I Don’t Want to Get Accredited… Here’s Why!

As the CEO of a nationally recognized accreditation consulting company, I am often confronted with questions about the benefits of a human service provider becoming accredited or I am asked to address perceived barriers to accreditation.  While earning national accreditation from organizations like The Joint Commission, CARF International, COA Accreditation (a division of Social Current)) or Accreditation Commission on Health Care (ACHC) can bring numerous benefits to behavioral health organizations, child welfare organizations, for-profit, nonprofit organizations and governmental agencies.  There may be valid reasons why some might choose not to pursue accreditation, and here are my responses to these top five fears:

1. Cost: We can’t afford it!

The accreditation process can be expensive, with costs related to application fees, facilities improvements, staff training, implementing necessary changes to meet accreditation standards, and potential consulting services. Some organizations, especially those operating on tight budgets, may fear the financial burden associated with accreditation to be a barrier.

Myth Buster – You can’t afford NOT to be accredited!

Accreditation is essential for organizations due to its pivotal role in enhancing credibility, competitive advantage, and access to opportunities. It ensures regulatory compliance, improves processes, and mitigates risks while fostering trust among stakeholders. In essence, it’s a strategic investment that bolsters reputation, expands market reach, and ensures sustained excellence in operations and performance.

2. Administrative burden: We are too busy running the organization and providing services!

Yes, it requires an investment of time, money and effort. Preparing for accreditation can be time-consuming and may require significant administrative efforts. Staff may need to find time to focus on compliance with accreditation standards, which could affect day-to-day operations.

Myth Buster – The heavy lift is with the initial accreditation; after that, proactive maintenance allows for the organization to fully benefit from the process and reaccreditation efforts should be much less of a lift.

Internal financial controls, governance, HR and training, strategic planning, risk management, ethical practices, outcomes measurement, and additional areas all require attention to be ready for review by your selected accrediting body.

Note: Many organizations seeking initial accreditation may find that they need to do more preparation work on the administrative/management side of the business rather than programs and services, due to the predominate focus of state licensing reviews on an organization’s programs.

3. Staffing constraints: We don’t have enough people to devote to accreditation efforts!

Health and human service organizations, especially those in underserved areas, may struggle to allocate the necessary human resources, time, and effort to meet accreditation requirements. Staffing shortages, high turnover, or limited access to training resources can make the accreditation process challenging.

Myth Buster – Accredited organizations regularly report that becoming accredited resulted in lower staff turnover and better recruitment efforts.

TJC Study on Accreditation ROI

TJC Infographic

Accreditation signals to employees and potential hires the organization’s commitment to quality, professionalism, and continuous improvement. Meeting standards often involves investing in employee training and development, which can increase job satisfaction and career advancement opportunities. Additionally, accreditation enhances the organization’s reputation, making it more attractive to top talent seeking stable and reputable workplaces. By showcasing adherence to industry standards and a dedication to excellence, accreditation strengthens recruitment efforts by positioning the organization as an employer of choice within the industry.

SMART PEOPLE LIKE TO WORK IN WELL-MANAGED, WELL-SUPERVISED, WELL-ORGANIZED AGENCIES!

4. Already meeting state regulations – Isn’t this enough?

Behavioral health, child welfare and other human service organizations are often subject to extensive state regulations and oversight. If an organization is already in compliance with state regulations, they might question the need for pursuing additional national accreditation, especially if they perceive the state’s regulations as rigorous and comprehensive.

Myth Buster – Meeting standards is compliance with the bare minimum.

Accreditation goes beyond mere compliance, offering a myriad of benefits that elevate the organization’s operations, services offered and reputation. It often unlocks access to additional funding streams and referral sources that prioritize accredited providers, expanding the organization’s financial resources and client base. Moreover, accreditation signals a commitment to excellence and best practices. By going above and beyond licensure requirements, accreditation distinguishes the organization from competitors, affirming its dedication to superior service delivery and continuous improvement. This distinction is increasingly important to individuals, families, and communities seeking reputable and reliable services. While meeting state standards is essential, accreditation propels human service organizations to new heights by securing funding, enhancing credibility, and ensuring unparalleled quality and distinction in service provision.

5. Philosophical differences

Some organizations may believe they have philosophical or ideological differences with the accrediting bodies and fear they may not align with the accreditation standards or requirements. They might prefer to operate independently, based on their own principles and values, rather than adhering to external accreditation criteria.

Myth Buster – Rejecting accreditation based solely on ideological differences risks limiting growth, impact, and credibility.

Operating independently based on an organization’s principles and values is admirable, but rejecting accreditation due to perceived philosophical differences can be short sighted. Accreditation standards are designed to ensure the highest quality of service delivery, client safety, and organizational effectiveness. By aligning with these standards, organizations demonstrate their commitment to excellence and accountability, which can enhance credibility and trust among stakeholders. Accreditation also provides an objective framework for self-assessment and continuous improvement, which will help them identify strengths, weaknesses, and areas for development.

The accrediting bodies research and develop standards in a way to allow for unique programs and services; they are not written to standardize program delivery. It is possible to find an accrediting body that aligns with your values! It’s essential for organizations to carefully weigh the benefits and drawbacks of an accrediting body before making a decision, considering how it aligns with their mission, vision, values, and goals for serving their communities. At Accreditation Guru, our experts will gladly help you find the right fit.

 

Ultimately, the decision to pursue or not pursue national accreditation should be carefully considered in the context of the organization’s unique circumstances, mission/vision, and priorities. This decision will certainly have implications for funding, reputation, and the ability to attract clients. It’s essential to weigh the potential benefits of accreditation against their specific circumstances and priorities before making a final decision.

Accreditation 101

For those who may be new to the accreditation game, in this video Jennifer goes over the basics of accreditation, including “how” and the “why” of accreditation for your organization.

Get Accredited Without Breaking the Bank

Human service organizations play a crucial role in meeting the needs of vulnerable populations, and it is essential that they are well-manage and effective in their operations. One way that organizations can demonstrate their commitment to quality is by becoming nationally accredited. However, the costs associated with accreditation can be a barrier for some organizations, especially those with limited resources.

While the costs of accreditation can be significant, it is important to remember that accreditation can lead to significant organizational improvements. Accreditation helps organizations to identify areas for improvement, implement best practices, and enhance their service delivery. These improvements can translate into better outcomes for clients and greater organization efficiency, which can help to offset the costs of accreditation over time.

Read on for tips on how a human service organization may approach the costs associated with becoming nationally accredited.

Direct vs. Indirect Costs

It is important to analyze the annual costs associated with accreditation and determine whether they are feasible for the organization. This analysis should include both direct costs (such as application fees and onsite survey expenses) and indirect costs (staff time spent on accreditation-related tasks or improvements to facilities, for example). By understanding the costs associated with accreditation, organizations can develop a realistic budget and plan accordingly.

TIP: When comparing fees from different accrediting bodies, they can vary widely based on your organization’s size, breadth of programs, number of locations, budget, etc. When you have an estimate of fees from an accrediting body (AB) for your entity, it helps to divide by three if that AB has a 3-year cycle (such as CARF International or The Joint Commission) or divide by four for a 4-year cycle (COA Accreditation, for example) to better directly compare total fees.

New Program Development & Expansion

New program development / expansion may come about as a decision while conducting strategic planning, assessing needs of defined service population, staffing needs, and accessibility of services. These decisions may require additional staffing, resources, and facilities improvements, which can add to the overall cost of accreditation. However, these investments can also help organizations to better serve their communities, enhance their long-term sustainability, and ultimately lead to higher revenue.

TIP: Be sure that your leadership and board of directors have accurate and complete data to make informed decisions. It may seem like this does not need to be said, but sometimes organizations want to paint a rosy picture of how things are going. Be honest, make hard decisions when needed, and be sure that you are serving the current needs of your defined service population.

Improved Operational Efficiencies

Accreditation helps an organization use its resources more efficiently and can result in cost savings. Accreditation requirements for clear and detailed written procedures based on well thought out policies can enhance staff performance, improve outcomes, and lead to better communication with, and satisfaction for, the clients. These efficiencies can help retain staff, strengthen relationships with funding and referral sources, and aid in compliance with state or federal regulatory bodies.

TIP: States recognize the positive impact of accreditation and many offer regulatory relief from licensing / certification requirements. Check with your state licensing or certification representative for recognitions of accreditation.

Liability Insurance

Accredited service providers may be eligible for considerations on their insurance policies. The reason is that insurance carriers understand achieving accreditation leads to more robust risk management and risk mitigation efforts, a focus on health and safety, corporate compliance, and ethical business practices. This can lead to lower liability insurance costs over time, which can help offset the initial costs of accreditation.

There is a reason that the first question after the demographics (name, address) on an insurance policy application is “Licensure and Accreditations.”

TIP: You will need to inquire about considerations related to accreditation. If your broker is, for some reason, not familiar with the many benefits of national accreditation, they should be educated on it (feel free to share this article).

Grant Opportunities

Two notes about grants. First, some foundations use accreditation as a qualifier to apply for a grant, while others may use accreditation as an internal selection criteria without formally stating it as a requirement. Why? Because foundations and other funders understand the benefits and importance of earning and maintaining accreditation.

Second, there are grant opportunities out there that can help offset the costs associated with accreditation. While you may not see grants specific to accreditation, many grants will cover some aspects of accreditation and / or fund ways to improve your service programs. The following are examples of areas addressed under accreditation, and a grant related to such can be earmarked to help defray costs:

  • Technology and equipment improvements
  • Strategic planning
  • Quality management programs
  • Capacity building
  • Board development

TIP: The National Council of Nonprofits has a listing of grant research tools, including a listing of state associations of nonprofits, which provides links to state-specific grant databases and member discounts on grant research tools.  https://www.councilofnonprofits.org/running-nonprofit/fundraising-and-resource-development/grant-research-tools. Also, Candid (formerly the Foundation Center) helps nonprofits find funders to support their work through their Foundation Directory (fee-based). https://candid.org

Facilities and Office Space

In some cases, organizations may need to make improvements to their facilities or office space in order to meet accreditation standards. This may require additional funding, which should be factored into the organization’s budget and fundraising plans.

TIP: Have someone other than the Facilities Manager do a walk-through of all residential and operational facilities to review against accreditation standards early on in the process. The “fresh eyes” approach can be very helpful, whether this is conducted by a staff member or an outside consultant.

Ensure Board & Leadership Buy-in

Finally, it is crucial to ensure that the organization’s board and leadership are fully committed to the accreditation process. This includes not only providing the necessary financial resources but also actively participating in the accreditation process and ensuring that the organization meets all of the necessary standards and requirements. Board and leadership buy-in are critical to the success of accreditation, and without this support, the accreditation process may be difficult to achieve or sustain.

Keep in mind, just because you do have board and leadership buy-in does not guarantee an easy road to accreditation, but if you do NOT have this buy-in, you are fairly definite to have problems along the way.

TIP: Meet with the leadership team and board of directors when first considering accreditation to discuss the benefits, accrediting body or bodies being considered, outline the timeline and process, review costs and allow them to ask questions, all with an eye toward building the all-important buy-in.

In conclusion, the decision to pursue accreditation is a significant one for any human service organization. While the costs of accreditation can be significant, they must be weighed against the benefits of improved service delivery, reduced liability risks, and increased organizational efficiency. By carefully considering the costs and benefits of accreditation, organizations can make an informed decision about whether accreditation is the right choice for them and ensure their long-term sustainability and success.

 

For more information or questions about the contents of this article, please write Peggy Lavin @ peggy@accreditationguru.com.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Where to Start if You’re Considering Accreditation for the First Time

Starting the accreditation process can be overwhelming: from determining which accrediting body to work with, to obtaining buy in from the board of directors and staff, to creating your team. In this video Jennifer highlights initial items to consider when beginning the road to national accreditation.

For assistance with any aspect of accreditation preparation or maintenance of accreditation, please contact us or schedule a free 30-minute consultation meeting.

How long does it take to become accredited?

We are often asked how long it takes to become nationally accredited. Whether you seek accreditation to increase reimbursement rates from private payers, to enhance your organization’s operations and program delivery or due to a mandate under the Family First Prevention Services Act (FFPSA), for example, achieving accreditation is a worthy endeavor. However, many organizations underestimate the time commitment involved.
Watch our brief video tip about how to best gauge the time required when preparing for accreditation and visit our blog on “National Accreditation – Where Do We Begin.

How to determine which accrediting body is the right fit for your organization

Selecting a national accrediting body to work with is a significant undertaking. The commitment goes beyond the initial accreditation cycle and, in most cases, it continues for many more years, sometimes even decades. Because of the investment in time, money and effort involved, the selection process should not be taken lightly. Watch our video for tips on determining which accrediting body is the right fit for your organization.

 

What is the importance of an annual plan?

While a strategic plan is the long-term framework for what is to come, an annual plan – or work plan – is staff-driven, designed with specific objectives, outcome measures, and areas of responsibility (including timelines) in order to provide the day-to-day guidelines needed to ensure the strategic goals are ultimately met.

Is Your Accrediting Body Still the Right Fit?

Your organization is not the same one it was 10 or 20 years ago (or likely even 3 years ago!). New programs/services may have been opened and staff changes have taken place. There are new requirements from payors, licensing bodies, the federal government, etc. Perhaps there has been a merger or acquisition, or new partnerships developed with other entities to ensure the continuum of care. Or, you may have directly integrated physical health care into your service delivery or begun to offer telehealth services as a result of the pandemic.

Likewise, the accrediting bodies may have changed over time:

  1. Standards are updated annually – do they still fit with your current program/services?
  2. Has there been a shift by the accrediting body to be more closely aligned with your line of business – toward behavioral health or toward child welfare, for example?
  3. Perhaps there has been a new approach to sales and marketing that could have affected customer service?

When you initially selected your accreditor, you likely considered such things as cost, reputation in the marketplace, and may have had a recommendation from another organization. (See our blog article on 10 Things to Consider When Selecting an Accrediting Body for more information.)

I’m sure that the intent was to do your research and find the best fit for a long-term relationship. However, relationships can change.

So, when do you know if it is time to look around? And, if you do, what questions should you ask?

If you are asking yourself these questions, might I suggest that you consider the following:

  1. Standards – your programs and services’ fit with the current accreditation standards
  2. Reputation – current feedback from other accredited organizations
  3. Mandates – is there a current mandate for accreditation or one on the horizon, and if so, does it specify a particular accrediting body or bodies?
  4. Effort – how much work will it take to switch vs. remain with your existing accreditor*
  5. Costs – fees always matter, but what is the true value of the accreditation process and experience and what is the cost to maintain your accreditation?
  6. Timing – how long have you been with your existing accreditor?

Note, I do not recommend making a change simply for the sake of change. However, it never hurts to look around and ask a few questions to make sure that your accrediting body is still the right fit for today and for the future of your organization.

 

*If already accredited and deciding to make a switch, it is important to focus on the similarities and differences between the two accrediting bodies’ standards and processes for the most effective use of time and resources. It is also critical to understand the different approaches and philosophies from one accrediting body to another.

To further discuss any of the above items, or if you are interested in assistance with switching from one accrediting body to another, please contact us at Info@AccreditationGuru.com / 212.209.0240. This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.