Patient Care Facility Accreditation Guide

The Basics

All applicants must meet the basic eligibility criteria as well as become compliant with the Standards listed in this Guide. Your compliance is determined by a review of your application materials, an onsite survey, and a final validation of your surveyor’s findings. The onsite survey is conducted by professionally trained and qualified surveyors.

As required by CMS, all surveys for patient care accreditation are unannounced and unscheduled and occur during your posted business hours.

By submitting your application, you declare that you are ready for an onsite survey at any time. Surveys will not be rescheduled due to emergency closure, staff unavailability, or lack of readiness. If you deny the surveyor access to your facility and/or essential paperwork or if your facility is closed during posted business hours, you must resubmit an online application and include all accreditation fees and documentation to be resurveyed.

Types of Surveys

Initial Survey (First-Time Applicants)

Initial surveys are for newly operating facilities, established facilities that have not been previously accredited, ownership changes, and facilities switching from another accrediting organization. Facilities considering accreditation are encouraged to review the Guide and complete the Pre-Application Checklist. To be placed in the queue for an initial survey, submit a request to create an account/login and then submit a completed online application.

Reaccreditation Survey

Reaccreditation surveys are utilized for sites with existing ABC accreditation. These surveys also cover physical address changes or additions to accreditation program. We send renewal reminders to the primary email address and mail them to the facility. Reaccreditation applications are due by January 15 of the expiration year. Late applications or holds may prevent completion of  the onsite survey before expiration. Reaccreditation surveys also review prior deficiencies and corrections. 

Verification Survey

ABC reserves the right to randomly visit accredited facilities to conduct verification surveys to assess compliance within a facility or for quality control purposes. .). ABC will notify the facility if a verification survey is required, and the facility is responsible for associated fees.

CMS-Directed Surveys

As a deemed accrediting organization, ABC may conduct additional surveys, outside of a regular renewal cycle, as directed by CMS. These surveys are random and unannounced. There is no charge for these types of surveys.

Surveyors

Surveys are conducted by either a single surveyor or a team of surveyors. On occasion, we will send a surveyor apprentice as part of the survey team, at no additional charge to you. All surveyors and surveyor apprentices have a photo identification badge issued by ABC. Surveyors are assigned based on the programs indicated on your application. Facilities cannot request a particular surveyor to conduct their survey.

Once a surveyor has been assigned to your facily's survey, you will receive an email with your surveyor’s name. All ABC surveyors/apprentices must disclose any potential conflict of interest with the applicant/facility to us before they are assigned to conduct the survey. If you have a conflict of interest with your assigned surveyor, please email accreditation@ ABCop.org with your name, facility’s contact information, and reason within five days of receiving your assigned surveyor email. Requests made after the five days will be denied. The following constitute a valid conflict of interest:

• The surveyor has provided consulting services or accreditation guidance of any kind to your facility.
• The surveyor has a personal relationship with an owner, shareholder, or other individual working at the facility.
• The surveyor enters into employment or contract with the facility.
• The surveyor was employed or contracted or currently employed or contracted with a competing business in your local area.
• Surveyors/apprentices with a confirmed conflict are not assigned that survey.

Your surveyor is not available to you after your onsite survey, and we cannot provide you with a surveyor’s personal contact information. ABC staff is available to you throughout your accreditation process for any questions you may have. Simply email us at accreditation@ABCop.org.

About Our Surveyors:

Background

Our surveyors come from a variety of backgrounds, giving them unique perspectives as they conduct your survey. ABC selects surveyors for their extensive experience, compliance knowledge, and commitment to ABC and our mission. They demonstrate objectivity, diplomacy, and dedication to our profession.

Site Surveyor Training

Each surveyor receives formal, structured training through regular workshops and hands-on individual training with a senior surveyor. In addition, each site surveyor has access to training materials and tools specifically created to facilitate the survey process and to validate their understanding of the ABC Accreditation Standards.

Approach

ABC surveyors demonstrate maturity, objectivity, diplomacy, and dedication. They project professionalism in both behavior and appearance. In addition, our surveyors appreciate the confidential nature of the task and understand the need for self-initiative, a cooperative attitude, an analytical approach, and the necessary flexibility.