Effective January 1, 2026, the Joint Commission introduced its inaugural National Performance Goals (NPGs), replacing the former National Patient Safety Goals. As part of this change, hospitals will be required to meet minimum nurse staffing standards. This new NPG will standardize hospital nursing staff levels nationally for the first time.
NPG 12 generally requires a hospital’s nursing staff level to be sufficient “ to meet patient needs, and to provide safe, quality care.”[1] More specifically, NPG Element of Performance 12.02.01 requires hospitals to designate a nurse executive (a registered nurse (RN) with oversight responsibilities for nursing services and an active leadership role within the hospital’s governing body) and to maintain RN coverage 24 hours a day, either through direct care or supervision. Facilities must also adopt staffing policies that ensure an appropriate number and mix of skilled licensed nurses and support personnel.[2] Joint Commission has also noted that hospitals must demonstrate their compliance with this new requirement through data-driven strategies and routine staffing assessments.
This marks the first time Joint Commission has required specific nurse-staffing levels under its accreditation standards. The development is being called a “defining moment” by the American Nurses Association and other national nursing groups, who argue that inadequate nurse staffing has long contributed to patient safety risks.[3]
For hospitals, NPG 12.02.01 carries significant implications. Because Joint Commission accreditation offers hospitals “deemed status” for Medicare and Medicaid participation, failure to comply could jeopardize their compliance with CMS’ Conditions of Participation.[4] Joint Commission’s decision to classify this requirement as an NPG is also a strong indication that the issue will be at the forefront of their surveyor’s thoughts while performing hospital surveys in 2026 and beyond.[5]
Hospitals should begin reviewing their staffing structures, policies and systems immediately to ensure compliance. Legal and compliance teams should likewise be looped in to assess risk exposure, update documentation protocols and prepare for possible impacts to accreditation.
[1] https://digitalassets.jointcommission.org/api/public/content/9ca80055182b4274842a5780a94f2c82?v=149a13a9
[2] Id.
[3] https://www.nursingworld.org/news/news-releases/2025/american-nurses-association-celebrates-inclusion-of-nurse-staffing-in-joint-commissions-national-performance-goals/
[4] https://www.ncbi.nlm.nih.gov/books/NBK597359/#:~:text=Definitions,participation%20in%20Medicare%20and%20Medicaid.
[5] TJC describes NPG’s as “requirements that rise above regulation into salient, measurable topics with clearly defined goals . . . to address critical issues that warrant elevation. . .” https://www.jointcommission.org/en-us/standards/national-performance-goals
