manual in force ______
3. Goals chapter, NPG or NPSG ______
4. Survey guide, SPG or SAG ______
5. Last full survey ______ Next window ______

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What has not changed

Joint Commission says the survey process for evaluating compliance has not changed under Accreditation 360, and there are no new documentation expectations.¹ The SAFER Matrix still scores findings, with SAFEST added to record strengths.⁵ For the ambulatory side of a system, see the National Patient Safety Goals for ambulatory care and the clinic AI guide for Washington DC.

Questions

Does Accreditation 360 apply to ambulatory care?

Not yet. It was rolled out first to the hospital and critical access hospital programs in 2026, and Joint Commission has not set dates for the other programs.

What replaced the National Patient Safety Goals for hospitals?

14 National Performance Goals, effective 1 January 2026, which incorporate the former National Patient Safety Goals.

Did Accreditation 360 change the hospital survey process?

Joint Commission says the survey process to evaluate compliance has not changed, though the Survey Process Guide replaced the Survey Activity Guide for hospitals.

Sources

1. 1Joint Commission, 2026Accreditation 360, Frequently Asked QuestionsRead source
2. 2Joint Commission, 2026Accreditation 360, The New StandardRead source
3. 3Joint Commission, 2026Survey Activity GuidesRead source
4. 4Joint Commission, 2026National Performance Goals (NPGs)Read source
5. 5Joint Commission, 2026What is the SAFER Matrix?Read source

Written by the wai team from Joint Commission guidance, checked on 15 October 2026. This is guidance, not legal advice. Joint Commission does not endorse wai or any software.