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        <PersonNm>Lenworth M Jacobs Jr MBBS MPH</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Marvin Strohschein Jr DDS</PersonNm>
        <TitleTxt>Commissioner</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Melinda L Estes MD MBA</PersonNm>
        <TitleTxt>Commissioner</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Michael B Simon MD MBA FASA</PersonNm>
        <TitleTxt>Commissioner</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Najmedin Meshkati PhD CPE</PersonNm>
        <TitleTxt>Commissioner</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Susan Fox MBA BSN</PersonNm>
        <TitleTxt>Commissioner</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Tracey L Henry MD MPH MS</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Vineet Arora MD MAPP</PersonNm>
        <TitleTxt>Commissioner</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Willie Underwood III MD MSc</PersonNm>
        <TitleTxt>Commissioner</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Jean Courtney CPA</PersonNm>
        <TitleTxt>EVP &amp; Chief Operating Officer</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>6.0</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lisa Diehl Vandecaveye JD HRM FACHE</PersonNm>
        <TitleTxt>Secretary &amp; EVP &amp; CHIEF LEGAL OFFICER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>16.0</AverageHoursPerWeekRltdOrgRt>
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        <OtherCompensationAmt>104069</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Lisa Steininger</PersonNm>
        <TitleTxt>Treasurer &amp; EVP &amp; Chief Financial Officer (Since Apr)</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>James Merlino</PersonNm>
        <TitleTxt>EVP Chief Innovation Officer</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Kenneth Grubbs Jr</PersonNm>
        <TitleTxt>EVP COO Accreditation &amp; Certification Ops</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>David Baker MD MPH FACP</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Kathryn E Spates</PersonNm>
        <TitleTxt>EVP Public Pol &amp; Govt Relations</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Kin Lee MS</PersonNm>
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        <PersonNm>Leslie Krohn</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Michael Kaba MS</PersonNm>
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          <BusinessName>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 842103</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>752842103</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>COGNIZANT TECHNOLOGY SOLUTIONS</BusinessNameLine1Txt>
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          <USAddress>
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            <CityNm>Chicago</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>29695 NETWORK PLACE</AddressLine1Txt>
            <CityNm>Chicago</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
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          </USAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>National Quality Forum</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1099 14TH STREET NW 500</AddressLine1Txt>
            <CityNm>Washington</CityNm>
            <StateAbbreviationCd>DC</StateAbbreviationCd>
            <ZIPCd>20005</ZIPCd>
          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CONNECTION</BusinessNameLine1Txt>
          </BusinessName>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>MOREDIRECT INC AKA</AddressLine1Txt>
            <AddressLine2Txt>P O BOX 536464</AddressLine2Txt>
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            <StateAbbreviationCd>PA</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
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      <GovernmentGrantsAmt>672564</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>139937</AllOtherContributionsAmt>
      <TotalContributionsAmt>812501</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Annual Subscription</Desc>
        <BusinessCd>541990</BusinessCd>
        <TotalRevenueColumnAmt>102318957</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>102318957</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>Survey Fees</Desc>
        <BusinessCd>541990</BusinessCd>
        <TotalRevenueColumnAmt>80648344</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>80648344</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>Performance Measurements</Desc>
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        <RelatedOrExemptFuncIncomeAmt>7261043</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>SHARED SERVICES FEE FROM RELATED TAX EXEMPT ORGANIZATIONS</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>9530978</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Transaction Fees</Desc>
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        <ManagementAndGeneralAmt>256165</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>875</ProgramServicesAmt>
        <ManagementAndGeneralAmt>337761</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>408730</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>275016</ManagementAndGeneralAmt>
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      <FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>240064</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>7199386</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7573310</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1160411</ProgramServicesAmt>
        <ManagementAndGeneralAmt>91280</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>485386</ProgramServicesAmt>
        <ManagementAndGeneralAmt>823837</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>3192715</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3295401</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1193811</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1015076</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>25631538</ProgramServicesAmt>
        <ManagementAndGeneralAmt>559564</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>555036</ProgramServicesAmt>
        <ManagementAndGeneralAmt>729384</ManagementAndGeneralAmt>
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        <ExplanationTxt>CHANGE IN NET PERIODIC PENSION COSTS OTHER - 4919321</ExplanationTxt>
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        <EmployeeCnt>4</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Conference Travel,Training</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>Sending agents of the organization to attend conferences and training</SpecificServicesProvidedTxt>
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      <AccountActivitiesOutsideUSGrp>
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      <SubtotalEmployeesCnt>13</SubtotalEmployeesCnt>
      <ContinuationTotalOfficeCnt>0</ContinuationTotalOfficeCnt>
      <ContinuationTotalEmployeeCnt>0</ContinuationTotalEmployeeCnt>
      <TotalOfficeCnt>0</TotalOfficeCnt>
      <TotalEmployeeCnt>13</TotalEmployeeCnt>
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      <ContinuationSpentAmt>0</ContinuationSpentAmt>
      <TotalSpentAmt>120006</TotalSpentAmt>
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          <BusinessNameLine1Txt>National Association for Healthcare Quality</BusinessNameLine1Txt>
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          <AddressLine1Txt>8600 W Bryn Mawr Ave Ste 710N</AddressLine1Txt>
          <CityNm>Chicago</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
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        <PurposeOfGrantTxt>Joint Commission formed a strategic alliance with the National Association for Healthcare Quality (NAHQ) to advance workforce readiness to achieve quality and safety goals leading to improved outcomes and safer care for all, regardless of setting. Joint Commission agreed to provide NAHQ with an unconditional contribution of $10,000,000 payable over the next five years for use by NAHQ solely for the purpose of advancing its mission of elevating the competency of healthcare professionals specializing in quality, safety, infection prevention, and related disciplines through support of strategic programs and investment in growth.</PurposeOfGrantTxt>
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        <PersonNm>Jonathan B Perlin MD PhD MSHA</PersonNm>
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        <PersonNm>Lisa Diehl Vandecaveye JD HRM FACHE</PersonNm>
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        <PersonNm>Kenneth Grubbs Jr</PersonNm>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>James Merlino</PersonNm>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <PersonNm>David Baker MD MPH FACP</PersonNm>
        <TitleTxt>EVP Health Care Quality Evaluation (Through April )</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <PersonNm>Leslie Krohn</PersonNm>
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        <PersonNm>Kathryn E Spates</PersonNm>
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        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a First-class or charter travel</FormAndLineReferenceDesc>
        <ExplanationTxt>Joint Commission'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. Joint Commission's CEO is allowed to travel first-class on business trips throughout the United States and international. First class travel benefits are not treated as taxable compensation to the interested person.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a Personal services</FormAndLineReferenceDesc>
        <ExplanationTxt>Two officers utilized an allowance for tax preparation. Not all officers eligible for the services utilize them. These services are treated as taxable compensation and reported on Form 990, Part VII, Column D as Reportable Compensation</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4a Severance or change-of-control payment</FormAndLineReferenceDesc>
        <ExplanationTxt>JOINT COMMISSION 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>
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        <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>
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        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>9580000</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>16026366</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>229946</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>15796420</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2016</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <EngageBondCounselResearchInd>true</EngageBondCounselResearchInd>
        <PrivateBusUseByOthersPct>0.01</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.01</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <TermOfHedgePct>0</TermOfHedgePct>
        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>false</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <TermOfGICPct>0</TermOfGICPct>
        <RegulatorySafeHarborStsfdInd>false</RegulatorySafeHarborStsfdInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column (f) Description of Purpose</FormAndLineReferenceDesc>
        <ExplanationTxt>Bond proceeds were used to finance a portion of the costs to renovate, remodel, and to purchase equipment for Joint Commission headquarters building, and all necessary and attendant facilities, equipment, site work, zoning, entitlements and utilities related thereto.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 3 Total Proceeds of Issue Amount Difference</FormAndLineReferenceDesc>
        <ExplanationTxt>The total proceeds of issue reported on Schedule K, Part II, Line 3 are not identical to the issue price listed in Part I, column (e), due to investment earnings.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part IV, Line 3 BOND ISSUE IS A VARIABLE RATE ISSUE</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORIGINAL BOND WAS ISSUED AT A VARIABLE RATE. IN 2022 THE ORGANIZATION EXECUTED THE FIRST AMENDMENT TO THE BOND AND LOAN AGREEMENT REFERRED TO AS THE INTEREST RATE RESET AND AMENDMENTS, WHICH RENEWED THE LOAN WITH THE CURRENT PURCHASER AT A FIXED RATE OF 2.8%.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part IV, Line 2c COLUMN A</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer name: Illinois Finance Authority The calculation for computing no rebate due was performed on 08/26/2020</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="24020961" softwareVersionNum="2024v5.1">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 1 ORGANIZATION'S MISSION</FormAndLineReferenceDesc>
        <ExplanationTxt>(CONTINUATION FROM PART III, LINE 1) recognized by the Gold Seal of Approval, demonstrates an organization's commitment to high performance and is a requirement for participation in Medicare and Medicaid programs. Joint Commission's accreditation and certification services extend across hospitals, clinical laboratories, ambulatory care facilities, nursing centers, home care providers, behavioral health programs, and assisted living communities. In addition, Joint Commission certifies disease-specific care programs-including stroke, heart failure, diabetes, joint replacement, and spinal surgery-along with health care staffing services, telehealth, and sustainability initiatives. Through its standards, surveys, and programs, Joint Commission emphasizes patient safety, quality outcomes, and risk reduction. Key initiatives include National Patient Safety Goals, Sentinel Event policies, infection prevention and control programs, and patient safety research. Joint Commission also engages the public through educational campaigns such as the Speak Up program, and supports caregivers through initiatives like the Care Badge. These efforts reflect Joint Commission's mission to advance safe, effective, and equitable health care nationwide.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 8b Committee authority to act on behalf of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE NARRATIVE FOR LINE 1A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1a Delegate broad authority to a committee</FormAndLineReferenceDesc>
        <ExplanationTxt>The board of directors may, by resolution, appoint an executive committee. The Executive Committee shall consist of one Commissions appointed by each member of the corporation to the board of commissions and one commissioner appointed by the board of commissioners. It shall be the duty of the executive committee to exercise the powers of the board when the board is not in session, including, without limitation, to take such emergency actions for the board as may be required between meetings of the board, and otherwise exercise the authority of the Board of Commissioners in the management of the corporation to the extent that the board may lawfully provide by resolution; council with the president regarding certain matters; and act upon recommendation of the chair of the board on the appointments to the standing committees.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 3 Delegation of management duties</FormAndLineReferenceDesc>
        <ExplanationTxt>Joint Commission hired Kim Michael-Lee through a contractual agreement with Randstad Digital LLC to perform the duties of Chief Financial Officer from January through April.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>Joint Commission has five corporate members who must approve changes to the organization's Bylaws and Articles of Incorporation. The members assist with appointing commissioners to the board. In addition, the members must approve the dissolution of 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 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>Joint Commission's management, including the 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 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 Commissioners 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>
      </SupplementalInformationDetail>
      <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 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 the top management officials', Dr. Jonathan Perlin, ceo, compensation is undertaken annually.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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 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: Lisa Diehl Vandecaveye - evp, lisa steininger - evp, and jean courtney - evp KEY EMPLOYEES: JOINT COMMISSION 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 DECISION MAKING 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 ALSO 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>JOINT COMMISSION 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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 2f Other Program Service Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Program Service Revenue - Total Revenue: 295045, Related or Exempt Function Revenue: 295045, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in net periodic pension costs other - -4919321; Change in unrecognized net defined benefit plan costs not yet recognized in net periodic benefit cost - 9109321; Transfer of Net assets to Parent co from Joint Commission Resources, Inc. EIN 36-3521721 - 10558534; Total - 14748534;</ExplanationTxt>
      </SupplementalInformationDetail>
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          <BusinessNameLine1Txt>JOINT COMMISSION RESOURCES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>ONE RENAISSANCE BOULEVARD</AddressLine1Txt>
          <AddressLine2Txt>SUITE 401</AddressLine2Txt>
          <CityNm>OAKBROOK TERRACE</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>60181</ZIPCd>
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        <EIN>363521721</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>JOINT COMMISSION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>National Quality Forum</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1099 14th St NW</AddressLine1Txt>
          <AddressLine2Txt>Suite 500</AddressLine2Txt>
          <CityNm>Washington</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>200054858</ZIPCd>
        </USAddress>
        <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>
        </DirectControllingEntityName>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>JCI ACCREDITATION (BEIJING) CO LTD</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <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>
        </ForeignAddress>
        <PrimaryActivitiesTxt>SEE STATEMENT</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CH</LegalDomicileForeignCountryCd>
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          <BusinessNameLine1Txt>JCR</BusinessNameLine1Txt>
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        <EntityTypeTxt>C Corporation</EntityTypeTxt>
        <ShareOfEOYAssetsAmt>5</ShareOfEOYAssetsAmt>
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      <IdRelatedOrgTxblCorpTrGrp>
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          <BusinessNameLine1Txt>Joint Commission Arabia Management Company</BusinessNameLine1Txt>
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          <AddressLine1Txt>2886 Northern Ring Road</AddressLine1Txt>
          <CityNm>Riyadh</CityNm>
          <CountryCd>OC</CountryCd>
          <ForeignPostalCd>13511</ForeignPostalCd>
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        <PrimaryActivitiesTxt>SEE STATEMENT</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>SA</LegalDomicileForeignCountryCd>
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          <BusinessNameLine1Txt>JCR</BusinessNameLine1Txt>
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        <EntityTypeTxt>C Corporation</EntityTypeTxt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <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>false</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>
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          <BusinessNameLine1Txt>JOINT COMMISSION RESOURCES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
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        <MethodOfAmountDeterminationTxt>ACTUAL</MethodOfAmountDeterminationTxt>
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          <BusinessNameLine1Txt>JOINT COMMISSION RESOURCES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>272688</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL</MethodOfAmountDeterminationTxt>
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        <OtherOrganizationName>
          <BusinessNameLine1Txt>JOINT COMMISSION RESOURCES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>9530978</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CONTRACTUAL</MethodOfAmountDeterminationTxt>
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          <BusinessNameLine1Txt>JOINT COMMISSION RESOURCES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>1589842</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL</MethodOfAmountDeterminationTxt>
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        <OtherOrganizationName>
          <BusinessNameLine1Txt>JOINT COMMISSION RESOURCES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>9109321</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CONTRACTUAL</MethodOfAmountDeterminationTxt>
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      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>National Quality Forum</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>1044026</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Contractual</MethodOfAmountDeterminationTxt>
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        <OtherOrganizationName>
          <BusinessNameLine1Txt>National Quality Forum</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>106342</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual</MethodOfAmountDeterminationTxt>
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        <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>
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</Return>