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        <BusinessName>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Jean Courtney CPA</BusinessNameLine1Txt>
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      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Joel Roos</BusinessNameLine1Txt>
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        <TitleTxt>VP Intl Accred, Quality Improvement &amp; Patient Safety</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Lisa Diehl Vandecaveye JD HRM FACHE</BusinessNameLine1Txt>
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        <BusinessName>
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      <Form990PartVIISectionAGrp>
        <BusinessName>
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      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Ying Qu</BusinessNameLine1Txt>
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      <Form990PartVIISectionAGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Catherine Hinckley</BusinessNameLine1Txt>
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        <TitleTxt>Exec Dir, Publications</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <BusinessName>
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        <TitleTxt>ED-US &amp; CSR Consulting Srvcs</TitleTxt>
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        <BusinessName>
          <BusinessNameLine1Txt>Andrea Q Slattery</BusinessNameLine1Txt>
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      <Form990PartVIISectionAGrp>
        <BusinessName>
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        <BusinessName>
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          <USAddress>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>175026</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2565</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>886113</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>136207</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Mark R Chassin MD FACP MPP MPH</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>1307407</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>220107</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>31456</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>43146</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1602116</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Jean Courtney CPA</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Chief Operating Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>260368</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>123628</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>-92777</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>20927</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>312146</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>120999</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Ying Qu</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>VP EPRODUCTS &amp; PER</TitleTxt>
        <BaseCompensationFilingOrgAmt>256258</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1562</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>125787</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27162</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>410770</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Paige Rodgers CPA</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Treasurer &amp; Chief Financial Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>505888</CompensationBasedOnRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>19495</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>913135</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>256580</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Lisa Diehl Vandecaveye JD HRM FACHE</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Secretary &amp; General Counsel</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>373406</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>6016</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>127390</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>43207</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>550019</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Marwa Zohdy PHD</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>VP GLOBAL CONSULTATIVE SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>265562</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>1332</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>242078</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>901</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>509873</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Catherine Hinckley</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Exec Dir, Publications</TitleTxt>
        <BaseCompensationFilingOrgAmt>190913</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>1726</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>19745</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>25267</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>237650</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Kristine Slepicka</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>ED-US &amp; CSR Consulting Srvcs</TitleTxt>
        <BaseCompensationFilingOrgAmt>182884</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1175</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9006</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27946</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>221011</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Paul Eskew</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>ED INTL CONSULTING</TitleTxt>
        <BaseCompensationFilingOrgAmt>154677</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>60200</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7041</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>36864</NontaxableBenefitsFilingOrgAmt>
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        <TotalCompensationFilingOrgAmt>258782</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Dana E McGrath</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Regional Client Relations Manager</TitleTxt>
        <BaseCompensationFilingOrgAmt>106794</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>37049</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>26592</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9847</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>25578</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>205860</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Bhavna Mishra</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Exec Director Electronic Products</TitleTxt>
        <BaseCompensationFilingOrgAmt>163828</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>1134</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>11243</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>25671</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>201876</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Bonnie L Quinn</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Executive Director Global Strategy</TitleTxt>
        <BaseCompensationFilingOrgAmt>162168</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1969</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>20387</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>41240</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>225765</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Andrea Q Slattery</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Director Consultant Development</TitleTxt>
        <BaseCompensationFilingOrgAmt>162918</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1054</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8277</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8196</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>180445</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a First-class or charter travel</FormAndLineReferenceDesc>
        <ExplanationTxt>JOINT COMMISSION RESOURCE'S TRAVEL POLICY PERMITS REIMBURSEMENT FOR THE PURCHASE OF UPGRADE COUPONS FOR FIRST-CLASS AIR TRAVEL. FIRST CLASS AIR TRAVEL BENEFITS ARE NOT TREATED AS TAXABLE COMPENSATION TO THE INTERESTED PERSON.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a Personal services</FormAndLineReferenceDesc>
        <ExplanationTxt>TWO OFFICERS UTILIZED AN ALLOWANCE FOR TAX PREPARATION SERVICES. NOT ALL OFFICERS ELIGIBLE FOR THESE SERVICES UTILIZE THEM. THESE SERVICES ARE TREATED AS TAXABLE COMPENSATION AND REPORTED ON SCHEDULE J, Part II Column (B)(iii), other reportable compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4a Severance or change-of-control payment</FormAndLineReferenceDesc>
        <ExplanationTxt>Joint Commission Resources made payments pursuant to an agreement in connection with staff separations. These payments were treated as taxable compensation and reported on Schedule J, Part II Column (B)(III), Other Reportable Compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>All officers are allowed to participate in a nonqualified supplemental defined benefit retirement plan. The increases in the value of the plan during the year are reflected in Column C deferred Compensation on Schedule J.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 5a Compensation contingent on revenues of the organization</FormAndLineReferenceDesc>
        <ExplanationTxt>BUSINESS DEVELOPMENT INCENTIVE PLAN JCR'S HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVED THE 2019 AND 2020 BUSINESS DEVELOPMENT INCENTIVE COMPENSATION PLAN, WHICH REWARDS REVENUE GENERATION FOR BOTH DOMESTIC AND INTERNATIONAL BUSINESS DEVELOPMENT. ACTUAL AWARDS MADE TO PLAN PARTICIPANTS WERE BASED ON 1% of the Target Incentive Amount for each 1% of Annual Sales Revenue Quota Performance Attainment. For amounts greater than the Annual Sales Revenue Quota Performance Target, the incentive was 1.5%. THERE IS A PLAN FOR GENERAL CONSULTANTS. THIS PLAN HAS 3-TIERS OF SALES RANGES OF $3,000 -24,999 in 2020 and $5,000-24,999 in 2019 FOR TIER 1, $25,000-$99,999 TIER 2, AND OVER $100,000 TIER 3, WITH A FLAT INCENTIVE PAYOUT RANGING FROM $100 , $500 AND $1,000, RESPECTIVELY. Each plan caps the maximum award opportunity to participants based on job function. PARTICIPANTS IN THIS PLAN DO NOT PARTICIPATE IN ANY OTHER INCENTIVE PLANS. FOR THE BUSINESS DEVELOPMENT INCENTIVE PLAN THERE WERE AWARDS ACCRUED FOR BASED ON 2019 FINANCIAL RESULTS FOR THE YEAR ENDED DECEMBER 31, 2019 THAT WERE PAID IN 2020. FOR THE BUSINESS DEVELOPMENT INCENTIVE PLAN THERE WERE AWARDS ACCRUED FOR BASED ON 2020 FINANCIAL RESULTS FOR THE YEAR ENDED DECEMBER 31, 2020 THAT WILL BE PAID IN 2021.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="20011424" softwareVersionNum="2020v4.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 1 Organization's Mission</FormAndLineReferenceDesc>
        <ExplanationTxt>(Continuation from Form 990 Part III, Line 1) Joint Commission Resources (JCR), a wholly controlled, not-for-profit affiliate of The Joint Commission, is a global, knowledge-based organization that disseminates information regarding accreditation, standards development and compliance, good practices, and patient safety and performance improvement. Joint Commission International (JCI), a division of JCR, has extensive experience working with public and private healthcare organizations, ministries of health, and local governments in more than 100 countries. JCI provides accreditation based on international standards, as well as third-party review and evaluation services. Examples of Projects in Support of JCR's Mission JCR's mission aims to help all healthcare providers no matter where they are on their journey in providing safe patient care. This resulted in the creation of JCI Navigator, designed to help organizations that we have not been able to serve with Accreditation. JCI Navigator is an online solution available to hospitals that are at the early stages of establishing quality and patient safety improvement initiatives.. In 2020, the Infection Prevention and Control Navigator module was shared with global organizations at no cost to assist in their efforts in building resilient infection prevention and control systems in the wake of the COVID-19 global pandemic. JCI-CRHG Academy of Hospital Management JCI has entered into a joint venture with China Resources Healthcare Group (CRHG), a healthcare organization in the People's Republic of China, to introduce JCI's knowledge system of quality and patient safety through training, education, and publications to educate local professionals in quality management, thus improving the quality and safety in Chinese healthcare organizations. The JCI-CRHG Academy of Hospital Management began offering education programs in China in 2016. Following this venture, in addition to the education offerings, the JCI-CRHG Academy of Hospital Management translated several JCR publications into simplified Chinese for release into the Chinese market. Free Resources JCR offers more than 125 free resources on quality and patient safety to customers and the public. These free resources, which are available on JCR's Web site, include articles published in JCR periodicals, books, whitepapers, toolkits, and checklists, on topics ranging from medication management to infection prevention and control to emergency management. In addition, JCR also partnered with Deloitte to develop and publish a free white paper entitled "COVID-19 Lessons Learned: A Resource for Recovery." The white paper catalogues a broad array of lessons learned and best practices identified during the period of March through August 2020. It lays out specific actions that healthcare organizations have taken to address a variety of issues, and provides access to guidance and tools that health care leaders can use to implement their own plans in pandemic management and recovery. JCR Primary Program Services JCR's primary program services are described below. Joint Commission International Accreditation JCI provides international standards and accreditation programs for international healthcare organizations. JCI standards and evaluation methods are designed to provide quantifiable benchmarks for patient care quality and improvement, to stimulate and support sustained performance improvement, and to provide a framework for risk reduction for international healthcare organizations. JCI offers accreditation programs for hospitals, academic medical centers, clinical laboratories, ambulatory care, long term care, home care, primary care, and medical transport organizations. JCI also provides disease-specific and clinical care program certification in programs such as primary stroke, heart failure, chronic kidney disease, HIV/AIDs, oncology care, palliative care, and diabetes care. JCI has accredited nearly 1000 healthcare organizations in more than 70 countries. JCI's accreditation program/organization, standards, and surveyor training program are accredited worldwide by the International Society for Quality in Health Care External Evaluation Association (IEEA), a non-profit, independent organization that accredits healthcare accrediting bodies. Accreditation under IEEA provides the assurance that the standards, training, and processes used by JCI to survey healthcare organizations meet the highest international benchmarks for accrediting bodies. Consultative Technical Assistance JCR supports its mission by providing consultative technical assistance services to healthcare organizations, ministries of health, and other third-party stakeholders on topics such as quality of care, patient safety, performance improvement, infection prevention and control, medication safety, environment of care, health-related systems evaluation, and accreditation preparation assistance. JCR also helps international governments develop their own national accreditation systems and broader quality and safety improvement strategies. JCR also offers consultative technical assistance to hospitals in the U.S. and globally (through JCI) that are renovating or building new healthcare structures. This service, Safe Health Design, integrates Joint Commission or JCI standards requirements, evidence-based design principles, and globally recognized patient safety and quality practices. JCR assists organizations in their efforts to maintain safe, high quality care by providing professionals to temporarily oversee certain quality and safety activities. The service can provide focused quality improvement in patient care and safety areas that need attention (e.g., readmissions and falls) and sharing of best practices from professionals with deep industry knowledge. Publications and Multimedia Applications JCR, the official publisher for the Joint Commission, publishes accreditation manuals, books, and periodicals on standards compliance, patient safety, performance improvement, infection control, medication management, and other issues related to healthcare quality. These resources are offered in print and electronically, including through web-based applications. JCR also manages The Joint Commission's peer-reviewed journal on quality and patient safety. JCR also offers electronic accreditation and certification manuals and other electronic products to help healthcare organizations assess and manage their compliance with Joint Commission standards and support organizations' efforts to improve the quality and safety of healthcare delivery. In addition, JCR offers a Web-based tool that allows healthcare organizations to trace a simulated patient's care throughout an organization to identify focus areas related to standards compliance, patient safety, and performance improvement. JCR also offers an online multimedia portal that features information about CMS' Conditions of Participation requirements and survey methodology for accredited and non-accredited hospitals. Other JCR Program Services JCR offers a service called Continuous Service Readiness that provides ongoing guidance with a dedicated healthcare quality and safety expert to help organizations meet the standards to achieve and maintain Joint Commission accreditation and/or disease-specific care certification. In addition, JCR aids organizations that are preparing for CMS or state agency (on behalf of CMS) surveys. JCR (and internationally through JCI) offers seminars, conferences, webinars, and other education programs that address standards compliance, performance improvement, and patient safety, among other topics, for different healthcare settings. JCI also offers diploma- and certificate-style education programs, which are intensive, 3-12 month education programs, for infection control and quality management and patient safety staff within healthcare organizations. JCR offers most of its educational offerings with continuing education credits from ANCC, ACCME, and ACHE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d Description of other program services</FormAndLineReferenceDesc>
        <ExplanationTxt>(Expenses $ 7,611,989 including grants of $ 0)(Revenue $ 7,829,767) JCR offers a service called Continuous Service Readiness that provides ongoing guidance from a dedicated healthcare quality and safety expert to help organizations meet the standards to achieve and maintain Joint Commission accreditation and/or disease-specific care certification. In addition, JCR aids organizations that are preparing for CMS or state agency (on behalf of CMS) surveys. JCR (and internationally through JCI) offers seminars, conferences, webinars, and other education programs that address standards compliance, performance improvement, and patient safety, among other topics, for different healthcare settings. JCI also offers diploma- and certificate-style education programs, which are intensive, 3--12 month education programs, for infection control and quality management and patient safety staff within healthcare organizations. JCR offers most of its educational offerings with continuing education credits from ANCC, ACCME, and ACHE. (See Schedule O, Part III, Line 1, for further description)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 16b Written Policy for Evaluation of Participation in JV Arrangements</FormAndLineReferenceDesc>
        <ExplanationTxt>Although there is no formal written policy, such arrangements are evaluated by the Enterprise Legal Department, appropriate accounting department personnel, and external tax advisers for compliance with applicable federal tax law, including taking appropriate steps to safeguard the corporation's tax exempt status. Furthermore, JCR Articles of Incorporation provide that The Joint Commission, as the sole member of JCR, reserves the power to approve all creations of subsidiaries or controlled affiliates, all permanent or long-term affiliations and all joint ventures of JCR involving capital investment in excess of $250,000. In addition, JCR's Code of Conduct highlights legal and ethical obligations to act in compliance with applicable laws and to engage in activities in furtherance of JCR's charitable purpose.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 8b Committee Authority to Act on behalf of the Governing Body</FormAndLineReferenceDesc>
        <ExplanationTxt>All board committees document their meetings and actions taken. However, no board committees have authority to act on behalf of governing board except by board resolution.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1a Delegate broad authority to a committee</FormAndLineReferenceDesc>
        <ExplanationTxt>As the sole member of the filing organization, The Joint Commission, a related tax-exempt organization, has broad authority to act on behalf of the governing body. Please see the narratives for Part VI, Lines 6, 7a and 7b for a description of such authority.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization has one sole member, The Joint Commission. The Joint Commission has the power to: 1) Appoint all Directors to the Board and remove them, with or without cause. 2) Appoint the Chairman, Vice-Chairman and the President/ Chief Executive Officer (President/CEO) of the Corporation and removing them, with or without cause. 3) Approve changes to the Bylaws, mission and/or vision statements, and all strategic or long-term plans of the Organization. 4) Approve all creations of subsidiaries or controlled affiliates, mergers, consolidations, permanent or long-term affiliations and all joint ventures of the Organization involving capital investments in excess of $250,000. 5) Approve the sale or encumbrance of all or substantially all the assets of the Organization and all long-term debt in excess of $250,000. 6) Approve the Organization's annual operating and capital budgets and material amendments thereto. 7) Approve the dissolution of and all liquidations from the Organization.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>See narrative for line 6</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>See narrative for line 6</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's management, including the Joint Commission CFO, Controller, Corporate Compliance &amp; Privacy Officer, and General Counsel performed a detailed review of the Form 990 with the paid tax preparer. Once this level of review was performed, a thorough walk through was done with the JCR Finance Committee prior to filing. A copy of the Form 990 was provided to the entire Board of Directors prior to filing. A final filed public disclosure copy of the return will be placed on the Organization's website for the public once accepted by the IRS.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>The policy states that any decision that could result in an actual or perceived conflict of interest must be avoided. All staff and board members review the policy on an annual basis and complete a Conflict of Interest questionnaire each year which, is designed to identify interests that could give rise to possible conflicts. Although many such potential conflicts are and will be deemed inconsequential, every individual of the Organization has an ongoing responsibility to disclose situations that involve personal, family, or business relationships that could be perceived as a conflict of interest. The interests identified are reviewed by the corporate compliance officer, general counsel, and governance committee and appropriately managed. All disclosures are pursued until 100% completed. Prior to any board or committee meeting, a member is required to disclose a conflict of interest or possible conflict of interest on any matter during a meeting and then not vote or use personal influence on the matter. The minutes of the meeting reflects that a disclosure was made and the member abstained from voting. At the beginning of each board or committee meeting a request is made to disclose any potential conflict of interest. The Compliance Officer monitors and reviews the conflict of interest policy as well as the responses to the questionnaires on an annual basis. The Organization also has available an independent hotline number for staff to report anonymously any potential conflicts during the year.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>The CEO's compensation arrangement is subject to an independent board committee review and approval referred to as the Human Resources and Executive Compensation Committee. Joint Commission Resources engaged an independent compensation consultant to assist in determining compensation of its CEO. In setting the CEO's compensation, the organization's Human Resources and Executive Compensation Committee relies on recent compensation studies that provide compensation data for comparable position in other organizations to support its decision-making process. The Human Resources and Executive Compensation Committee adequately documents its compensation determinations and deliberations regarding compensation in its committee minutes on a timely basis. Each voting Committee member has been determined to be independent in accordance with intermediate Sanctions regulations and signs the Board's Conflict of Interest policy annually to ensure that he or she is independent. The Board engages in an active review of the compensation recommended by the Committee. In addition, the Board conducts an annual evaluation of the CEO. The process for determining Paula Wilson, CEO, compensation is undertaken annually.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b Process to establish compensation of other employees</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER OFFICERS: THE OTHER OFFICERS' COMPENSATION ARRANGEMENT IS SUBJECT TO AN INDEPENDENT BOARD COMMITTEE REVIEW AND APPROVAL REFERRED TO AS THE HUMAN RESOURCES AND EXECUTIVE COMPENSATION COMMITTEE. JOINT COMMISSION RESOURCES ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST IN DETERMINING COMPENSATION OF ITS OTHER OFFICERS. IN SETTING THE OTHER OFFICERS' COMPENSATION, THE ORGANIZATIONS' HUMAN RESOURCES AND EXECUTIVE COMPENSATION COMMITTEES RELY ON RECENT COMPENSATION STUDIES THAT PROVIDE COMPENSATION DATA FOR COMPARABLE POSITIONS IN OTHER ORGANIZATIONS TO SUPPORT ITS DECISION-MAKING PROCESS. THE HUMAN RESOURCES AND EXECUTIVE COMPENSATION COMMITTEES ADEQUATELY DOCUMENTED ITS COMPENSATION DETERMINATIONS AND DELIBERATIONS REGARDING COMPENSATION IN ITS COMMITTEE MINUTES ON A TIMELY BASIS. EACH VOTING COMMITTEE MEMBER HAS BEEN DETERMINED TO BE INDEPENDENT IN ACCORDANCE WITH INTERMEDIATE SANCTIONS REGULATIONS AND SIGNS THE BOARD'S CONFLICT OF INTEREST POLICY ANNUALLY TO ENSURE THAT HE OR SHE IS INDEPENDENT. THE BOARD ENGAGES IN AN ACTIVE REVIEW OF THE COMPENSATION RECOMMENDED BY THE COMMITTEE. IN ADDITION, AN ANNUAL PERFORMANCE EVALUATION OF THE OFFICERS IS CONDUCTED. The process for determining the organizations' other officers' compensation is undertaken annually FOR: Marwa Zohdy - vp, Jean Courtney - vp, Ying Qu - vp, and Joel Roos - vp. KEY EMPLOYEES: JOINT COMMISSION RESOURCES ENGAGES ITS HUMAN RESOURCES DEPARTMENT TO ASSIST IN DETERMINING COMPENSATION OF ITS KEY EMPLOYEES. IN SETTING THE KEY EMPLOYEES' COMPENSATION, THE HUMAN RESOURCES DEPARTMENT RELIES ON INDEPENDENT SURVEY AND COMPENSATION DATA FOR COMPARABLE POSITIONS IN OTHER ORGANIZATIONS AND/OR ON THE INTERNAL JOB EVALUATION SYSTEM TO SUPPORT ITS DECISIONMAKING PROCESS. THE KEY EMPLOYEES' COMPENSATION IS DETERMINED BY THE COMPENSATION POLICY AND GUIDELINES, WHICH ARE ESTABLISHED ANNUALLY BY THE HUMAN RESOURCES DEPARTMENT. INCENTIVE COMPENSATION FOR KEY EMPLOYEES IS REVIEWED BY THE ORGANIZATION'S HUMAN RESOURCES AND EXECUTIVE COMPENSATION COMMITTEE. THE PROCESS FOR DETERMINING THE ORGANIZATION'S KEY EMPLOYEES' COMPENSATION IS UNDERTAKEN ANNUALLY FOR ALL KEY EMPLOYEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization makes its governing documents and the form 990 available to the public upon request and in accordance with applicable laws. The conflict of interest policy and the Joint Commission Consolidated financial statements are made available to the public on the Joint Commission website. The organization also makes available on its website a public disclosure copy of form 990-t and form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 2f Other Program Service Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>Contract Evaluation Services - Total Revenue: 340088, Related or Exempt Function Revenue: 340088, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other - Total Revenue: 679842, Related or Exempt Function Revenue: 679842, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER FEES - Total Expense: 6958049, Program Service Expense: 6739643, Management and General Expenses: 218406, Fundraising Expenses: ; SHARED SERVICES FEE - Total Expense: 7029684, Program Service Expense: 1910347, Management and General Expenses: 5119337, Fundraising Expenses: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>Return of net assets from parent company - The Joint Commission EIN 36-2229255 - 3360216; Change in unrecognized net defined benefit plan costs not yet recognized in periodic benefit cost - 131369; Change in net periodic pension costs other - -78786;</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>COVID-19 IMPACT</FormAndLineReferenceDesc>
        <ExplanationTxt>In March 2020, the World Health Organization declared the outbreak of a coronavirus to be a pandemic. In that same month, the United States of America declared a national public health emergency concerning the COVID-19 outbreak. Consequently, The Joint Commission enterprise suspended all on-site customer engagements. Shortly thereafter, virtual engagement models were created for accreditation, certification, education, consultative technical assistance, and high reliability training activities; these models of service delivery began to roll out in May, increasing in volume over the course of the year. In June, on-site engagements were restarted and continued through year-end on a limited basis. In addition, The Joint Commission enterprise aggressively reduced costs to mitigate the impact of lost on-site revenues. Despite these measures, the pandemic resulted in a significant operating deficit in 2020. Although vaccines for COVID-19 are currently available to the general public in the U.S. and around the world, it will take time for the vaccines to materially affect the spread of the virus and the outbreak could have a continued adverse impact on the organization. Management forecasts suggest it may take several years before the enterprise returns to historical revenue levels. To date, the organization has been able to sustain its operations through operating cash and has kept its reserves intact. Management continues to monitor the situation very carefully and is prepared to take any actions needed to keep the organization financially sound.</ExplanationTxt>
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