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CARF Accredidation: What You Need to Know About Rehabs

When you’re looking for an addiction rehab, take the time to check into accreditation. The Commission on Accreditation of Rehabilitation Facilities (CARF) is the industry standard.
While it’s not likely that just anyone would hang out a shingle and tout their addiction recovery services, not every treatment facility is equal. That’s a big reason why treatment facility accreditation matters. But there are many more aspects to treatment facility accreditation and why it’s important. Here are some to consider.

Accreditation Standards are High

To receive accreditation, a treatment facility must receive approval from an outside accrediting body. This process involves conforming to hundreds of standards for providing superior addiction care. For residential treatment facilities, requirements are still more stringent.

About CARF Accreditation

Founded in 1966, CARF is an international, independent, nonprofit organization. It aims to advance the quality of services that rehabilitation facilities provide. CARF provides accreditation services worldwide at the request of health and human services providers.
 
Treatment centers that meet CARF standards have demonstrated their commitment to being among the best facilities available in the field.
 
CARF is not limited to addiction services. It accredits organizations in various health sectors, such as the behavioral health services, 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 6,000 CARF-accredited providers serve over 8.3 million persons every year.
 
Over the past four decades international teams of policymakers, service providers, consumers, payers, and family members have worked together to develop and refine the CARF accreditation standards. These same standards are also submitted to the public for review, a transparent process that keeps CARF standards relevant.

Levels of CARF Accreditation

Three-Year Accreditation

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.

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 and 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.

How Treatment Facilities Attain CARF Accreditation

When a rehab decides to pursue CARF accreditation, it begins an arduous process. Each step is systematic and orderly. It begins with the service provider’s commitment to continuous improvement. It culminates with an external review and recognition that their business and service practices meet international standards for quality. The interim stages focus on creating the best outcomes for the individuals the facility serves.
 
The process begins with a thorough self-evaluation of CARF standards against the organization’s current practices. When and if the organization feels they have conformed, the treatment facility submits a request for an on-site survey. The survery takes place at least three months later. 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 made up of industry peers. In conducting the on-site survey, the team members act as consultants, rather than inspectors. They conduct interviews with the treatment facility staff, the clients they serve and family members of the clients. They also review appropriate treatment facility documentation and observe organizational practices. This allows them to answer questions and offer suggestions on ways that the treatment facility can improve.
 
After the on-site survey is complete, about 6 to 8 weeks later, the CARF team makes a decision on accreditation. It also delivers a report identifying the facility’s strengths and weaknesses and how well it conforms to CARF standards.
 
The facility must complete an annual Quality Improvement Plan within 90 days after receiving the survey report. In addition, it must submit an Annual Conformance to Quality Report for each year of the accreditation term.

Why CARF Accreditation Matters to YOU

You need a way to identify quality care at addiction rehab facilities. CARF accreditation means you know the organization adheres to the highest quality standards. Here’s what else you get when the facility you choose has CARF accreditation:

  • Assurance that the organization meets internationally accepted standards of quality
  • Assurance that the facility has made a commitment to continual improvement
  • Confidence that the treatment facility will communicate in a timely and effective manner
  • Knowledge that the treatment facility uses person-focused standards that emphasize an integrated and individualized approach to treatment
  • Assurance of accountability to referral agencies, the community and to funding sources
  • Efficient, cost-effective management techniques based on outcomes and consumer satisfaction
  • Confidence that the treatment facility’s personnel receive guidance for professional growth and responsible management

The whole concept of getting back to the basics – concentrating on the satisfaction of the customer – is important. The fact that they have strived to achieve accreditation, and to maintain it once achieved, is a testament to the facility’s commitment to the highest quality standards.

There are many addiction rehabs in the US, but strive to look only for those with CARF accreditation or are in the process of gaining CARF accreditation.

Important Questions to Ask of the Treatment Facility

After checking a rehab’s CARF status, you still need to know that the facility is right for you. Here are some of the other questions you should any treatment facility you consider.

  • 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?
  • 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 an Addiction 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 and/or hours available.

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, 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 and medication management. 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.

The 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.

Posted on June 16, 2010 and modified on May 1, 2019

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