Why Treatment Center Accreditation Matters
Accreditation Standards are High
In order to receive accreditation, a treatment facility must receive approval from an outside accrediting body. This process involves confirmation of conforming to hundreds of standards for providing superior care in the field of addiction treatment and recovery. Residential treatment facilities must also meet additional stringent requirements for safety and health, corporate compliance, business practices, and governance.
Types of Accreditation
National accreditation programs include the Joint Commission, the National Committee for Quality Assurance, the All-States, and the Commission on Accreditation of Rehabilitation Facilities (CARF).
About CARF Accreditation
Founded in 1966, CARF is an international, independent, nonprofit organization whose focus is on advancing the quality of services that facilities provide to their clients in order to achieve the best possible outcomes. CARF accreditation services are provided worldwide at the request of health and human services providers. Those providers that meet CARF standards have demonstrated their commitment to being among the best facilities available in the field.
CARF accredits organizations in various health sectors, including behavioral health services (such as substance abuse), child and youth services, aging services, employment and community services, and medical rehabilitation. Data from the CARF website shows that CARF organizations currently accredit close to 47,000 programs and services at more than 20,000 locations in 16 countries on five continents (North and South America, Europe, Asia, and Africa). More than 8.3 million persons are served annually by more than 6,000 CARF-accredited providers.
The standards for CARF accreditation have been developed over 40 years by international teams of policymakers, service providers, consumers, payers, and family members. In order to validate relevance and to ensure input from all interested stakeholders, the standards are also submitted to the public for review.
Among the CARF accreditation outcomes, the three-year accreditation is the highest. (Promises earned the three-year accrediation.) Three-year accreditation means that the organization satisfies each of the CARF accreditation conditions and demonstrates substantial standards conformance. The organization is designed and operated to benefit the persons it serves. In addition, the organization demonstrates quality improvement from any previous periods of CARF accreditation.
The others include one-year accreditation, provisional accreditation, nonaccreditation, preliminary accreditation, and accreditation with stipulations.
• One-Year Accreditation – The organization satisfies each of the CARF accreditation conditions and demonstrates conformance to many of the standards. Although there are significant areas of deficiency in relation to the standards, there is evidence of the organization’s capability to correct the deficiencies and a commitment to their progress toward correction.
• Provisional Accreditation – Following the expiration of a one-year accreditation, a provisional accreditation is awarded to an organization that is still functioning at the level of a one-year accreditation. Awarded for a period of one year, an organization with provisional accreditation must be operating at a three-year accreditation level at its next survey or it will receive a nonaccreditation status.
• Nonaccreditation – As the term indicates, nonaccreditation means the organization has major deficiencies in several areas of the standards. There are also serious questions as to the benefits of the services, serious questions as to the health, safety, or welfare of those served. It may also be that the organization has failed to bring itself into substantial conformance to the standards over time, or it has failed to satisfy one or more of the CARF accreditation conditions.
• Preliminary Accreditation – Valuable for new organizations, preliminary accreditation allows them to establish demonstrated use and implementation of standards prior to the direct provision of services to individuals served. To be awarded preliminary accreditation, there must be evidence of processes and systems for program and service delivery that have been designed to provide a reasonable likelihood that they will benefit the persons served. About 6 months after services are initially provided to clients, a full follow-up survey of the organization is conducted.
• Accreditation with Stipulations – Of note to consumers, if an organization’s accreditation status is displayed as having stipulations, it means that CARF may require ongoing reporting or other action from the provider relative to its progress in maintaining conformance to CARF accreditation standards. Consumers should contact the organization directly to inquire about the progress of the accreditation status. If not satisfied, consumers should look for another service provider that has either a one-year or three-year CARF accreditation.
Value of CARF Accreditation – Treatment facilities that receive CARF accreditation are held in high regard. Such accreditation signals their commitment to continually improving their services, serving the community, and encouraging feedback.
How Treatment Facilities Attain CARF Accreditation
In order to achieve CARF accreditation, a treatment facility has to undergo an arduous process. This is a systematic and orderly process that begins with the service provider’s commitment to continuous improvement and culminates with an external review and recognition that their business and service practices meet international standards for quality. The interim stages focus on optimum outcomes for the individuals the facility serves as well as the organization’s sustained success.
Other CARF accreditation benefits include improved organizational effectiveness and efficiency, greater satisfaction of stakeholders, and an enhanced image in the community.
After the treatment facility commits to CARF accreditation, the process begins with a thorough self-evaluation of the relevant CARF standards against the organization’s current practices. When and if the organization conforms to CARF standards, the treatment facility submits a request for a CARF on-site survey. This needs to take place at least 3 months in advance of the desired survey date. By the date of the actual survey, the treatment facility must be in compliance with all CARF standards for a period of 6 months.
The CARF survey team is comprised of industry peers. In conducting the on-site survey, the team members utilize a consultative approach, as opposed to an inspective one. Interviews are conducted with the treatment facility staff, the clients they serve, and family members of the clients. Surveyors also review appropriate treatment facility documentation, observe organizational practices, answer questions, and offer suggestions on ways that the treatment facility can improve their service delivery and operations.
After the on-site survey is complete, about 6 to 8 weeks later, the CARF team renders a decision on accreditation and delivers a report identifying the service providers strengths and weaknesses (or areas that need improvement), as well as its level of demonstrated conformance to CARF standards.
Ongoing conformance to CARF standards requires that the treatment facility or service provider complete an annual Quality Improvement Plan within 90 days after receiving the survey report. In addition, the service provider or treatment facility is required to submit an Annual Conformance to Quality Report for each year of the accreditation term.
Why CARF Accreditation Matters to Consumers
Consumers need a way to identify quality care, particularly in the area of addiction treatment facilities. In addition to providing benefits to the treatment facility or service provider, consumers gain a level of confidence that the organization adheres to the highest quality standards. Specific benefits include:
• Assurance that the organization meets internationally accepted standards of quality
• Assurance that the treatment facility or service provider has made a commitment to continually enhance the quality of its services and programs and that its focus is on the satisfaction of the individuals it serves
• Confidence that the treatment facility will communicate with clients in a timely and effective manner
• An understanding that the treatment facility uses person-focused standards that emphasize an integrated and individualized approach to treatment and services
• Accountability to referral agencies, the community, and to funding sources
• Management techniques that are based on outcomes and consumer satisfaction and are also efficient and cost-effective
• Evidence to assure federal, state, provincial, or local governments of the quality of programs and services that receive government funding
• Confidence that the treatment facility’s personnel receive guidance for professional growth and responsible management
• The treatment facility or service provider has adequate marketing programs and services for consumers, referral sources, and third-party funders
• The treatment facility or service provider receives ongoing CARF support in the form of newsletters, consultation, training opportunities, publications, and conferences
The whole concept of getting back to the basics – concentrating on the satisfaction of the customer – is important. And it’s not only important to the customer. It’s also important to the service provider. Knowing that they have received the accreditation from CARF is like an added level of accountability and excellence that they can point to with their clients. The fact that they have strived to achieve accreditation, and to maintain it once achieved, is a testament to their overall commitment to the highest quality standards.
Consumers looking for organizations in their state or community can search nationally and receive referrals from other organizations to service providers and treatment facilities nearby that carry the CARF accreditation.
While there are many treatment facilities for addiction in the United States, only those with accreditation should be considered by consumers looking for the best treatment facility for themselves or their loved ones. Certainly, there are many fine treatment facilities that have just started up, or are in the process of refining and updating their standards. What CARF accreditation does for such organizations is to help them identify and address any gaps in their service delivery methods. By utilizing the wealth of knowledge about best practices and standards, CARF helps treatment facilities and service providers to ultimately result in better services for their clients.
Important Questions to Ask of the Treatment Facility
Consumers looking for a CARF-accredited treatment facility still need to be assured that the facility is right for their particular needs. This involves asking the appropriate questions about the treatment facility’s services and the choices available to the consumer.
Understanding the Services – Ask the following questions of the potential treatment facility personnel:
• How long does it take for services to begin?
• Is there a waiting list to get into treatment?
• How often will I receive the services, and how long will the services last?
• What will the services cost me?
• Tell me how my family or I will participate in the planning of my services and determining the schedules?
• What outcomes can I expect from the services or treatment?
• Tell me about my rights and responsibilities as a client of the treatment facility.
• What are the service goals for my particular plan of service and for the facility overall?
• How does the treatment facility handle suggestions it receives from the persons it serves?
Knowing Your Choices – Of course, you will have other questions, so it’s important to know what your other choices are that may be available to you. Ask about:
• Is other assistance available if I need it?
• What about transportation? Can the treatment facility assist me with that if I need it?
• If needed, are referrals to other service providers available?
• Tell me about the types and number of services available at/through the treatment facility (self-help, 12-step groups, family therapy, etc.)
• What are my available choices regarding grooming, rooms, recreational facilities, meals, etc.?
Other Considerations to Selecting a Treatment Facility
What are the most important issues to you? The list may include what your private insurance or governmental programs cover, the range of services offered by the treatment facility, the location of and convenient access to the facility, hours available, and/or its commitment to quality improvement through accreditation.
Other issues to consider are how stable the treatment facility is, its management and care philosophy, its ability to perform according to the philosophy, its willingness and ability to customize treatment plans to the individual client, and its reputation with current clients. Check online to learn about the treatment facility’s health inspection results, information about quality, and customer comments about the treatment facility that are available through your health department.
Beyond accreditation, and asking relevant questions, consumers in search of a treatment facility for addiction should also spend some time onsite. Look around and satisfy yourself of your first impressions of the organization. When you arrive, are you greeted in a manner that is friendly? Do they see you immediately or are you left to wait for a long period of time? Do the premises look clean, well-managed, and well-maintained? Does the facility look safe? How do you feel about the level of service, from what you can readily observe? How do the staff members interact with each other and with the clients they serve? What is the ratio of staff to clients?
In addition, pay attention to safety with respect to the treatment facility and the clients it serves. Be sure to look at the credentials of all the staff members. Inquire about health and safety policies in place at the treatment facility, particularly those involving any incidents of injury, medication management, natural disasters, and others. Ask about annual staff turnover and what procedure exists to handle complaints – as well as policies to prevent reprisals.
If available, try sampling the treatment facility’s services. Many residential addiction treatment facilities have guest quarters, or have programs where you can receive overviews of services provided. This may prove invaluable to potential clients and their families before making a long-term commitment.
Bottom line: when it comes to choosing the right addiction treatment facility, accreditation matters – a great deal. Treatment facilities that carry accreditation have demonstrated an ongoing commitment to continuing improvement in the highest quality standards – and to focusing on customer satisfaction. While there are no guarantees that treatment will be successful for everyone, the fact that the organization adheres to internationally-accepted quality standards is a sign that clients can expect the very best in professional care and a commitment to helping clients achieve the hoped-for outcome: recovery.