The Joint Commission’s CEO and president, Jonathan Perlin, MD, PhD, will retire at the end of 2026. Its board of commissioners appointed COO James Merlino, MD, to succeed Dr. Perlin Jan. 1, 2027, as the organization’s eighth president and CEO.
Dr. Perlin told Becker’s he plans to remain active in healthcare, and said he has been intentional about succession planning, and believes a handoff works best when an organization is in its strongest position. Dr. Perlin will stay on as a strategic advisor and hold the title of president emeritus.
“This seemed like the right moment to pass the baton,” Dr. Perlin said.
Dr. Perlin said the board considered both domestic and international candidates, adding that Dr. Merlino was his “absolute recommendation.” Dr. Perlin described him as the “co-architect” of the organization’s transformation over the past three years.
Dr. Merlino joined the Joint Commission in 2023 as executive vice president and chief innovation officer. Before that, he was Cleveland Clinic’s chief clinical transformation officer. Earlier, he served as Cleveland Clinic’s chief experience officer and as chief transformation officer at Press Ganey, where he built the company’s consulting division.
In January 2026, Dr. Perlin oversaw the implementation of Accreditation 360, the most extensive overhaul of accreditation since Medicare was established in 1965, according to the commission. The program cut obsolete standards and focused surveys on the priorities that matter most to patients and providers.
The organization also launched a responsible AI certification. Internationally, its Patient Safety Pathways Program works with 30 low- and middle-income countries, “where every fourth healthcare encounter results in harm,” Dr. Perlin said.
Before joining the Joint Commission in 2022, Dr. Perlin was president of clinical operations and chief medical officer at Nashville, Tenn.-based HCA Healthcare. Earlier, he was undersecretary for health at the U.S. Department of Veterans Affairs.
What comes next
Dr. Perlin and Dr. Merlino said the past five years went toward rebuilding the organization’s reputation. Five years ago, Dr. Merlino said, it was “known more … as an accreditation body than an organization that drives safety and quality.”
Dr. Merlino said he would continue his work in safety improvement and sharing best practices and explore new focus areas, such as pediatrics, which the organization began last year. He also wants the organization to bring experts together on workforce challenges.
Part of that shift is about responding to the needs of surveyors. The Joint Commission’s long-standing Safer matrix scores how harmful and widespread a problem is. A newer program, Safest, looks for what’s working and spreads those practices across the organization’s network.
“Safety 1.0 is only looking at failure modes. Safety 2.0 is looking at success modes,” Dr. Perlin said.
The organization also combined its safety event taxonomy with the National Quality Forum’s into one classification system. Dr. Merlino said that could eventually support industrywide benchmarking of errors, though he did not give a timeline.
Certification is next. Dr. Merlino said the Joint Commission is working to evaluate organizations on outcomes data rather than whether they completed a set of processes.
“It doesn’t really matter how you get to an outcome as long as those outcomes are where they need to be from a national performance standpoint,” Dr. Merlino said. “That’s how we should be evaluating organizations, and that’s what we’re working on right now.”
He framed the organization’s role as closing a gap between the “haves and have-nots” of safety. Large systems invest heavily in improvement, while small and rural hospitals often lack sufficient resources. The Joint Commission can collect best practices from across its network and pass them along to organizations that cannot develop them alone.
Advisory boards of chief medical officers and chief nursing officers guide that work. Dr. Merlino said the organization deliberately staffed those boards to reflect the industry rather than academic medicine alone, with rural, midsize and system hospitals represented.
As Cleveland Clinic’s chief experience officer, Dr. Merlino helped build patient experience into the system’s brand. He now defines patient experience as three priorities in order: safety, quality and an environment where patients feel cared for. He recalled surgeons asking him why they should care about making patients happy instead of focusing on quality.
“First of all, I want you to think about safety, because if you do something that hurts a patient, then everything else doesn’t really count, regardless of how great of a surgeon you are,” Dr. Merlino said he told them.
After his Dec. 31 retirement, Dr. Perlin will help with the transition and maintain the organization’s domestic and international relationships, which, Dr. Merlino said, were too valuable to lose.
“If anyone would think for a minute that … I would allow that to get away, it’s not going to happen,” Dr. Merlino said.
Founded in 1951, the Joint Commission is a nonprofit that sets healthcare standards and accredits organizations. It also evaluates more than 23,000 healthcare organizations and programs across the U.S.
