CARF, Joint Commission expand accreditation pact

Duplication cut for hospital-based programs

If your hospital-based medical rehabilitation program is CARF-accredited but seeking accreditation from the Joint Commission on Accreditation of Healthcare Organizations as well, you can decrease some of the documentation time and personnel involved in preparation under a new cooperative agreement between the Joint Commission and CARF...The Rehabilitation Accreditation Commission in Tucson, AZ.

The Joint Commission in Oakbrook Terrace, IL, has agreed to honor CARF accreditation of medical rehabilitation programs in hospitals seeking accreditation under the its hospital accreditation standards. The cost of accreditation surveys will remain the same, but rehab providers will save time, effort, and money because of reduced paperwork and the singular effort required to prepare.

Some of the conferences and interviews are conducted jointly by the accrediting groups. Also, the new agreement makes it possible to request a combined survey from the accrediting bodies. Freestanding rehab hospitals, hospitals and rehab units within a network have been able to undergo dual surveys since 1997. Under the new agreement, which went into effect in August, if your hospital is seeking accreditation under the Joint Commission’s hospital accreditation standards, you may undergo a limited Joint Commission survey of your CARF-accredited program areas, says Sally Saadeh, director of special projects for CARF’s medical rehabilitation division..

For CARF-accredited medical rehabilitation programs, the Joint Commission conducts a brief overview with the operational leadership to address how the program integrates with the entire hospital and meets its needs. Among the topics of discussion are leadership standards, staff competencies, information management standards, performance improvement issues, and environment of care/life safety issues.

CARF-accredited medical rehab programs are not required to participate in other components of the survey, such as staff interviews, patient interviews, and review of active patient records. "The process applies only to CARF-accredited, hospital-based medical rehabilitation programs undergoing JCAHO accreditation hospital based survey. Providers must notify the Joint Commission that they have a CARF-accredited program when they put in their survey application, and show the CARF survey report at the time of the Joint Commission survey," Saadeh says.

The arrangement is the third in a series of agreements between the two accrediting bodies. In the first step in the agreement, which went into effect in January 1997, the two organizations offered freestanding rehabilitation hospitals the option of undergoing a combined survey leading to dual accreditation. Since November 1997, the Joint Commission has recognized CARF accreditation of medical programs in freestanding rehab hospitals and hospital-based units seeking accreditation under JCAHO’s network accreditation standards.

Phase II under way

The dual accreditation process for freestanding rehab hospitals began in 1997 with minimal integration. This month, rehab hospitals undergoing joint accreditation will progress to phase II: moderate integration of the survey process.

With moderate integration, there still will be two survey teams and two survey outcomes, Saadeh says. However, surveyors from both accrediting organization will have undergone training together, some of the interviews will be combined to reduce duplicate questions, and there will be structured schedules for both organizations, with built-in consultation time.

CARF and the Joint Commission will move toward a fully integrated survey process by the end of the year 2000, she says. Details have not been worked out, she adds.

If a freestanding rehab hospital seeks accreditation from both organizations, it must file two applications, pay the customary fees from each organization, and contact both organizations a minimum of six months in advance to give them the opportunity to coordinate the time frames for the survey. Each accrediting body will issue its own accreditation decision based on its own standards and will compile its own survey report.