Joint Commission Finally Recognizes Nurse Staffing as a National Performance Goal 2026

Joint Commission Makes History by Adding Staffing to 2026 National Performance Goals

In a watershed moment for patient safety and the nursing profession, The Joint Commission has formally recognized staffing as a critical component of healthcare quality by including it in the 2026 National Performance Goals.

• For the first time, hospitals seeking accreditation must meet specific staffing standards under Goal 12, which states: "The hospital is staffed to meet the needs of the patients it serves, and staff are competent to provide safe, quality care.
• The new standard places particular emphasis on nursing leadership through requirement 12.02.01, which specifically highlights "the role of the nurse executive in directing nurse staffing".
• Element of Performance 5 further mandates: "There must be an adequate number of licensed registered nurses, licensed practical (vocational) nurses, and other staff to provide nursing care to all patients, as needed."

This requirement represents a significant shift from previous approaches that often treated staffing as primarily an operational or budgetary concern. By elevating staffing to a National Performance Goal, The Joint Commission acknowledges what frontline nurses have long advocated – that adequate staffing is a fundamental patient safety issue requiring standardized oversight.

The timing of this change is particularly significant. According to the 2022 NSI National Health Care Retention & RN Staffing Report, hospital RN turnover reached 27.1% in 2021, with 73% of hospitals reporting increases in nurse vacancy rates. The COVID-19 pandemic exacerbated existing staffing challenges, bringing renewed attention to the consequences of inadequate nurse-to-patient ratios.

The new standard will affect all hospitals and Critical Access Hospitals beginning in 2026 as part of The Joint Commission's comprehensive "Accreditation 360" overhaul. This broader initiative aims to streamline some administrative requirements while intensifying focus on staffing and patient outcomes (The Joint Commission, 2023).

Goal:
 Ensure that hospitals are adequately staffed with competent personnel to deliver safe, high-quality care to all patients.

NPG.12.01.01 — Leadership Responsibility for Staffing

Focus: Hospital leadership ensures sufficient and qualified staff across all departments.

Key Points:

• Leaders must provide an adequate number and skill mix of staff based on services and patient needs.
• Applies to all service areas including rehabilitation, emergency, outpatient, respiratory, pharmacy, and radiology.
• Hospitals must have qualified professionals to oversee:
  • Medical records (administrative responsibility and staffing)
  • Dietetic services (qualified dietitian, director, or consultant)
  • Pharmacy (led by a registered pharmacist)
  • Infection prevention (qualified infection preventionist)
  • Surgical services (supervised by experienced RNs or physicians)

Documentation required for all key service areas.

NPG.12.02.01 — Nursing Leadership and Staffing Plan

Focus: The nurse executive, a licensed registered nurse, directs and oversees nursing operations and staffing.

Key Points:

• Responsible for nursing policies, staffing levels, and skill mix.
• Must hold or be working toward a postgraduate degree in nursing or a related field.
• Participates in hospital-wide leadership and decision-making.
• Ensures 24/7 RN supervision and that a nurse (RN or LPN) is always on duty.
• Staffing must ensure RNs are immediately available for patient care.
• Establishes policies for outpatient departments that may not require RNs, reviewed every three years.

Documentation required for nurse executive qualifications and staffing plans.

Overall Takeaways

For hospital administrators and nurse leaders, the implications are substantial. Organizations must now develop robust staffing plans, implement reliable measurement tools, and establish clear accountability structures. The standard specifically positions nurse executives as responsible for staffing decisions, creating a direct line of accountability for this critical aspect of patient care.

For bedside nurses, this change represents validation of their long-standing concerns about workload and patient safety. A 2022 survey by the American Nurses Foundation found that 89% of nurses reported their organization was experiencing staffing shortages, with 52% citing inadequate staffing as a reason they were considering leaving their position.

The inclusion of staffing in the National Performance Goals transforms it from a background concern to a measurable, accountable performance indicator that directly impacts organizational accreditation. Hospitals failing to meet these standards may face not only accreditation challenges but also potential reimbursement implications from payers who increasingly tie payment to quality metrics.

As implementation approaches, healthcare organizations have a critical window to assess current staffing models, develop evidence-based staffing plans, and ensure nurse executives have the authority and resources to meet these new requirements. The standard represents not just a compliance challenge but an opportunity to prioritize the foundation of quality healthcare – appropriate staffing with competent professionals.

🤔 Nurses, share your thoughts in the discussion forum below.

If you have a nursing news story that deserves to be heard, we want to amplify it to our massive community of millions of nurses! Get your story in front of Nurse.org Editors now - click here to fill out our quick submission form today!