The Joint Commission: Regulatory Agency or Private Organization?

Is you is or is you ain’t my baby? – Louis Jordan, Chris Barber

A key private company that teaches nursing students thinks it is a regulatory agency.  One of its exercises asks, “A nurse is explaining the differences among the various agencies that address health care. The nurse should note that which of the following are health care regulatory agencies? (select all that apply)”.  Content Mastery Series, Fundamentals for Nursing, Ed. 8.0 (2013).

The possible answers include: The Joint Commission on Nursing, State boards of nursing and the Food and Drug Administration (FDA).  Surprisingly, all three are the correct answer according to ATI Testing.  The second two are obvious regulatory agencies.  State boards of nursing can also have judicial powers.

The Joint Commission (TJC), formerly known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), does not consider itself to be a regulatory agency.  It calls itself “an independent not-for-profit organization”.1

TJC has a president and chief operating officer.2  Regulatory agencies do not have presidents and chief operating officers.  They are governed by appointees of elected officials.

What is the Cause of Confusion?

TJC accredits and certifies that programs are in compliance with its standards.3  Regulatory agencies then incorporate that accreditation or compliance into their regulations.  In Nevada, a hospital can operate without TJC accreditation.  Such a hospital would then be inspected on-site annually by the Nevada state agency, the Department of Health and Human Services.  NAC 449.310.  If the hospital is accredited by TJC, then no such inspection is required.

The Nevada government is outsourcing quality control to a private organization in the TJC.  Most, if not all, of U.S. states do.

Another way Nevada controls hospitals via TJC is by determining what medical services will by paid for by government-funded insurance.  For the treatment of abuse of alcohol and drugs, it will be paid if licensed by the Health Division of DHHS and accredited by TJC.  NRS 689A.046.

Therefore, TJC is not a regulatory agency, at least not in Nevada.






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