How is accreditation achieved?

Achieving accreditation requires a service provider to commit to quality improvement and place its focus on the unique needs and results of services for each of the persons the provider serves.

A service provider begins the accreditation process with an internal examination of its program and business practices. Then the provider requests an on-site survey that will be conducted by a team of expert practitioners selected by CARF. During the survey, the provider must demonstrate that it conforms to a series of rigorous and internationally recognized CARF standards.

Based on the results of the survey, CARF prepares a written report of the provider’s strengths and areas for improvement. If a provider has sufficiently demonstrated its conformance to the standards, it earns CARF accreditation.

After receiving the report, the provider must submit a quality improvement plan to CARF to show how it is addressing any areas for improvement. Then, each year during the term of accreditation, the provider must submit a report to CARF documenting additional improvements it has made.

Steps to accreditation

Condensed from the CARF standards manuals.

(If your organization is applying for a CARF survey, please review the complete steps to accreditation published in the standards manuals.)

The steps to accreditation may involve one year or more of preparation before the site survey and ongoing quality improvement following the survey.

1. Consult with a designated CARF resource specialist to receive guidance and technical assistance regarding the accreditation process. Learn about our quality standards and visit our Online Store to obtain a standards manual.

2. Conduct a self-evaluation. The service provider conducts a self-study and evaluation of its conformance to the standards.

3. Submit the Intent to Survey. The Intent to Survey includes detailed information about leadership, the programs and services that the service provider is seeking to accredit, and the service delivery location(s).

4. CARF invoices for the survey fee. The CARF fee is based on the number of surveyors and days needed to complete the survey. The CARF-CCAC fee is fixed, with additional fees if additional programs are added to the survey.

5. CARF selects the survey team. Surveyors are selected by matching their program or administrative expertise and relevant field experience with the service provider’s unique requirements.

6. The survey team conducts the survey and determines the service provider’s conformance to all applicable standards on site by observing services, interviewing persons served and other stakeholders, and reviewing documentation. Surveyors also provide consultation to the provider’s personnel.

7. CARF renders the accreditation decision. CARF reviews the survey findings and renders one of the following accreditation decisions:


Three-Year Accreditation
One-Year Accreditation
Provisional Accreditation

Five-Year Term of Accreditation
Approximately six to eight weeks after the survey, CARF notifies the service provider of the accreditation decision and sends the report and Quality Improvement Plan (QIP).

8. Submit a Quality Improvement Plan. Within 90 days following notification of the accreditation outcome, the service provider fulfills an accreditation condition by submitting to CARF a QIP outlining actions that have been or will be taken in response to the areas for improvement identified in the report.

CARF-CCAC-accredited service providers must also submit an annual QIP with the Annual Conformance to Quality Report (ACQR).

9. Submit an Annual Conformance to Quality Report. A service provider that earns accreditation submits to CARF a signed ACQR on the accreditation anniversary date in each of the years following the award.

10. CARF maintains contact with the service provider during the accreditation tenure. Providers are also encouraged to contact CARF as needed to help maintain conformance to the standards.

To learn more about CARF International please visit