to main content Verification - Education | Critical Access Hospital | Human Resources HR | The Joint Commission
Verification - Education

HR.01.01.01 EP 3 requires that "The organization verifies and documents that the applicant has the education and experience required by the job responsibilities." Does this mean that verification via primary source is required?

Any examples are for illustrative purposes only.

No, primary source verification of education is not required at this element of performance.   Organizations are required to verify and document education and experience only when specific minimum requirements are written into the job description.  For example, if the Nurse Manager job description specifically requires the incumbent to possess a Master's Degree in Nursing (MSN), the organization must verify the individual has this credential.  Organizations determine how verification and documentation of education and experience will be managed.  Examples may include, but are not limited to:
  • Review of an original diploma or certification that demonstrates completion of an education course or degree, then retaining a copy as documentation of this education. Organizations also determine if documentation will be retained as 'paper' or in an electronic format, such as a scanned document.
  • Alternatively, such a document could be reviewed (but not copied) and then a note of attestation by the person reviewing the document could be entered into an HR file. The date the document was reviewed should be documented.
  • Use of an external service, such as a Credentials Verification Organization (CVO).   The glossary of the accreditation manual contains a definition of a CVO.

Manual: Critical Access Hospital
Chapter: Human Resources HR
Last reviewed by Standards Interpretation: April 19, 2022 Represents the most recent date that the FAQ was reviewed (e.g. annual review).
First published date: May 12, 2016 This Standards FAQ was first published on this date.
This page was last updated on April 19, 2022 with update notes of: Review only, FAQ is current Types of changes and an explanation of change type: Editorial changes only: Format changes only. No changes to content. | Review only, FAQ is current: Periodic review completed, no changes to content. | Reflects new or updated requirements: Changes represent new or revised requirements.

If no, please comment on how we could improve this response.

If you have additional standards-related questions regarding this topic, please use the Standards Online Submission Form