Certified Provider Credentialing Specialist Showdown 2026 – Master the CPCS with Confidence!

The governing body or board is the entity that may amend the medical staff bylaws according to The Joint Commission (TJC). This authority is grounded in the understanding that the governing body has the ultimate responsibility for the hospital's operations and ensuring compliance with regulations and standards.

Medical staff bylaws set forth the rules, regulations, and procedures under which the medical staff operates; however, any amendments or changes to these bylaws must be approved by the governing body to provide oversight and maintain alignment with the hospital's mission and strategic direction. This governance structure helps ensure that medical staff bylaws not only reflect the needs and input of the medical staff but also adhere to the policies and regulatory requirements established by the institution and governing entities.

While medical staff members, the chief medical officer, or hospital administrators may have roles in proposing amendments or providing insights on amendments, it is ultimately the governing body that holds the final authority to approve any changes to the medical staff bylaws.