The field is confused now with CMS’s release on the “oneness” of hospitals. Clearly a hospital system can have one governing body. This has made sense for a long time and Joint Commission seems to be bending to the CMS permission. However, there is confusion in the field over one medical staff. The AMA is CEARLY against this, feeling strongly that each separate hospital needs its own medical staff, though it seems that CMS would allow otherwise. If there is one unified medical staff, it would seem to necessitate the development of SITE specific privileges, something that went away in the standards quite a few years ago.