CARF Accreditation: Where do I start???

Although it seems like an obvious enough question, I realized recently that I’ve never written a post about it. I’ve addressed how to prepare for a site visit and how to maintain conformance, but haven’t started from the start. Yet it’s absolutely crucial to start things off right to avoid huge pitfalls! So here’s the basics;

Get Connected to CARF and Get the (right) CARF Manual!

The first thing you’ll need to get sorted is which standards manual you will be using (CARF has several) and which standards within that manual you will be applying to your programs (there are literally dozens of possibilities).  It’s always my very first task with a new client seeking accreditation.  You need to know the scope of the work before you can develop a proper workplan.  You can contact CARF directly to get set up and it costs you nothing.  They will assign a Resource Specialist to your organization that will walk you through the process of figuring out which manual you will be using. They will also help you figure out which of their specific program standards will apply, though I strongly suggest getting some third party advice on that topic from colleagues, other similar accredited agencies, or an experienced CARF consultant.  I’ve seen lots of folks end up under the wrong program type, and that has the potential to cause huge problems when the survey team arrives!

Do a Gaps Assessment

Once you know where you fit in the CARF standards manual, you’ll need to figure out what you have and don’t have in relation to the standards.  I suggest being methodical – going standard by standard – to figure out what’s missing.  CARF has developed a resource called the CARF Preparation Workbook that can support this process.   It isn’t required, but some people find it helpful.  I prefer a simple workplan type format that lists the standards being applied, assesses conformance, and allows you to specify who is going to do what to address gaps in conformance.  Remember to review the examples and intent statements that come after each standard in the standards manual to make sure you understand what is required.  It’s also wise to review the appendices in the back of the manual that list what documents are required (Appendix A), what the operational timelines are for time sensitive processes (Appendix B), and what training is required for your staff (Appendix C).

Decide On Your Timeline and Build Your Workplan

With your gaps assessment in hand, you’re ready to plan your work.  I STRONGLY recommend establishing a timeline at the beginning and sticking to it as best as possible.  There is never a good time.  There will always be unforeseen circumstances and challenges. Putting your timeline in writing helps keep everyone focused. The absence of a timeline gives people permission to keep putting it off. You should count on the preparation work taking between six months and one year, depending on number and size of the gaps, the complexity of your organization, and the resources you have available to get the work done.  Work backwards from your deadline to figure out when tasks need to be completed. I tend to leave document development tasks (e.g., certain policies, procedures and plans) until later and focus on process tasks (e.g., performance measurement, staff training) first except where they overlap. I DO NOT recommend working through the standards manual in a linear fashion (from A to Z) because many of the different content areas overlap.  For example, risk management and strategic planning overlap with performance measurement and management. Make sure you develop your plan with that in mind or you can end up creating re-work.

Get Educated & Get Help When You Need It!

CARF offers regular training across the US and Canada.  They also have webinars and resources you can purchase.  It’s absolutely worth it to have one or two staff get trained. It helps you to decipher CARF-ese and make sense of how to implement the standards in your organization.  You can also access your CARF Resource Specialist for free at any time as you prepare for the site visit.  These folks can be an invaluable source of information and assistance in interpreting the standards.  Other organizations that are CARF accredited or that are going through the preparation process at the same time can be a valuable source of support as well.  After all, misery loves company!

Some organizations choose to purchase the services of a consultant to support them through the process. While building up expertise internally is always wise, having outside guidance can help streamline the work and avoid pitfalls.  I’m planning to do a blog post on how to choose a consultant as I think there are more than a few pitfalls to avoid with that as well!

Consider Doing a ‘Mock’ Review

Many of the organizations I’ve worked with hire a local surveyor or consultant to do a ‘mock’ survey.  Having a dry run with someone that is objective helps to ensure that you are ready and haven’t missed anything important in your preparations.  It also helps put staff a bit more at ease as they will get some sense of what the actual survey will be like.

Submit Your Application

Once you’ve worked your plan, it’s time to submit the application to CARF.  Submitting the application is your indication to CARF that you are operating in conformance with the standards. You can expect to have your site visit from CARF inside of six months from the time you submit the application.  The specific timelines are listed in the CARF manual.

Preparing for the Site Visit (aka What to Expect When You’re Expecting… CARF)

The key task in the run up to the site visit is staying on track with all CARF related processes.  You definitely don’t want to let off the gas. If you need assistance with preparing for the actual site visit, you can refer to my blog post “Five Tips for a Successful CARF Accreditation Survey”. And if you need more info or clarification on anything in this article, don’t hesitate to reach out.

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