Accreditation puts your facility ahead of the competition
CARF approval becoming a requirement for payers, consumers
When the American Association of Retired Persons mentioned in its newsletter that chronic pain programs could be accredited, CARF...The Rehabilitation Accreditation Commission received 6,000 calls in just one week for a list of accredited pain programs. Meanwhile, more than 300 large purchasers of managed care coverage have asked to receive lists of organizations accredited by CARF.
These two examples consumer and payer pressure show the power of CARF accreditation in today’s competitive health care market, says Christine MacDonell, national director of the medical rehabilitation division of the Tucson, AZ, accrediting body.
Many managed care payers include CARF accreditation among their criteria, reports Linda Maher Williams, MN, RN, CRRN, CCM, director of rehabilitation services at Columbia Northlake Regional Medical Center in suburban Atlanta.
"Taking the extra step to meet national standards gives consumers and payers confidence and security. We know we do a good job, but CARF accreditation affirms it," explains Williams, who is leading her three-year-old rehab unit toward its first CARF survey.
Although it’s important to let consumers and payers know your facility meets stringent standards, that shouldn’t be the only reason you apply for CARF accreditation, says Karen Clarke, RN, MSN, division manager of rehabilitation services at Memorial Hospital of Gulfport (MS). Her facility went through CARF accreditation in December, just six months into a new model of care.
"It was the best learning experience we could have gone through. It helped us focus on the delivery of health care that will take us into the 21st century," she says.
You must be committed to change, however, to make the time, energy, and expense of a CARF survey worthwhile, Clarke advises.
"It’s a strategic decision that you are committed to delivering care following state-of-the-art standards. If you just want to be able to say you are CARF-accredited, but you have no plans for giving something back to the community, it’s not worth it," she adds.
Seeking accreditation is a good housecleaning tool to make your facility look at new, creative ways of doing business, MacDonell says.
"Accreditation puts you in a mode that you will never be still. The changing health care arena demands that we learn new ways to get things done through creative problem-solving that utilized continuous quality tools," she explains.
In 1967, a year after CARF was established, the commission had accredited four programs. From January 1994 to January 1996, the number of accredited comprehensive inpatient programs grew from 587 to 732. Now there are 12,500 programs in the United States, Canada, and Sweden. CARF is considering requests to set up accreditation standards for rehabilitation facilities in 14 other countries, MacDonell says.
In addition to comprehensive inpatient rehabilitation in three categories acute rehab, subacute, and skilled nursing accredited facilities include individual programs such as spinal cord injury; brain injury; pain management; outpatient, home-, and community-based programs; health enhancement programs; occupational rehab; employment services; community support services; and early childhood and family support services.
In January 1997, CARF began accrediting Veterans Affairs rehabilitation programs under an agreement with the U.S. Department of Veterans Affairs. (See related article, p. 107.)
Your facility may seek accreditation for its comprehensive inpatient programs or for individual programs in any or all of the three categories. However, if one of your programs gets a one-year accreditation, all programs will be accredited for only one year, even if the others meet the criteria for three-year accreditation.
You must apply for accreditation by March 31, 1998, to use the 1997 standards manual. After that, you must meet the criteria in the 1998 manual. Your accreditation application is good only for six months. You must schedule your survey at least two months in advance.
If you already are accredited, allow six to eight months to prepare for a new survey. If you are a new facility, the standards must have been in use for six months.
The cost is $550 for the application fee and $950 per surveyor per day. About 98% of surveys involve a minimum of two surveyors for two days, MacDonell says. Only small programs can be surveyed in a shorter time, she adds. There is a $700 fee if you need to reschedule after the surveyors have been assigned.
About six to eight weeks following a survey, you will receive a written report with your accreditation outcomes. The exit conference with surveyors mirrors the report and gives you a chance to produce proof if you feel your program meets the standards. You may videotape or audiotape the exit conference.
After your survey, you’ll be required to submit a quality improvement plan within 90 days. You don’t have to complete the actions called for in the plan within 90 days, but surveyors will use it during the next survey. Keep a copy of the plan and use it as a basis to keep you focused on where you are headed, MacDonell advises.
[Editor’s note: For more information on CARF accreditation, contact Chris MacDonell at (520) 325-1044, Ext. 124. E-mail: [email protected].]
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