Northern California Kaiser Foundation Hospitals' Biomedical Engineering developed a regional rental medical equipment management program in response to the revised 1989 Joint Commission's Health Care Organization Accreditation Standards. The program shifts the operational and safety responsibility for the equipment from the hospitals to the rental vendor. Rental vendors who agreed to Biomedical Engineering's performance standards became preferred vendors from which Kaiser Foundation Hospitals rented their equipment. This program has become a standard adopted by other hospitals that are members of BAMMI (Bay Area Managers of Medical Instrumentation).