Frontline Initiative Communication

Accreditation and Certification: Indicators of Quality
CARF... The Rehabilitation Accreditation Commission

CARF is a private, not-for-profit organization that grew out of medical and vocational rehabilitation’s need to promote quality programs for people with disabilities and others in need of rehabilitation services. Approximately 10 years before CARF’s formation, two national associations representing many providers in the rehabilitation industry began developing standards for their respective memberships. In 1966, the two groups, the Association of Rehabilitation Centers and the National Association of Sheltered Workshops and Homebound Programs, formed the Commission on Accreditation of Rehabilitation Facilities - now known as CARF...The Rehabilitation Accreditation Commission. The mission of CARF is to serve as the preeminent standards-setting and accrediting body which promotes and advocates for the delivery of quality rehabilitation services.

CARF accreditation is a statement that the organization is proud of the results it achieves for its stakeholders, while at the same time remains committed to continually improving services. The value of accreditation or certification has to be much more than a framed document hanging on the wall. Organizations seeking accreditation for their services from CARF must demonstrate a clear focus on their customers, their customers’ expectations, and the results of services provided in terms of the achievement of desired goals, and customer satisfaction. Individuals seeking professional certification from various sources must demonstrate the results of their personal knowledge, experience, and focus on results as well. In both cases, a clear indication is evident of service delivery beyond baseline expectations—as well as commitment to continual learning, changing and improving.

 As a first step in seeking accreditation from CARF, an organization makes a commitment to enhancing the lives of the persons served as defined by the person served. Organizational policies, or public value statements, are developed or revised to reflect this commitment. Next, the organization examines its structure and mission in light of current environmental factors. To do this, stakeholders are identified, their needs prioritized, and changes in service delivery are implemented when appropriate.

The organization also sets up an outcomes measurement system to observe changes in the lives of persons served, the organization, or the community as a result of services provided. The results from these observations drive changes to individuals’ service plans and services, as well as the organization’s daily operations and future plans. CARF, meanwhile, conducts site survey visits to provide an impartial, external review by a team of professional peers. This review is made using accepted standards and accessing the organization’s policies or value statements. In other words, is the organization walking its walk and not just talking its talk? Conformance to the standards is demonstrated through team observations, interviews with consumers, families, staff, and other stakeholders, answers to questions about important points in the standards, and a review of appropriate documentation.

A survey report is then compiled from these observations, which contains recommendations to reinforce the organization and staff for best practices. It contains suggestions for improving services based on the experiences of the survey team and questions from the organization. 

Equipped with this information, the organization prepares a quality improvement plan to address these recommendations during the term of the accreditation award. Using its outcome measurement system, the organization continues to refine and improve its services. 

Throughout the term of accreditation, training and publications are available from CARF to help the organization implement its own quality improvement plans and continue to improve customer-focused services for its stakeholders.

Presently, CARF has accredited close to 15,000 programs in the United States, Canada, and Sweden in areas of medical rehabilitation, behavioral health, and employment and community services.