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  • Level of Care Certification – Conditions


    1. CARF extranet.The organization must designate at least one representative with administrator permissions for the CARF extranet, Customer Connect ( https://customerconnect.carf.org). Customer Connect is CARF’s secure, dedicated website for certified organizations and organizations seeking certification. Customer Connect is CARF’s primary means of transmission for important notices, communications and other documents. Organizations should use Customer Connect regularly to view certification-related documents and to keep CARF informed of organizational changes, including but not limited to the name and email address of the organization’s designated representative.

    2. Application process. A separate application and fees are required for each discrete physical location at which the organization delivers services seeking certification (“Services”). The application process is considered complete when CARF issues the Survey Information Summary. If any information in the application changes after submission, the organization must immediately notify CARF in writing.

    3. Fees. CARF will determine all certification fees consistent with the published fee schedule in effect upon application submission. Any change affecting fees after issuance of an invoice may result in revised fees and issuance of a new invoice.

    4. Scheduling. The submitted application must specify all conflicts and days during the six-month survey timeframe that may pose problems for the organization. CARF will commence scheduling immediately upon completion of the application process. If CARF determines that scheduling the survey to occur within the timeframe is not practicable, CARF will make best efforts to schedule the survey to occur as soon as practicable. If CARF is unable to schedule a recertification survey during the timeframe due to no fault of the organization, the current certification will continue in effect until the recertification decision is issued.

      The organization may submit a written request stating a bona fide conflict of interest to change the assigned surveyor, which request must be received by CARF within 10 calendar days of the date on which CARF transmits notification of surveyor assignment. A change in surveyor assignment is made when just cause has been presented.

      The survey is considered scheduled when the notice of survey date(s) is issued by CARF. If the organization requests any change to the scheduled survey date(s), the organization must timely pay the current rescheduling fee plus all related nonrefundable travel expenses. No survey will be rescheduled until payment of the rescheduling fee and related expenses are received in full.

    5. Survey.The organization is responsible for providing to CARF during the survey all information demonstrative of satisfaction of the rating elements and must have all such information readily available to and set aside for CARF, preferably with each item marked with the element(s) to which it corresponds (if possible). CARF will work independently during most of the survey. The survey findings are contained in the Plan of Action form issued with the certification decision and are not communicated during the survey.

    6. Certification decision. The certification decision is based on the organization’s demonstration during the survey of substantial satisfaction of the applicable rating elements, including but not limited to each and every defining element. The certification decision is not transferrable to any other person or entity, Level of Care, service, or location. At all times while certification is in effect, the organization is authorized to publicly display the Level of Care certificate and communicate that it is certified to deliver the certified Level(s) of Care at the certified location (read the Guide to Promoting Your ASAM Level of Care Certification for more information).

    7. Term of certification. Once issued, certification is considered effective as of the survey end date and will expire on the last day of the month that is three years from and after the survey end date (or prior expiration date, in the case of recertification), unless the survey is supplemental to an active certification or the certification is earlier terminated or otherwise modified by CARF. Any organization seeking an extension of certification should submit its written request, including a sufficiently detailed explanation of the supporting rationale for CARF to give it reasonable consideration, prior to timely submission of its recertification application. While no request for extension will be approved prior to submission of the application and payment in full of the certification fees, organizations are advised to contact CARF in advance for guidance regarding the likelihood that an extension will be granted under the circumstances. Extensions are generally not granted for more than three months. If an extension is granted, only Level(s) of Care that are currently certified and listed in the submitted recertification application will be included in the extension. The survey following an extension will be conducted using the elements then in effect, and any expiration date issued will typically reflect the month of the prior survey end date. Organizations that submit a recertification application, request for extension, or certification fees after the application due date risk a lapse in certification.

    8. Subsequent surveys. To maintain uninterrupted certification beyond the expiration date, the organization must submit a recertification application by the applicable due date, timely pay the certification fees in full, and successfully complete a timely recertification survey. CARF may conduct announced or unannounced surveys of certified Services at any time, as determined in its sole discretion.

    1. Ongoing communication. During the term of certification, the organization must provide timely information to CARF about certain events that occur within or may affect the certified Services. Some situations may require further actions to be taken, as determined in CARF’s sole discretion. Information about the events listed below must be communicated to CARF within 30 days of their occurrence:
      1. Change in leadership.
      2. Change in ownership (e.g., asset transfer, statutory merger, consolidation, or stock or membership transfer).
      3. Change in organization name.
      4. Change in mail and/or email address.
      5. Relocation.
      6. Change of Level(s) of Care.
      7. Elimination of Services.
      8. Change of licensure status.

      9. Reporting forms are available at carf.org/loccertification/reporting. Please contact CARF for more information.

    1. Review of certification decision. Services not issued certification for one or more Levels of Care as a result of a survey may obtain one review of the certification decision (“Review”) in accordance with the process set forth below.
      1. CARF must receive the applicable Review fee and completed Review Request Form (“Request”), as directed in such form, within ten calendar days of the date of the letter that communicates the certification decision from the survey.
        1. A Review shall be a “Summary Review” if five or fewer defining elements are cited in the Plan of Action form (“POA”) for each Level of Care under review and all such defining elements are eligible for Summary Review. In the case of a Summary Review, the timely Request must identify each and every such defining element number and include each written document* specifically responsive to each and every such defining element.
        2. Any Review that is not a Summary Review shall be an “Full Review”.
      1. CARF shall make best efforts to conduct the Review within 90 days of receipt of the timely Request.
        1. In the case of a Summary Review, CARF shall conduct a review of each document* included with the Request to determine satisfaction of each eligible defining element identified in the Request (not to exceed five per Level of Care).
        2. In the case of a Full Review, CARF shall conduct a review of the information* (e.g., interviews, observations, records and other documents) deemed appropriate to determine satisfaction of each rating element cited in the POA and subject to the Review.
      1. CARF shall issue a certification decision based on the survey findings as modified by the Review (“Findings”).
      2. The certification process and conditions in effect from time to time are applicable to the Review and this review process to the extent not inconsistent.
      3. The Findings, certification decision and all other matters related to the Review and this review process are final and not subject to dispute.
      4. All decisions and determinations related to and interpretations of this review process shall be determined at CARF’s sole and binding discretion.

      5. *If any relevant document or other information changes subsequent to the survey under review (e.g., updated policies and procedures), the Review shall consider the information current when included with the Request for Summary Review or at the time of the Full Review, as applicable.

    Effective Date: July 17, 2020

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