Alternatives in The United States
The Joint Commission is not a complete monopoly and while many states in the U.S. make use of their services, not all do. Some states have set up their own alternative assessment procedures; the Joint Commission is not recognized for state licensure in the states of Oklahoma (except for hospital-based outpatient mental health services), Pennsylvania, and Wisconsin. In California, The Joint Commission is part of a joint survey process with state authorities.
There are also other healthcare accreditation organizations in the U.S. unrelated to the Joint Commission. These include the American Osteopathic Association (AOA), Healthcare Facilities Accreditation Program (HFAP), Commission on Accreditation of Rehabilitation Facilities(CARF), Community Health Accreditation Program (CHAP), the Accreditation Commission for Health Care, Inc. (ACHC), Utilization Review Accreditation Commission (URAC), the "Exemplary Provider Program" of The Compliance Team and the Healthcare Quality Association on Accreditation (HQAA), who are recognised in the state of Ohio. HFAP is older than the Joint Commission, having been in operation since 1945.
On September 26, 2008 the Centers for Medicare and Medicaid Services (CMS) granted deeming authority for hospitals to DNV Healthcare Inc. (DNVHC), an operating company of Det Norske Veritas (DNV), a Norwegian international company that has been operating in the U.S. since 1898.
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—Henry David Thoreau (1817–1862)
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—James Madison (1751–1836)