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  • Level of Care Certification

    Frequently Asked Questions

    Q: What is Level of Care certification?
    A: Level of Care certification demonstrates the capacity of a substance use disorder program to deliver residential treatment services to adults consistent with Level of Care 3.1, 3.5, and/or 3.7 described in the ASAM Criteria®, creating market transparency around the treatment services offered by the organization. Visit ASAMcertification.org for more information.

    Q: Who do I contact if my organization is interested in certification?
    A: Contact CARF directly at (888) 281-6531, ext. 7080, and ask to speak to the Certification Support Team. You can also email the Certification Support Team at LOCcertification@carf.org.

    Q: What is the process of obtaining certification?
    A. Once the complete application and fees are received, CARF will schedule and conduct a survey of the identified level(s) of care and issue the certification decision. Visit carf.org/LOCcertification/process for more information.

    Q: Where do I get the rating elements that will be applied during the certification survey?
    A: The rating elements and related resources are available from the American Society of Addiction Medicine (ASAM) at ASAMcertification.org.

    Q: How much does it cost to become certified?
    A: For certification fees, visit carf.org/LOCcertification/fees.

    Q: Are resources available to help my organization obtain certification?
    A: Publications and trainings related to the rating elements applied during the survey and the underlying ASAM Criteria® are available from ASAM at ASAMcertification.org. A webinar recording that explains how to prepare for and what to expect during the survey is available from CARF at carf.org/LOCcertification/surveypreparation.

    Q: How is certification different than accreditation?
    A: Accreditation and certification have similarities, but there are significant differences. First, certification addresses only the capacity of an organization to deliver services at a specific level of care, while accreditation addresses the quality of an organization’s business and service delivery practices. Since certification addresses capacity, the surveyor will focus on assessing the presence of information that demonstrates satisfaction of the rating elements; however, since accreditation addresses quality, the surveyors will provide recommendations and consultation for quality improvement. In addition, the issuance of certification requires that the organization meet each and every applicable defining element and substantial satisfaction of the applicable non-defining elements, while each CARF accreditation decision is determined on the balance of the organization's strengths and areas for improvement. For information about CARF accreditation, visit carf.org/accreditation, email asc@carf.org, or call (888) 281-6531, ext. 7080.

    Q: If my organization is already accredited, does it need to review the rating elements?
    A: The certification rating elements are different, and often more specific, than accreditation standards. In order to have a positive certification experience, it is critical to review and ensure that your organization satisfies the rating elements regardless of accreditation status. Being accredited does not mean that the organization satisfies the elements for certification.

    Q: What are defining elements?
    A: Defining elements are those rating elements deemed crucial to the operation of all treatment programs providing services at a specific level of care. All applicable defining elements must be met for the program to be issued certification for any level of care. Failure to meet any defining element during the survey will result in the program not achieving certification for that level of care.

    Q: What happens if my organization does not meet a defining element?
    A: One-hundred percent of all applicable defining elements must be met to be issued certification. If even one defining element is missed, certification will not be issued for that level of care. Please ensure that your organization can adequately demonstrate satisfaction of all defining elements.

    Q: What can my organization expect from the surveyor during the survey?
    A: The surveyor and the organization’s primary point of contact will introduce themselves and, after a brief tour, the surveyor will independently conduct facility observations and review documents provided by the organization. The surveyor may ask for additional information or clarifications, if needed. Unlike a CARF accreditation survey, the surveyor will not provide recommendations or consultation. Instead, the surveyor will focus on assessing the presence of information that demonstrates satisfaction of the rating elements so that CARF may determine whether the organization has the capacity to deliver services at the surveyed level(s) of care. For more information, visit carf.org/loccertification/surveypreparation.

    Q: How consultative is the certification survey?
    A: Although the certification survey is interactive at times, it is not consultative like a CARF accreditation survey. Each rating element is either met or not. All communication related to interpretation and how to meet the elements must occur between the organization and ASAM prior to the survey. If you need clarification about any rating elements, visit ASAMcertification.org or contact ASAM directly at certification@asam.org.

    Q: How long is the certification survey?
    A: Each certification is specific to a single location, and the length of the survey varies depending on how many levels of care are surveyed at the location. A survey that includes one or two levels of care will be completed in one day, while a survey that includes three levels of care will be completed in two days.

    Q: Will there be an orientation or exit conference during the survey?
    A: The surveyor will briefly meet with the organization’s primary point of contact at the beginning and end of the survey. The surveyor may also check in periodically during the course of the survey, as needed, including to solicit additional information if it appears any defining elements may not be satisfied. Immediately prior to concluding the survey, the surveyor will advise whether any defining elements will be cited.

    Q: Will the surveyor guide my organization on how to meet the elements?
    A: No. All communication related to interpretation of and how to meet the elements must occur between the organization and ASAM prior to the survey. If you need clarification about any rating elements, please visit ASAMcertification.org or contact ASAM directly at certification@asam.org.

    Q: How long does it take to get the certification decision?
    A: The certification decision is issued and made available to the organization, along with the Plan of Action form containing the cited elements, approximately 6-8 weeks after the survey.

    Q: Will my organization receive a report with its certification decision?
    A: CARF will issue a Plan of Action (POA) form with the certification decision. The POA identifies the applicable rating elements not satisfactorily demonstrated during the survey. If certification is issued, the POA must be completed and returned to CARF within 90 days. If certification is not issued, the POA will serve as a road map to make changes before reapplying for certification.

    Q: How long does certification last?
    A: Once issued, certification is generally effective for three years from the survey end date.

    Q: Can the certification decision be appealed?
    A: Any program not issued certification as a result of a survey may obtain one review of the certification decision. Visit carf.org/LOCcertification/conditions for more information.

    Q: What happens if my organization moves its certified program?
    A: Certification is tied directly to a single service location. Any physical move to a different location will require a new survey. Certification is not transferable to another location and will terminate upon relocation. 

    Q: What happens if my organization or its certified program is sold?
    A: Certification cannot be sold or transferred. However, under certain circumstances, a certified program may retain its certification following an ownership change. If at any time an ownership change appears likely, please contact CARF immediately. 

    Q: What if the treatment location address is different than the housing location address?
    A: Each survey includes both the program’s treatment and housing facilities, as there are rating elements applicable to each. Although certification is specific to the address where services are delivered, the survey may include treatment and housing with different addresses if they are physically located on the same campus. Please indicate appropriately on the survey application.

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