How To Evaluate Licensure Versus Accreditation

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The explosive growth of the retirement living market has left consumers with many challenging choices to make from among countless providers. Increasingly, overwhelmed consumers are learning to look for certain designations to ensure that providers are reliable and dedicated to providing quality service. There are three levels of recognition that a facility or long-term care provider may obtain, including Licensure, Certification, and Accreditation.

Licensure- The type of recognition long used in most governmental systems is licensure. It has established guidelines and directs providers to local codes. A license is contingent on a licensee passing an inspection by a regulatory agency.

Licensees may be individuals or organizations. Hospitals and nursing homes must be licensed before they can open. Social workers, psychologists, and nursing home administrators may also be licensed. A licensed individual has passed a state board or a professional college set of requirements and has demonstrated that he or she has sufficient education and training to perform their work.

Generally, the state agency mandates the passing of a basic licensure exam covering rules and regulation for operation, combined with an inspection of the facility, before they will grant a license. Once an organization obtains licensure, they are subject to periodic inspections, called “surveys.” If a provider is in violation of state regulations, they can be fined, have limits placed on their admissions, or, if violations continue, be forced to close. Licensure is important for the consumer because it ensures they are using a legitimate provider who is meeting basic state regulations for care delivery.

Certification, Credentialing, and Registration- We often see terms such as “certified rehabilitation therapist” or “certified counselor.” Certification recognizes individuals who have achieved levels of skills or education usually established by an association or an educational institution. It is awarded to individuals who complete a specified combination of classroom training and work experience.

The term “credentialed” is sometimes used interchangeably with “certified” when applied to individuals. Similarly, registration is another way of recognizing an individual’s professional achievement, e.g., the term “registered nurse.”

Although often applied to an individual, organizations may also be certified. A country, state, or association that has a watchdog arm provides the certification. The certification usually addresses points such as business licenses, staff background checks, accounting procedures, and insurance coverage.

Accreditation- In addition to meeting state and federal licensure and certification requirements, some providers may voluntarily opt to go through the accreditation process. A key distinction between accreditation and licensure or certification is that accreditation can be granted only after a provider demonstrates conformance to standards. Licensure and certification, on the other hand, may be required of providers before they can deliver services.

Accreditation determines if the processes of the service provider produce positive outcomes. Accredited organizations are usually required to demonstrate strategic and ethical business practices and positive community influence. An organization’s conformance to standards is verified by an outside-third party of trained professionals that come to the organization to review materials and speak to residents, families, staff members, and boards.

For more information about accreditation or lists of the accredited providers in your area, please contact any of the more prominent organizations currently offering accreditation to retirement living service providers.

To learn more about the accreditation of Continuing Care Retirement Communities and similar organizations, Adult Day Services, Assisted Living, Behavioral Health, Employment and Community Services, Medical Rehabilitation, and Opioid Treatment Programs, contact the Commission on Accreditation of Rehabilitation Facilities and Continuing Care Accreditation Commission (CARF-CCAC) at (520) 325-1044 or www.carf.org. The mission of CARF-CCAC is to promote the quality, value, and optimal outcomes of services through a consultative accreditation process that centers on enhancing the lives of the persons served. Founded in 1966, CARF is an international, independent, not-for-profit accreditor of human service providers. The CCAC was founded in 1985 as the nation’s only accrediting body for continuing care retirement communities. CCAC merged with CARF in 2003.

The Community Health Accreditation Program (CHAP) offers accreditation to Home Care and Community-based Health-care providers and can be contacted at (800) 656-9656 or www.chapinc.org. CHAP’s mission is to provide leadership for enhancing the health and well-being of diverse communities by developing Standards of Excellence, which assure the management of ethical, humane, and competent care in home and community based organizations. CHAP is an independent, non-profit accrediting body that was founded in 1965.

Contact the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) at (630) 792-5000 or www.jcaho.org for information about the accreditation of Assisted Living, Home Care, Dementia Special Care Facilities, and Sub-acute Care Providers. The mission of JCAHO is to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations. JCAHO is an independent, not-for-profit organization established over 50 years ago.

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