CARF International | Commitment to Excellence | Brian J. Boon, Ph.D.

Person-centered care has been written into the CARF standards since their inception, and thus persons served are deemed the moral owners of CARF. The standards are informed by industry experts and stakeholders, including persons served. Persons served are represented in CARF’s advisory bodies, including the CARF Board of Directors, International Standards Advisory Committees, and the Financial Advisory Panel.

Why Accreditation is Important

Achieving accreditation requires a service provider to commit to quality improvement, focus on the unique needs of each person the provider serves, and monitor the results of services. A service provider begins the accreditation journey by examining its program and business practices internally. During the survey, the provider must demonstrate that it conforms to rigorous and internationally recognized CARF standards. CARF standards, including those for service delivery and business practices, have been built upon the principles of person-centered care for more than 56 years. CARF standards are developed using feedback from organizations, payers, and health and human service experts across the globe. Rooted in person-centered care, accessibility, cultural competency, diversity, inclusion, safety, and performance improvement, CARF’s standards are widely regarded as industry best practice.

The regular review of standards is built into CARF’s ongoing business model. CARF’s standards manuals are updated annually based on feedback received and developments in the field. CARF conducts vital stakeholder interviews and input forums and convenes International Standards Advisory Committees.

For service providers, the value of accreditation goes beyond a competitive distinction and framework for continuous improvement. CARF accreditation ensures that a provider is committed to managing risk, adhering to the highest professional and ethical standards, and improving service delivery based on outcomes data. Persons served and their family members can be assured that they receive services from providers consistently held to the highest industry standards.

The hallmark of the CARF accreditation process is the peer-review survey. The peer survey is unique in the fact that it is not intended to pinpoint deficiencies but rather to collaborate, highlight strengths, and suggest approaches that contribute value and enhance the efficiency of service delivery, not only elevating the provider seeking accreditation but contributing to best practices across the health and human services industry.

Setting the Standards

Although not new, disparity in healthcare based on the social determinants of health (SDH) is one of the most significant challenges facing the health and human services industry. SDH is defined as the conditions in which people live, work, and age and includes factors like housing stability, employment status, geographic location, education, and other socioeconomic circumstances. SDH, often determined by the distribution of wealth and resources, has proven responsible for inequities in healthcare and has become its biggest cost driver.

The World Health Organization (WHO) continually monitors this relationship between SDH and health. CARF accredits programs that serve individuals across the lifespan. The field review and standards development process ensures that evidence-based practices related to service integration, transitions, and population specialization are written into all areas of the standards.

The CARF standards encourage organizations to include SDH in their planning. For instance, the standards related to accessibility planning include financial, attitudinal, transportation, and other barriers related to social needs that may impact an individual’s ability to access services that can improve their health and community functioning. CARF concentrates on improving healthcare for persons served with standards that direct providers of care and services to consider social impediments and supports that may impact the success of service.

Many healthcare payers and regulators look to accreditation to identify service quality and realize an adequate return on their investment (ROI). CARF’s standards and accreditation process can help payers and regulators identify quality services delivered by organizations with efficient business practices and performance management systems that focus on ensuring a strong ROI. By deploying data-driven systems and tools, providers can effect real change—locally and globally—in reducing SDH-related barriers and improving outcomes for persons served.

Making the Difference

Senior Resource Group (SRG) started the CARF accreditation process in 2003 and operated communities throughout Arizona, California, Oregon, Washington, Georgia, Florida, and Texas. Vice President of Operations Ron Mead feels achieving conformance to CARF standards sets it apart and aligns its communities with industry best practices.

CARF accreditation has given SRG communities a marketing advantage in attracting residents and family members. Mead said, “Family members want to bring their loved ones to a home meeting the highest standards. Displaying the CARF accreditation certificate as well as sharing the survey report seem to bring family members a sense of calm and assurance that they are leaving their loved ones to be cared for by ‘the best of the best.’”

Prospective residents and family members are just some parties taking notice of the benefits of accreditation. Insurers, investors, and payers are also paying attention. SRG’s implementation of CARF’s risk management standards is evidence of their liability insurance carrier. It has commended the organization’s ability to lower risk by measuring outcomes and setting goals to reduce areas of significant loss exposure. “The insurance company sees the value in CARF, which helps with our rates,” Mead said.

SRG has seen measurable, positive results in staff retention, with turnover rates trending down. SRG found that its staff takes pride in the accreditation process. With lower turnover and increased staff satisfaction, the quality and level of care are markedly increased, reflecting a positive ROI across stakeholder groups.

CARF continues to respond to needs in the health and human services industry, with accreditation being expanded to new programs and service areas as well as additional product offerings. For 2023, CARF’s standards for crisis programs have been revised and organized into a continuum of care, and updates were made to the aging services standards for residential communities and information and communication technology standards for all accreditation areas.