CARF Surveyors share their experiences and how this work enriches their lives

As the cornerstone of CARF’s peer review accreditation process, surveyors promote CARF’s mission, vision, values, goals, and objectives by conducting on-site reviews of health and human service organizations. In applying standards from the respective CARF standards manual, surveyors interview personnel, persons served, and other stakeholders; observe organizational processes and service delivery; and review documents, including records of persons served, plans, policies, and procedures to determine conformance to the standards.

Surveyors also offer relevant, experience-based consultation to organizations regarding conformance to the standards and performance improvement. Part-time, intermittent surveyors are professionals in their fields with full-time responsibilities independent of CARF.

There are rich benefits to individuals who become CARF Surveyors:

• Professional growth and development of leadership skills
• Influence industry performance and improve service quality
• Connection to international peer groups and professional networks
• Access to emerging best practices and insights from industry thought leaders
• Annual continuing education conferences to learn about new topics and field trends
• Access to complimentary training and education, standards manuals, publications, and other tools and resources

Interested in learning more about what surveyors’ experience? Please read the Question & Answer section below.

Q: Why did you become a CARF surveyor?

I became a CARF surveyor for several reasons. Primarily, it offered an opportunity to help my organization improve its services by learning from the best practices of other organizations across the nation and internationally. Additionally, our organization previously had an onsite CARF surveyor, and leadership wanted to fill that gap. Another reason came after a survey, we received multiple recommendations and consultations to enhance our focus on performance management, making my role essential. Finally, I saw this as a valuable avenue for professional growth and development.

–Dawn Jones, Director of Performance Management and Quality, Cleveland Sight Center, became
a surveyor in 2022 for Employment & Community Services, and Vision Rehabilitation.

To expand my first-hand knowledge of how rehab is developing outside of my own organization.

–Steven Mandley, PT, CBIS, Physical Therapist, Program Director, Rehab & Community
Integration, PLLC, became a surveyor in 2009 for Medical Rehabilitation.

I worked closely with a co-worker who was a CARF surveyor for many years, and she kept encouraging me to consider it. I blew it off until I was in the position of having to help prepare our programs for a survey and realized the benefits of becoming a surveyor. I got to understand I would gain a deeper knowledge of the standards as well as being able to give back to the field. I believe in and practice, that it is very important to bring others along, and becoming a surveyor is the perfect way to do that. I finally got to a place in my job where the opportunity presented itself and decided to go for it.

–Jeannie Lewis-Whitaker, LMHC, CADC, MAC, VP of Accreditation & Clinical Integrity, WestCare
Foundation, became a surveyor in 2018 for Behavioral Health, and Child & Youth Services.

I strongly believe that sometimes we choose our path, and other times, a path is chosen for us. My sister’s birth with down syndrome played a significant role in shaping my initial decision to pursue a career in healthcare. After many years in rehabilitation medicine as both a clinician and director, I developed a deep interest in analyzing and improving the quality of healthcare delivery. Serving as a CARF surveyor perfectly aligns with my values of helping others, being a lifelong learner, enhancing healthcare models on both individual and organizational levels, and giving back. This combination of learning, contribution, and meaningful impact makes being a CARF surveyor incredibly rewarding.

–Pawan Galhotra, Program Director, Polytrauma System of Care, Veterans Affairs Palo Alto
Health Care System, became a CARF surveyor in 2003 in Medical Rehabilitation.
The opinions expressed are not those of the Veterans Affairs or any other governmental agency.

Surveys can directly impact important decisions within a company, leading to significant and clear improvements in patient care. I became a CARF surveyor because I wanted to join a dedicated team that offers valuable insights to organizations helping them refine their strategies and enhance operational effectiveness. As a surveyor, you can directly contribute to development and growth of person-served care.

–Angela Bonaguidi, Director, University of Colorado, Addiction Research and Treatment Services,
became a CARF surveyor in 2017 for Opioid Treatment Programs.

At the time I believed becoming a surveyor would enhance my knowledge in coordinating surveys at our organization. Additionally, our organization has a high degree of commitment to supporting activities which enhance our field of service.

–Jim Bernardo, Special Advisor, Presbyterian Senior Living, became a CARF surveyor in 1988
for Aging Services and Continuing Care Retirement Communities.

Q: What is a unique benefit of working as a surveyor?

A unique benefit of working as a surveyor is the continuous learning and leadership development it provides. This role allows me to stay current with evolving standards and practices, and it also enables me to bring valuable insights back to my own organization. –Dawn

The benefit to me is the transparency of colleagues and peers to collaborate and share challenges and breakthroughs, especially within the working environment. It is so different from conference or professional networking. –Steven

Always getting exposed to a clearer understanding of what the standards are really about (quality); becoming aware that there is not one way to achieve conformance, there are multiple ways; becoming exposed to other organizations and the work they do in real time; and of course, the travel – the opportunity to go to locations you might never ever have reached without this opportunity. –Jeannie

One unique benefit of working as a surveyor is the opportunity to suggest enhancements of service delivery for an organization which positively impact not only the persons served today but also may have a lasting impact for those served in the future. Another unique benefit of being a surveyor is the continual growth of my cultural competence as I expand my understanding of how cultural, social, and economic factors influence the delivery of rehabilitation services both nationally and internationally. This deepens my appreciation for the value society places on rehabilitation and the profound impact it has on those who contribute to the community. –Pawan

The fast-paced nature of surveying demands that we stay continuously updated on the latest industry trends and innovations while actively seeking to acquire new knowledge and skills. Collaborating with various organizations not only enhances technical expertise but also helps to build a broader and more diverse professional network. –Angela

There are several benefits: the opportunity to advance quality, learning best practices, and creating meaningful relationships with fellow surveyors. –Jim

Q: What do you think has been your most impactful moment as a surveyor so far?

My most impactful moment as a CARF surveyor was when Dr. Baxter, a well-respected surveyor, trainer, and longtime partner of CARF, took the time to guide me through the Performance Measurement and Management Standards. His patience, depth of knowledge, and critical insights challenged me to think more deeply about the standards and how to apply them effectively. Dr. Baxter’s mentorship in developing a solid performance measurement plan left a lasting impression on me, as he encouraged me to refine my approach and elevate my understanding of quality management. I am still in awe of the time and care he invested in helping me as a new surveyor, ensuring I was equipped to produce a high-quality performance measurement plan. In the end, our organization received no recommendations in this area, which I attribute to his invaluable guidance. I am immensely grateful for his mentorship, which continues to influence my work to this day. –Dawn

When a rehab director smiles and realizes that the CARF standards genuinely can help them promote their local/branch mission, versus being a chore just to please their corporate reports. –Steven

Oh wow – what a great but hard to answer question. I have two answers. 1. My most impactful moment for me was when I stood my ground as an intern on my first survey as a Program Surveyor. I felt confident in my knowledge of the standard and did not respond to pressure from the organization to change my decision. It was one of those, very few, black and white standards which made it easier. But the fact that I was confronted with it on my first survey was initially challenging. 2. My most impactful moment while with an organization was as I was explaining different ways to conform to the standard, I could see the lightbulb go on. As we further discussed options during consultation, it turned into a brief creative process for the person that I had the privilege of witnessing. It was very cool. –Jeannie

Many years ago, after conducting a survey, I received an email from a member of the executive leadership team of an organization we had assessed. The email highlighted the results of a consultation we provided during the survey, along with a television news story showcasing the positive impact of that consultation on the community. It’s always incredibly rewarding to witness the tremendous success of an organization you’ve surveyed. –Pawan

As a surveyor, my most impactful experience occurred during a return survey. The survey team discovered significant gaps in the documentation of patient care which could lead to misunderstandings about treatment quality. After discussing findings with leadership and staff, we worked together to improve their record-keeping practices. This collaboration not only enhanced the facility’s conformance to standards but also directly benefited persons served by ensuring they received appropriate care. Witnessing the positive changes reinforced my belief in the importance of thorough surveying in promoting better health outcomes. –Angela

Meeting with a group of Continuing Care Retirement Communities (CCRC) residents who told me that the CARF Accreditation process affirmed their choice of their CCRC. –Jim

Q: What has been your favorite survey experience and why?

My favorite survey experience was a luncheon with the surveyed organization’s leadership, staff, and individuals they served. This informal setting allowed for genuine conversations, and I was impressed by the open, welcoming culture of the organization. It was a memorable and impactful experience that demonstrated the organization’s commitment to inclusivity. –Dawn

A Canadian survey where I first saw how rehab professionals were dedicated to doing rehab right was my favorite survey experience. They were able to influence government funders to do the right thing, especially when it involved returning injured workers back to a productive and meaningful life, safely. –Steven

My favorite survey was my first one. It was such an experience. –Jeannie

My most memorable survey experiences are those that challenge me clinically and operationally. Over the years, I’ve encountered numerous organizations that have developed innovative processes, procedures, and programs tailored to meet the individualized needs of the people they serve, all while adhering to CARF quality standards. For instance, one survey of a brain injury specialty program stood out due to its exceptional focus on community inclusion, where the community was intricately connected to the program, offering unparalleled opportunities for employment, education, housing, and independence. –Pawan

I really enjoy surveying organizations in small communities because it offers unique cultural experiences. In these settings local values and traditions may have more influence in the way organizations operate. Each organization has its own story reflecting the community’s history and identity. Connections to culture and identity make my work more meaningful and enjoyable. –Angela

When conducting a survey at a Ukrainian organization in Canada, I had the opportunity to experience the cultural infusion of traditions and the impact they had on the lives of the persons served. –Jim

Q: How has being a surveyor challenged you the most?

One of my most challenging experiences was a Digitally Enabled Site Survey for an organization in another country. This survey required me to adapt to different cultural expectations, interpret standards in unique ways, and manage time zone differences—all while maintaining professionalism and focus. –Dawn

Learning what is possible outside of my own organization and posing new opportunities to those who have never seen alternative rehab programming outside of their own organization. –Steven

When I first began doing surveys, I was anxious, nervous, and questioning my knowledge base, and really agonizing on how to not let how we do it at my organization influence how I reviewed and rated another organization’s work product. It took me a few surveys to be able to remove that potentially irrelevant judgement. Now, I am able to take what is presented and look at each document as unique and with fresh untainted eyes. Now, it is about what I see that is in conformance and where could they improve (if relevant) vs “we don’t do it like this.” This has allowed me to see opportunities to improve our documents. –Jeannie

Being a surveyor has constantly challenged me to maintain an open mind and value diverse perspectives on service delivery. –Pawan

Surveyors have to comprehend various regulations and standards that oversee person-served care. This understanding is essential to guarantee that organizations deliver appropriate care and comply with legal obligations. Furthermore, surveyors might encounter pushback from employees who may feel uneasy about the audit process. Finding the right balance between providing meaningful guidance and keeping good relationships can be difficult but essential for impacting improvements in an organization. –Angela

Conducting a survey of one location of a multifacility organization which did not support the corporate mandate for survey accreditation and being inserted in the middle of an organizational conflict. –Jim

Q: What advice would you give to future or aspiring surveyors?

Network with other surveyors and find mentors in both administrative and program areas. This support will help you refine your skillset. I also recommend attending the CARF Continuing Education Conference and Performance Management workshop for additional insights and connections. –Dawn

Be humble and expect to learn things you have never seen implemented before. Go into a survey to learn and be blown away. Don’t go in to be the hero and save or correct them. –Steven

Always be yourself. As you go through the training and are then actually conducting surveys, it is important to not forget who you are and let your work and interactions reflect that. If you are funny, be funny but also be about the work and the purpose of your time with them. Being yourself helps to reduce their anxiety and allows your knowledge, your love for “the work and the clients” and helping others show. –Jeannie

Embrace new adventures and opportunities for discovery—there is always so much to learn and share. –Pawan

As aspiring surveyors, it is important to approach your work with both diligence and empathy. Understand the unique challenges that organizations face in delivering care. Thoroughly review documentation and ensure conformance but also recognize the human element behind the standards. Engaging with providers can foster better relationships and enhance the survey process. Finally, always stay updated on field and standards changes to improve your effectiveness as a surveyor in this vital field. –Angela

Be open to learning new and different experiences. –Jim

Q: Can you give an example of how the peer model allowed you to both share and develop your own experience in the field?

The peer model has been essential to my growth as a CARF surveyor. Collaborating with experienced surveyors has exposed me to diverse perspectives, which has broadened my approach and refined my methods. After each survey, we receive feedback not only from peers but also from the organization and editors, providing a well-rounded evaluation that drives continuous improvement. This multi-layered feedback process has strengthened my analytical skills and increased my confidence in delivering actionable insights. The collaborative peer model has deepened my understanding of CARF standards and empowered me to develop effective quality improvement strategies for my organization. –Dawn

Once I learned how to earn peer trust in another organization, the transparency allows fast and effective learning on both sides when you are collaborating with those who share your passion in a specialty area. I learn so much more during a survey than I ever could in an onsite course or conference. –Steven

As an admin and program surveyor, I get to experience both sides of the coin when I work with other peers. When I function as a program surveyor, I love to see how the administrative person presents guidance in the pre-survey calls about what needs to be provided for us to review and experiencing different ways of presenting the entrance and exit conference. One of the things I learned from the peer model is also humility. We are coming in, in a way, as the “authority,” but during the survey process, watching my peers has helped me to go back to my roots of listening keenly and being open. Because I do both types of surveys, when I am with peers, I always will be the program surveyor because I get a chance to be really clearly reminded why we do what we do. –Jeannie

As a surveyor, I have had the privilege of integrating best practices to enhance efficiencies while maintaining exceptional quality and recognizing the invaluable contributions of all stakeholders. The CARF surveyor cadre offers guidance not only to the organizations we survey but also to one another. I hold the utmost respect for my fellow surveyors and their unwavering dedication to advancing the field of rehabilitation medicine. –Pawan

After finishing a survey, CARF surveyors go back to their main jobs. It’s not unusual for a surveyor to have recently taken part in a CARF survey, but from the opposite side. Because we are in the field, we can look at a survey not just as someone checking the work but as someone who is invested in person-served care. As such, there is a deeper level of mutual understanding and respect. –Angela

My example is more general. The peer model allowed me to calibrate how I evaluate the relative quality of my own program and eliminate pride. –Jim

Q: How has being a surveyor impacted your professional development?

Being a surveyor has greatly improved my skills in coaching, public speaking, and training. I used to feel nervous about public speaking, but this role has helped me build confidence and ease in presenting and leading discussions. –Dawn

It has allowed me to speak with confidence and with real plan/objectives to leadership about the importance of implementing best practices and the ability to do what is right. –Steven

Every year when the new manuals are released, I develop a “new manual changes” document for my organization. I review the changes document, compare it to the old manual, and write a brief summary with examples that are relevant to my organization including a “what does this mean for you” explanation that is shared during our accreditation call. This process alone helps me with my understanding of the changes/standards and gives me a better grasp for when I am helping my organization to prepare for its survey. –Jeannie

Professionally, I have greatly benefited from the opportunity to implement many of the excellent processes I’ve observed over the years. My expanded knowledge of quality standards, coupled with a deeper understanding of how the ASPIRE standards and program standards work together, has been instrumental in my professional development. –Pawan

Being a surveyor contributes to professional development as there is an inherent responsibility to remain informed and keep up with the latest trends in healthcare services. As a surveyor, you’re held accountable and have to demonstrate standards and field knowledge. Sure, the general field has annual expectations, but it’s on a different level when you’re a CARF surveyor. You have a duty to CARF and the surveyed organization to be knowledgeable, communicate well, and provide a meaningful survey experience. –Angela

By providing the skills and exposure to identify components of success and incorporate them in our own services and being able to offer better consultation as a surveyor. –Jim

Q: Has your reason for being a CARF surveyor changed from when you first started?

While my primary motivation remains the same, my interest in professional development has deepened. I now see ongoing growth and learning as essential to my role as a surveyor and as a quality improvement specialist. –Dawn

Yes. I now want to spread best practices and show American practitioner’s how rehab can be provided to help catastrophically injured people regain function with dignity in a way that is not pressured by profit. Other countries with very different payer schemes are doing it, and so can we. –Steven

Not really, I still practice bringing others along, having integrity in my work and sharing experience, strength, and hope. The only thing that has changed is my commitment to continue to do this work for as long as I can as a CARF surveyor. –Jeannie

Each survey has been an opportunity for growth and learning. Over the years, I have significantly expanded my knowledge base, enabling me to share best practices with organizations. At its core, my motivation for being a CARF surveyor remains unchanged since I began: to listen, learn, and share. –Pawan

At first, I remember becoming a surveyor to better understand the process and CARF standards. At some point the original reason evolved into a desire to continue surveying because of the strong connections and teamwork with others in the field. There are many reasons why I keep doing surveys but one of the main ones is that I get to be part of a team that really makes care better. –Angela

Not really. –Jim

If interested in learning more or completing an application go to this section of the website: https://carf.org/surveyor/.