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        <ExplanationTxt>The Internal Revenue Service has determined that Joint Commission and its affiliates are exempt from federal income taxation under Section 501(a) as organizations described in Section 501(c)(3) of the Internal Revenue Code (IRC). Joint Commission and its affiliates are subject to income taxes on income determined to be unrelated business taxable income (UBTI), which is taxed at the corporate income tax rate. Joint Commission Resources continues to evaluate its tax positions pursuant to the Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Subtopic 740 10, Income Taxes - Overall. As of December 31, 2024 and 2023, Joint Commission Resources believes it has taken no significant uncertain tax positions. JCR's Singapore branch is subject to Singapore taxes on its operations. As of December 31, 2024 and 2023, $50,000 tax credit has been reported in accounts receivable and $59,300 tax payable has been reported in other accrued expenses in the accompanying consolidated statements of financial position, respectively. Starting in 2024, JCR's Dubai branch is subject to UAE taxes on its operations. As of December 31, 2024 $6,600 taxes have been reported in other accrued expenses in the accompanying consolidated statements of financial position. Also, JCR's Joint Commission Arabia Management Company is subject to Saudi Arabia corporate income taxes on its operations. As of December 31, 2024 and 2023, $85,075 and $223,304 taxes have been reported in accounts payable in the accompanying consolidated statements of financial position, respectively. JCR actively analyzes its income tax exposure in foreign jurisdictions and evaluates the potential effect that status changes will have on its financial and business operations. As of December 31, 2024 and 2023, JCR does not believe that such future changes would have a material impact on the consolidated financial statements. JCR have been classified as an organization that is not a private foundation under IRC Section 509(a) and may receive deductible contributions under Section 170(c). JCR is an organizations that normally receives more than 33 1/3% of their support from contributions, membership fees, and gross receipts from activities related to its exempt functions and no more than 33 1/3% of its support from gross investment income and unrelated business taxable income under IRC Section 509(a)(2).</ExplanationTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jean Courtney CPA</PersonNm>
        <TitleTxt>EVP &amp; Chief Operating Officer</TitleTxt>
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        <NontaxableBenefitsRltdOrgsAmt>28278</NontaxableBenefitsRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>James Merlino</PersonNm>
        <TitleTxt>EVP Chief Innovation Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>837162</CompensationBasedOnRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>1326</NontaxableBenefitsRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>1101472</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kathy J Eichner</PersonNm>
        <TitleTxt>Generalist Principal Consultant</TitleTxt>
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        <BonusFilingOrganizationAmount>69826</BonusFilingOrganizationAmount>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kenneth Flowe</PersonNm>
        <TitleTxt>Physician Consultant</TitleTxt>
        <BaseCompensationFilingOrgAmt>241249</BaseCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Ying Qu</PersonNm>
        <TitleTxt>VP EPRODUCTS &amp; PER (Through November)</TitleTxt>
        <BaseCompensationFilingOrgAmt>315086</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>40766</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>330600</OtherCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Joel Roos</PersonNm>
        <TitleTxt>VP Intl Accred, Quality Improvement &amp; Patient Safety (Through July )</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Andrew Rosen</PersonNm>
        <TitleTxt>VP Joint Commission International (Since April)</TitleTxt>
        <BaseCompensationFilingOrgAmt>255769</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>25000</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>1954</OtherCompensationFilingOrgAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>303653</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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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 DOES NOT PERMIT REIMBURSEMENT FOR THE PURCHASE OF UPGRADES FOR FIRST-CLASS AIR TRAVEL TO EMPLOYEES. Any exceptions to this policy are handled on a case-by-case basis and requires officer approval. FIRST CLASS AIR TRAVEL BENEFITS ARE NOT TREATED AS TAXABLE COMPENSATION TO THE INTERESTED PERSON.</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, but some choose not to participate and receive a lump sum instead. The increases or decreases in the value of the plan during the year are reflected in Column C Deferred Compensation on Schedule J, Part II. In the event that a participant terminates employment before becoming vested in the plan, the decreases will be reported in Column C deferred Compensation on Schedule J.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4a-4c Description of program services</FormAndLineReferenceDesc>
        <ExplanationTxt>(Expenses $ 10,703,221 including grants of $ 0)(Revenue $ 14,965,060) JCR offers a service called Continuous Service Readiness that provides ongoing guidance from a dedicated healthcare quality and safety expert to help organizations improve patient safety and quality and to meet the standards to achieve and maintain Joint Commission accreditation and/or disease-specific care certification. 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 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 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 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization appointed Joint Commission's CEO to serve as the top management official for Joint Commission Resources, Inc. Accordingly, the individual's compensation is determined and paid by Joint Commission (a related organization) through its established process. The compensation arrangement is reviewed and approved by Joint Commission's Human Resources and Compensation Committee, which is composed entirely of independent members who annually sign the Board's conflict of interest policy. In carrying out its responsibilities, the committee engages an independent compensation consultant, relies on recent comparability studies for similar positions in other organizations, and contemporaneously documents its deliberations and determinations in committee minutes. This review is performed annually. Therefore, this question is marked "No" in accordance with IRS instructions.</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, 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>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 4 Significant changes to organizational documents</FormAndLineReferenceDesc>
        <ExplanationTxt>On November 13, 2024, the organization amended its Bylaws to revise the rules governing the composition of Board committees. Previously, all committees (with limited exceptions) were required to include at least two Directors and have a majority of Directors as members. The amended Bylaws now specify that only the Executive Committee must be composed entirely of Directors, and that other committees may include individuals who are not members of the Board. This change was made to provide greater flexibility in committee appointments while preserving overall Board oversight.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization has one sole member, Joint Commission. 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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>See narrative for line 6</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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 8b Documentation of meetings held by committees of 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. As such, this line is not applicable and has been checked no in accordance with the instructions</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's management, including 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 copy of Form 990 was provided to the JCR Finance Committee for their review and opportunity to ask questions prior to filing. A copy of the Form 990 was provided to the entire Board of Directors prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>JCR MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE PERIOD AS SET FORTH IN IRC SECTION 6104(D).</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 2f Other Program Service Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>Grants &amp; Contracts - Total Revenue: 887203, Related or Exempt Function Revenue: 887203, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Fee for Service contracts - Total Revenue: 540209, Related or Exempt Function Revenue: 540209, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Honorarium - Total Revenue: 60425, Related or Exempt Function Revenue: 60425, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Foreign Translation Gain(Loss) - Total Revenue: -29265, Related or Exempt Function Revenue: -29265, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Revenue - Total Revenue: 718240, Related or Exempt Function Revenue: 718240, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>Professional Fees - Consulting Services - Total Expense: 732882, Program Service Expense: 85848, Management and General Expenses: 647034, Fundraising Expenses: ; Professional Fees - Outsourced Services - Total Expense: 7713378, Program Service Expense: 7531655, Management and General Expenses: 181723, Fundraising Expenses: ; Other Misc Fees &amp; Services - Total Expense: 154328, Program Service Expense: 22848, Management and General Expenses: 131480, Fundraising Expenses: ; Market Research Services - Total Expense: 3684, Program Service Expense: 3684, Management and General Expenses: , Fundraising Expenses: ; Merchant Fees - Total Expense: 164122, Program Service Expense: 164122, Management and General Expenses: , Fundraising Expenses: ; Shared Services Fee - Total Expense: 9530978, Program Service Expense: 7294419, Management and General Expenses: 2236559, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in unrecognized net defined benefit plan costs not yet recognized in periodic benefit cost - 1109337; Change in net periodic pension costs other - -162845; Change in Foreign Currency Revaluation - -4696; TRANSFER OF UNDESIGNATED NET ASSETS TO PARENT CO - JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS EIN 36-2229255 - -9109321; Total - -8167525;</ExplanationTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>JOINT COMMISSION ON ACCREDITATION OF HC</BusinessNameLine1Txt>
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          <AddressLine1Txt>ONE RENAISSANCE BLVD</AddressLine1Txt>
          <CityNm>OAKBROOK TERRACE</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60181</ZIPCd>
        </USAddress>
        <EIN>362229255</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>JOINT COMMISSION</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>National Quality Forum</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1099 14th St NW</AddressLine1Txt>
          <AddressLine2Txt>Suite 500</AddressLine2Txt>
          <CityNm>Washington</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>200054858</ZIPCd>
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        <EIN>522175544</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>JOINT COMMISSION</BusinessNameLine1Txt>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>JCI ACCREDITATION (BEIJING) CO LTD</BusinessNameLine1Txt>
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        <ForeignAddress>
          <AddressLine1Txt>Rm 1538 FL 15 Bldg 3</AddressLine1Txt>
          <AddressLine2Txt>Yard 2 Jianguomenwai Street</AddressLine2Txt>
          <CityNm>Chaoyang District</CityNm>
          <ProvinceOrStateNm>Beijing</ProvinceOrStateNm>
          <CountryCd>CH</CountryCd>
          <ForeignPostalCd>100022</ForeignPostalCd>
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        <PrimaryActivitiesTxt>See Statement</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CH</LegalDomicileForeignCountryCd>
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          <BusinessNameLine1Txt>JCR</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corporation</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>-8866</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>5</ShareOfEOYAssetsAmt>
        <OwnershipPct>1</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Joint Commission Arabia Management Company</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>2886 Northern Ring Road</AddressLine1Txt>
          <CityNm>Riyadh</CityNm>
          <CountryCd>OC</CountryCd>
          <ForeignPostalCd>13511</ForeignPostalCd>
        </ForeignAddress>
        <PrimaryActivitiesTxt>See Statement</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>SA</LegalDomicileForeignCountryCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>JCR</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corporation</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>3232555</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>3022000</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>true</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>JOINT COMMISSION ARABIA MANAGEMENT COMPANY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>185951</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>JOINT COMMISSION ARABIA MANAGEMENT COMPANY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>1831954</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Contractual</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>JOINT COMMISSION ARABIA MANAGEMENT COMPANY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>736714</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule R, Part IV, Column (b) Primary Activity</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVIDED INTERNATIONAL STANDARDS AND ACCREDITATION AND CERTIFICATION PROGRAMS FOR HEALTHCARE ORGANIZATIONS THROUGHOUT CHINA</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule R, Part IV, Column (b) Primary Activity</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVIDES INTERNATIONAL STANDARDS AND ACCREDITATION AND CERTIFICATION PROGRAMS FOR HEALTHCARE ORGANIZATIONS THROUGHOUT Saudi Arabia</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>