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Where CARF surveyors come from

Understanding who your surveyors are and why they do what they do

CARF intern Gemma Gomez contributed to this article

Updated May 31, 2019

The CARF surveyor cadre numbers around 1,600 surveyors. From the CARF website and other materials, you may already know that surveyors are your peers—professionals, executives, managers, and clinicians—who work at other programs accredited by CARF.  

But why does this matter and what does it mean in practice?

Providers new to CARF are likely aware of what accreditation is, but may mistakenly associate CARF surveyors with a non-CARF, inspective model of accreditation (CARF uses a peer-driven consultation model, as opposed to a regulatory, off-site paper review, or medical audit model).

To give you more perspective on CARF’s approach, we spoke with three former surveyors who are now CARF staff members. They shared some interesting context on themselves and why they first got into surveying.

Dan Miller on learning from other providers
Dan MillerDan Miller, survey findings reviewer, was a surveyor for eight years. He was first introduced to CARF in the late 1990s while working as a quality improvement coordinator. At that point, he had been in the behavioral health industry for a decade.

After a cycle of two successful surveys, the surveyors who visited him began to persuade him to join the cadre as well. “They asked me, ‘Why don’t you come join us? It’s a good experience. It helps you, it helps your organization. You won’t get rich doing it, but you benefit a lot,’” Dan says. “So I said, ‘Ok, I’m in!’”

Like most surveyors, Dan would have to take time off from his primary job to conduct surveys, so he pitched the idea to his boss as a way to benefit his own organization.

“When you become a surveyor, it broadens your experience, it broadens your understanding of the standards and the variations of how they can be applied,” he says. “It helps improve the quality of care that your own organization is providing.”

Dan’s boss agreed, and he was able to count his time as a surveyor under his company’s educational leave, which was exactly the benefit he received from doing it.

“I learned something from every person I met, every organization I visited. Of course I was also consulting and acting as a subject-matter expert for the organizations I surveyed, but it’s a two-way street. It’s a benefit for the surveyor as well as the organizations being surveyed.”

“I like the term ‘colleague’ a lot when describing surveyors,” Dan adds. “It’s important for organizations and surveyors to recognize that they all have the same general goal of improving services to the persons that receive them.”

John Hannon on impacting the field itself
John HannonJohn Hannon, senior resource specialist in the Employment and Community Services accreditation area, worked for a couple of organizations with CARF-accredited programs. He helped prepare for many surveys, both on the service-delivery and operational sides of things.

One place he worked had a practice to have a CARF surveyor on staff. The organization found similar value to what Dan described from having an in-house person versed in both the CARF standards and the innovative practices being used elsewhere. When the previous in-house surveyor left the company, John was asked to take on that role. He gladly decided to do it.

Although John agrees with Dan and his former employer about the educational benefits of surveying, he also highlights how important he considered the opportunity to improve the field.

“For myself and other surveyors I’ve talked with, the primary motivation for being a surveyor is helping improve service delivery in the field and improving how organizations operate. You are able to share with them things you learned as a professional, at your own organization or from other organizations you visited as a surveyor.”

“That seems to be something that organizations definitely value,” he adds. “The consultation that they get from their peers in the field; sometimes it may directly relate to the standards, and other times it’s not even related to the standards.”

“That was a great part of being a CARF surveyor; the collaborative effort. I know it can be a nerve-racking experience having someone from outside come in to look at what you do. But with CARF, surveyors aren’t conducting an audit, walking around with a clipboard and a checklist saying ‘I got you.’ It’s more of a collaborative, peer-to-peer approach about how you improve what you do.”

Bettye Harrison on validating why she got into the business
Bettye Harrison, former account manager for CARF’s Opioid Treatment Program area, took an unconventional path to the surveyor cadre, in which she served for seven years.

About 25 years ago, Bettye had taken a position at the South Carolina Department of Alcohol and Drug Abuse Services. A CARF managing director, who Bettye met and spoke with at length at a CARF 101 training, invited her to attend surveyor training. 

Bettye agreed to go, simply as a learning experience and to better understand what the state’s funded entities have to go through. But that purpose quickly changed.

In a move symbolic of the CARF survey process, Bettye says, “I started as an observer, but at the training, they said to me, ‘If you really want to understand the process, you have to get off the wall and sit at a table.’”

After the training, Bettye began to attend surveys as an intern, still unsure she would really join the cadre. But working with a survey team continued to catch her attention.

“The first two people I did my surveys with were excellent, very competent, and fun to work with. I saw that camaraderie that came with the team, but also exactly the prep work they did to get ready for the survey.”

Having gone through the training and internship thinking it would be only for education, Bettye finally agreed to conduct surveys herself. On why she was initially so reluctant, she says, “I had this lofty opinion about what a CARF surveyor was. I was using that perception about what my work experience was at that time. I didn’t think I measured up.”

“To be perfectly honest, I asked the managing director years later why she recommended me. Because in all the times I’d interacted with her, we had never talked about CARF. She said that that’s the way she chose surveyor candidates. She got to know them first. She said, and I believe this too, that CARF can train you to be a surveyor, but she wanted personable people who had a good grasp of why they got into the business. And that’s what she and I had talked about.”

(Aging Services,Behavioral Health,Employment and Community Services,Child and Youth Services,Medical Rehabilitation)

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