Accreditation 360: What It Is — and Why It Matters

The Joint Commission's Accreditation 360 program represents the most significant update to hospital accreditation in more than a decade. Rolling out January 1, 2026, Accreditation 360 applies to hospitals and critical access hospitals and is designed to simplify, align, and modernize how organizations are surveyed — without changing what they are expected to do.

A Simpler, More Aligned Accreditation Model

Accreditation 360 replaces the long-familiar Environment of Care (EC) and Life Safety (LS) chapters with a new, unified structure:

• PE (Physical Environment) – consolidates the requirements that govern how hospitals manage and maintain the built environment, fire and life safety systems, utilities, and medical equipment.
• NPG (National Performance Goals) – gathers certain performance-based standards related to staff safety, emergency management, infection prevention, workplace violence, competency, and patient rights.

The goal is alignment — ensuring Joint Commission standards match the CMS Conditions of Participation (CoPs) and the State Operations Manual more directly. By eliminating duplication, Accreditation 360 cuts the total number of standards and elements of performance (EPs) by nearly half, making the manual more readable and less redundant.

The Purpose Behind Accreditation 360

According to Jim Grana, Field Director at the Joint Commission:

"Accreditation 360 simplifies and unifies our standards with CMS requirements. Instead of layers of overlapping interpretation, we're aligning expectations so hospitals can focus on what matters most — safety, compliance, and outcomes."

In other words, Accreditation 360 is about clarity, not complexity. Hospitals will use the same survey process and tools they've always used, but the standards they're measured against will be streamlined.

What's Changing with Accreditation 360

Current (Through 2025): EC (Environment of Care) & LS (Life Safety) chapters → New (Beginning 2026): PE (Physical Environment)

• 40+ standards and 450+ EPs → 12 standards and 67 EPs (≈75% reduction)
• Separate, sometimes overlapping requirements → Unified, CMS-aligned structure
• Multiple interpretations → Single, simplified scoring and documentation

The survey process itself does not change. Organizations will still see familiar tools such as the Document Review Tool, Building Tour, Kitchen Tracer, Emergency Management Review, and the SAFER matrix for scoring risk and pervasiveness.

What's Staying the Same

• Conditions of Participation (CoPs) remain unchanged.
• NFPA codes (101 and 99, 2012 editions) remain in effect — no new codes are being adopted.
• Survey complement, length, and agenda stay identical.
• Expectations for compliance are unchanged; only the labeling and organization of the standards are different.

"If you had a successful survey last time," says Grana, "you should expect a successful one again in 2026 — because the process hasn't changed."

Joint Commission Accreditation 360: New Tools and Resources

To help hospitals prepare, the Joint Commission has released a series of free resources:

• PE and NPG Webinars – 25–30 minute overviews explaining how old standards map to new ones.
• Survey Process Guide (2025 edition) – the updated 600-page playbook replacing the Survey Activity Guide, including all updated tracer tools.
• Disposition Report – a "crosswalk" showing exactly where each current EP landed (deleted, moved, or revised).
• Crosswalk Compare Report – aligns Conditions of Participation with both old and new standards.
• Accreditation 360 FAQ – an evolving library of real questions from the field.

Accreditation 360 Requirements: What Hospitals Should Do Now

1. Review the PE and NPG webinars for an overview.
2. Download the Disposition Report and map your EC and LS programs to PE and NPG.
3. Update internal documentation (policies, references, and training materials) to reflect new nomenclature.
4. Use the updated survey tools to perform internal mock surveys.
5. Keep monitoring Joint Commission newsletters (Perspectives, EC News) for micro-updates.

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