State Recognition Details | Joint Commission
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Friday 11:07 CST, January 19, 2018

State Recognition Details

State Recognition Contact Directory


The Joint Commission actively monitors state legislative and regulatory activities for the purpose of identifying additional opportunities for state reliance on Joint Commission accreditation/certification.

The Joint Commission’s various accreditation/certification programs are recognized and relied on by many states in the states’ quality oversight activities. Recognition and reliance refers to the acceptance of, requirement for, or other reference to the use of Joint Commission accreditation, in whole or in part, by one or more governmental agencies in exercising regulatory authority. Recognition and reliance may include use of accreditation for licensing, certification or contracting purposes by various state agencies. 
 

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State: Alabama
Program: Office-Based Surgery
Agency: Alabama Board of Medical Examiners
State Reference: 540-X-10-.01 (i)540-X-10-.02(4)540-X-10-.02 (5)
Setting/Service: Any Setting Where Levels 4 and 5 Anesthesia are Provided
Type of Recognition: Guideline

(i) Facility accreditation is encouraged for those settings where deep sedation/analgesia (level 4) and general anesthesia (level 5) are provided.

(4) Deep Sedation/Analgesia. A drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. Reflex withdrawal from painful stimulation is NOT considered a purposeful response. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.

(5) General Anesthesia. A drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.


State: Alabama
Program: Behavioral Health Care
Agency: Alabama Medicaid Agency
State Reference: AL ADC 560-X-41-.02
Setting/Service: Hospital: Inpatient Psychiatric Treatment for Individuals Under 21 and Residential Psychiatric Treatment Facilities for Individuals Under 21
Type of Recognition: Medicaid

(1) Hospitals: In order to participate in the Title XIX Medicaid program and to receive Medicaid payment for inpatient psychiatric services for individuals under age 21, a provider must meet the following conditions:

(a) Be certified for participation in the Medicare/ Medicaid program;

(b) Be licensed as an Alabama psychiatric hospital in accordance with current rules contained in the Alabama Administrative Code Chapter 420-5-7. State hospitals which do not require licensing as per state law are exempt from this provision (Code of Ala. 1975, Section 22-50-1, et seq.);

(c) Be accredited by the Joint Commission on Accreditation of Healthcare Organizations;

(4) Residential Treatment Facilities (RTFs): In order to participate in the Title XIX Medicaid program and to receive payment for residential psychiatric treatment services for individuals under age 21, RTFs must meet the following conditions:

(a) Be accredited by JCAHO, CARF, COA, or be certified as an Alabama RTF in accordance with standards promulgated by the Alabama Department of Human Resources (DHR), the Department of Mental Health/Mental Retardation (DMH/MH)or the Department of Youth Services (DYS), or the Department of Children's Affairs (DCA) Upon enrollment and each time the RTF is recertified a copy of the certification letter must be sent to Medicaid within forty-five business days


State: Alabama
Program: Behavioral Health Care
Agency: Alabama Medicaid Agency
State Reference: AL ADC 560-X-52-.02 
Setting/Service: Out-of-Home Respite Care for Individuals Under 21
Type of Recognition: Medicaid

(9) Respite Care

(e) Out-of-home respite care may be provided in a certified group home or ICF/MR. In addition, if the recipient is less than 21 years of age, out-of-home respite care may be provided in a JCAHO Accredited Hospital or Residential Treatment Facility (RTF). While a recipient is receiving out-of-home respite, no additional Medicaid reimbursement will be made for other services in the institution.


State: Alabama
Program: Behavioral Health Care
Agency: Department of Mental Health and Mental Retardation
State Reference: L ADC 580-3-23-.05
Setting/Service: Mental Health and Substance Abuse Services Providers
Type of Recognition: Licensure

(2) DMH/MR in its sole discretion may choose to accept wholly or partially a certificate/license/accreditation issued by any other state or national regulatory or other body for services and providers that would otherwise be reviewed through the DMH/MR certification process.

State: Alabama
Program: Behavioral Health Care
Agency: Department of Mental Health and Mental Retardation
State Reference: AL ADC 580-2-13-.15
Setting/Service: Designated Mental Health Facilities
Type of Recognition: Licensure

(2) For a hospital to be a Designated Mental Health Facility for purposes of inpatient commitment and/or detaining a person in accordance with the Community Mental Health Officer Act, it must operate psychiatric beds that have the ability to receive persons for evaluation, examination, admission, detention, or treatment pursuant to the provisions of the Commitment Law and meet the following criteria:

(a) Be accredited for psychiatric inpatient services by the Joint Commission on Accreditation of Healthcare Organizations and acknowledge that by being a DMHF, the Office of Advocacy Services will investigate and review complaints using the Consumer Protection standards or be certified by Medicare and acknowledge that by being a DMHF, the Office of Advocacy Services will investigate and review complaints using the Consumer Protection standards and Adult Seclusion and Restraint standards.

(b) Apply for designation.

(c) Be approved.

(d) Agree to forward reports of renewals of JCAHO or Medicare accreditation immediately upon receipt as well as copies of any other JCAHO or Medicare action that affects their accreditation status in any way.


State: Alabama
Program: Home Care
Agency: Department of Public Health
State Reference: AL ADC 420-5-17-.09
Setting/Service: Hospice Contracted Services
Type of Recognition: Licensure

(2) When a provider of a hospice care program arranges for a hospital, a home providing nursing care, or home health agency to furnish a component or components of the hospice care program to its patient, the care shall be provided by a licensed, certified, or accredited hospital, inpatient hospice, home providing nursing care, or home health agency pursuant to a written contract under which:

(a) The provider of a hospice care program furnishes to the contractor a copy of the hospice patient's interdisciplinary plan of care which specifies the care that is to be furnished by the contractor.

(b) The regimen described in the established plan of care is continued while the hospice patient receives care from the contractor, subject to the patient's needs, and with approval of the coordinator of the interdisciplinary team.

(c) All care, treatment, and services furnished by the contractor are entered into the patient's medical record.

(d) The designated coordinator of the interdisciplinary team ensures conformance with the established plan of care.

(e) The contractor complies with the requirements of these rules.

(f) Those hospices not providing inpatient care shall encourage any hospital contracting for inpatient care to offer temporary limited privileges to the hospice patient's attending physician while the hospice patient is receiving inpatient care from the hospital.


State: Alabama
Program: Hospitals
Agency: Department of Public Health
State Reference: Alabama Code § 22-21-24
Setting/Service: Hospital
Type of Recognition: Licensure

All hospitals which are accredited by the joint commission on accreditation of hospitals shall be deemed by the State Health Department to be licensable without further inspection or survey by the personnel of the State Department of Health. Further accreditation by the joint commission on accreditation of hospitals shall in no way relieve that hospital of the responsibility of applying for licensure and remitting the appropriate licensure fee as specified in this article.

State: Alabama
Program: Nursing Care Center
Agency: Department of Public Health
State Reference: AL ADC 420-5-4, App. A
Setting/Service: Long-Term Care Facilities
Type of Recognition: Licensure

22-21-20. Definitions. For the purpose of this article, the following terms shall have the meanings respectively ascribed to them by this section:

(1) HOSPITALS. General and specialized hospitals, including ancillary services; independent clinical laboratories; rehabilitation centers; ambulatory surgical treatment facilities for patients not requiring hospitalization; end stage renal disease treatment and transplant centers, including free-standing hemodialysis units; abortion or reproductive health centers; hospices; health maintenance organizations; and other related health care institutions when such institution is primarily engaged in offering to the public generally, facilities and services for the diagnosis and/or treatment of injury, deformity, disease, surgical or obstetrical care. Also included within the term are long term care facilities such as, but not limited to, skilled nursing facilities, intermediate care facilities, homes for the aged, domiciliary care facilities and related health care institutions when such institution is primarily engaged in offering room, board, laundry and personal assistance with activities of daily living and incidentals thereto. The term “hospitals” relates to health care institutions and shall not include the private offices of physicians or dentists, whether in individual, group, professional corporation or professional association practice. This section shall not apply to county or district health departments.

§ 22-21-24. Same -- Fees; term; form; nontransferable; posting; renewal; hospital licensable when accredited by joint commission. The application for a license to operate a hospital shall be accompanied by a standard fee of $200.00, plus a fee of $5.00 per bed for each bed over 10 beds to be licensed in accordance with regulations promulgated under Section 22-21-28. Increase in a hospital's bed capacity during the calendar year is assessed at the standard fee of $200.00 plus $5.00 each for the net gain in beds. No fee shall be refunded. All fees received by the State Board of Health under the provision of this article shall be paid into the State Treasury to the credit of the State Board of Health and shall be used for carrying out the provisions of this article. All licenses issued under this article shall expire on December 31 of the year in which it was issued. All licenses shall be on a form prescribed by said department, shall not be transferable or assignable, shall be issued only for the premises named in the application, shall be posted in a conspicuous place on the licensed premises and may be renewed from year to year upon application, investigation and payment of the required license fee, as in the case of procurement of the original license. All fees collected under this article are hereby appropriated for expenditure by the State Health Department. All hospitals which are accredited by the joint commission on accreditation of hospitals shall be deemed by the State Health Department to be licensable without further inspection or survey by the personnel of the State Department of Health. Further accreditation by the joint commission on accreditation of hospitals shall in no way relieve that hospital of the responsibility of applying for licensure and remitting the appropriate licensure fee as specified in this article.


State: Alaska
Program: Laboratory
Agency: Department of Health
State Reference: 7 AK ADC 12.990 
Setting/Service: Laboratory
Type of Recognition: Licensure

(7) “approved laboratory” means a laboratory that is (A) certified by the (i) federal government under the Clinical Laboratories Improvement Act of 1967, 42 U.S.C. 263(a) or Title XVIII of the Social Security Act, as amended, 42 U.S.C. 1395 et seq.; (ii) College of American Pathologists; or (iii) Joint Commission on Accreditation of Hospitals; or

State: Alaska
Program: Laboratory
Agency: Department of Health
State Reference:
Setting/Service: Laboratory
Type of Recognition: Licensure

CLIA Certification

State: Alaska
Program: Hospitals
Agency: Department of Health and Public Services
State Reference: AS §18.20.080
Setting/Service: Hospital
Type of Recognition: Licensure

The department shall make annual inspections and investigations of hospital facilities. The department may accept accreditation by the Joint Commission on the Accreditation of Hospitals in lieu of an annual inspection by the department for the year in which the accreditation was granted if the accreditation standards of the commission are substantially similar to the inspection standards of the department.

State: Alaska
Program: Behavioral Health Care
Agency: Department of Public Health
State Reference: 7 AAC 70.030; 70.150
Setting/Service: Behavioral health clinic services; Behavioral health rehabilitation services; Detoxification services; Residential substance use treatment services
Type of Recognition: Licensure

7 AAC 70.030. Department approval of a provider of behavioral health services. (a)

The department will approve an organization to provide behavioral health services in this state only if that organization(1) meets the requirements for

  (A) a community behavioral health services provider under 7 AAC 70.100 that is providing one or more of the following:

      (i) behavioral health clinic services;

     (ii) behavioral health rehabilitation services;

     (iii) detoxification services;

     (iv) residential substance use treatment services in accordance with 7 AAC 70.120; or

  (B) a substance use treatment provider under 7 AAC 70.130; and

(2) is accredited or working toward accreditation in accordance with 7 AAC 70.150.

7 AAC 70.150. Behavioral health services provider accreditation. (a) Except as provided in (b) of this section, to receive a department approval under 7 AAC 70.030, a behavioral health services provider must

   (1) be accredited to provide behavioral health services by

       (A) The Joint Commission;

       (B) the Commission on Accreditation of Rehabilitation Facilities(CARF); or

       (C) the Council on Accreditation (COA);

   (2) be accredited by an alternative accreditation agency approved by the department under 7 AAC 70.160; or

   (3) meet the interim standards for operation under 7 AAC 70.200 - 7 AAC 70.265.

(b) After June 30, 2015, a behavioral health services provider must

   (1) be accredited to provide behavioral health services by

       (A) The Joint Commission;

       (B) the Commission on Accreditation of Rehabilitation Facilities (CARF);

       (C) the Council on Accreditation (COA); or

       (D) an alternative accreditation agency approved by the department under 7 AAC 70.160; or

  (2) be issued a provisional department approval under 7 AAC 70.030(d).


State: Alaska
Program: Hospitals
Agency: Health and Social Services
State Reference: 7 AK ADC 43.560  
Setting/Service: Inpatient Psychiatric Services
Type of Recognition: Medicaid

(a) To receive payment under Medicaid for inpatient psychiatric services, an enrolled inpatient psychiatric hospital facility must (1) be licensed under AS 18.20, and accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

State: Alaska
Program: Behavioral Health Care
Agency: Health and Social Services
State Reference: 7 AK ADC 43.560  
Setting/Service: Inpatient Psychiatric Services
Type of Recognition: Medicaid

(a) To receive payment under Medicaid for inpatient psychiatric services, an enrolled inpatient psychiatric hospital facility must

 (1) be licensed under AS 18.20, and accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)


State: Alaska
Program: Behavioral Health Care
Agency: Health and Social Services
State Reference: 7 AK ADC 43.1164  
Setting/Service: Residential Psychiatric Treatment Center
Type of Recognition: Medicaid

(b) To be endorsed by the department to provide FASD/SED waiver services a provider must attest that the provider has participated in FASD/SED waiver services training, if training is available through the department. In addition, the provider must be enrolled as

(1) a community mental health clinic under 7 AAC 43.725(a)(1) that

(A) is accredited as a children's service provider by

(i) the Council on Accreditation (COA);

(ii) the Commission on Accreditation of Rehabilitation Facilities (CARF); or

(iii) The Joint Commission


State: Arizona
Program: Behavioral Health Care
Agency: Arizona Health Care Cost Containment Administration
State Reference: AZ ADC R9-22-1205
Setting/Service: Residential Treatment Center Services
Type of Recognition: Insurance

B. Level 1 residential treatment center services. Services provided in a Level 1 residential treatment center as defined in A.A.C. R9-20-101 are covered subject to the limitations and exclusions under this Article.

1. Level 1 residential treatment center services are not covered unless provided under the direction of a licensed physician in a licensed Level 1 residential treatment center accredited by an AHCCCS-approved accrediting body as specified in contract


State: Arizona
Program: Hospitals
Agency: Arizona Health Care Cost Containment System Administration
State Reference: AZ ADC R9-22-505  
Setting/Service: Hospital
Type of Recognition: Licensure

An Indian Health Service (IHS) hospital and a Veterans Administration hospital shall not provide services to a member unless accredited by the Joint Commission on Accreditation of Healthcare Organizations.

State: Arizona
Program: Laboratory
Agency: Department of Health
State Reference:
Setting/Service: Laboratory
Type of Recognition: Licensure

CLIA Certification

State: Arizona
Program: Behavioral Health Care
Agency: Department of Health Services
State Reference: AZ ADC R9-33-103
Setting/Service: Group Homes for the Developmentally Disabled
Type of Recognition: Licensure

A. At least 30 days before the anticipated date of opening a group home, an applicant shall submit to the Department a completed application packet that contains:

2. A copy of the applicant's accreditation report issued by a nationally recognized accreditation organization, if applicable.

3. The substantive review time-frame described in A.R.S. § 41-1072(3) is 60 days and begins on the date the Department provides written notice of administrative completeness to the applicant; e. If an applicant meets the requirements of this Section and Chapter, the Department shall issue to the applicant:

i. A two-year regular license to operate a group home;

or

ii. If the applicant is accredited, a regular license to operate a group home for the duration of the accreditation period, not to exceed three years;


State: Arizona
Program: Behavioral Health Care
Agency: Department of Health Services
State Reference: AZ ADC R9-20-103 AZ ADC R9-20-104
Setting/Service: Behavioral Health Services Agencies
Type of Recognition: Licensure

A. According to A.R.S. § 36-422, a person applying for an initial license to operate an agency shall submit:

o. Whether the agency is accredited by a nationally recognized accreditation organization, and if so:

i. The name of nationally recognized accreditation organization that accredited the agency;

ii. If accredited by the Joint Commission on Accreditation of Health Care Organizations, whether the agency was accredited under the inpatient standards or community behavioral health standards;

iii. If the applicant is submitting an accreditation report in lieu of all licensing inspections conducted by the Department, a copy of the accreditation report;

iv. The dates of the accreditation period;

and

v. If an agency is seeking licensure as a Level 1 RTC or a Level 1 sub-acute agency and the agency is also seeking Title XIX certification, whether the agency is accredited by the Joint Commission on Accreditation of Health Care Organizations, the Council on Accreditation for Children and Family Service, or the Commission on Accreditation of Rehabilitation Facilities

B. Unless the licensee submits a copy of the agency's accreditation report from a nationally recognized accreditation organization, the Department shall conduct an onsite inspection of the agency to determine if the licensee and the agency are in substantial compliance with the applicable statutes and this Chapter.


State: Arizona
Program: Hospitals
Agency: Department of Health Services
State Reference: A.R.S. § 36-424 
Setting/Service: Hospital
Type of Recognition: Licensure

The director shall accept proof that a health care institution is an accredited hospital or is an accredited health care institution in lieu of all compliance inspections required by this chapter if the director receives a copy of the institution's accreditation report for the licensure period. If the health care institution's accreditation report is not valid for the entire licensure period, the department may conduct a compliance inspection of the health care institution during the time period the department does not have a valid accreditation report for the health care institution.

State: Arizona
Program: Ambulatory Health Care
Agency: Department of Health Services
State Reference: R9-10-107
Setting/Service: Ambulatory Surgical Center
Type of Recognition: Licensure

If a licensee submits a health care institution’s current accreditation report from a nationally recognized accrediting organization, the Department shall not conduct an onsite inspection of the health care institution as part of the substantive review for a renewal license.


State: Arizona
Program: Disease-Specific Care
Agency: Department of Health Services, Emergency Medical Services
State Reference: R9-25-601,ff
Setting/Service: Primary Stroke Center
Type of Recognition: Certification

1. “Acute stroke-ready hospital” means a hospital that is certified by a national stroke center certification organization as meeting national stroke care standards for the initial assessment, diagnosis, stabilization, and either: a. Transfer of a stroke patient to a primary stroke center or comprehensive stroke center, or b. Care of a stroke patient with input from the staff of a primary stroke center or comprehensive stroke center.

2. “Comprehensive stroke center” means a hospital that is certified by a national stroke center certification organization as meeting national stroke care standards for the assessment, diagnosis using advanced imaging devices, and treatment of stroke patients with complex cases of ischemic stroke, caused by the loss of the blood supply to a part of the brain, or hemorrhagic stroke, caused by bleeding into a part of the brain.


7. “National stroke center certification organization” means an entity:

a. Such as:

i. The Joint Commission;

ii. The Healthcare Facilities Accreditation Program;

iii. Det Norske Veritas Healthcare, Inc.; or

iv. The American Heart Association/American Stroke Association;

     b. That assesses the compliance of a hospital with
        national stroke care standards; and
     c. That documents hospitals that meet national stroke
         care standards.
8. “Primary stroke center” means a hospital that is certified by a national stroke center certification organization as meeting national stroke care standards for the assessment, diagnosis, and treatment of stroke patients.

d. Location of emergency receiving facilities that:

i. Are:

(1) Acute stroke-ready hospitals,

(2) Primary stroke centers, or

(3) Comprehensive stroke centers; and

ii. Participate in quality improvement activities, including the submission of data on stroke care provided by the emergency receiving facility that may be compiled on a statewide basis;

 


State: Arizona
Program: Critical Access Hospitals
Agency: Department of Public Health and Safety
State Reference: A.R.S. § 36-424
Setting/Service: Hospitals and Health Care Institutions
Type of Recognition: Licensure

C. The director shall accept proof that a health care institution is an accredited hospital or is an accredited health care institution in lieu of all compliance inspections required by this chapter if the director receives a copy of the institution's accreditation report for the licensure period. If the health care institution's accreditation report is not valid for the entire licensure period, the department may conduct a compliance inspection of the health care institution during the time period the department does not have a valid accreditation report for the health care institution.

State: Arizona
Program: Home Care
Agency: Department of Public Health and Safety
State Reference: A.R.S. § 36-424
Setting/Service: Healthcare Institutions
Type of Recognition: Licensure

C. The director shall accept proof that a health care institution is an accredited hospital or is an accredited health care institution in lieu of all compliance inspections required by this chapter if the director receives a copy of the institution's accreditation report for the licensure period. If the health care institution's accreditation report is not valid for the entire licensure period, the department may conduct a compliance inspection of the health care institution during the time period the department does not have a valid accreditation report for the health care institution.

State: Arkansas
Program: Ambulatory Health Care
Agency: Arkansas Board of Podiatric Medicine
State Reference: A.C.A. § 17-96-101 (2011)
Setting/Service: Ambulatory Surgery Center
Type of Recognition: Certification

 (3) "Podiatrist" means a physician legally licensed to practice podiatric medicine. However, no podiatrist shall amputate the human foot or perform nerve or vascular grafting or administer any anesthetic other than a local anesthetic. All ankle surgery performed above the level of the foot other than skin and skin structures shall be performed in a facility accredited by either Medicare or by the Joint Commission on Accreditation of Healthcare Organizations.
 


State: Arkansas
Program: Hospitals
Agency: Department of Health
State Reference: A.C.A. § 20-9-219  
Setting/Service: Hospital
Type of Recognition: Licensure

(c) Each hospital accredited by an accrediting organization shall be deemed by the department to be licensable without further survey by the personnel of the division if:

(1) The hospital holds current, full accreditation; and

(2) The division receives a copy of the hospital's official accreditation certificate and the complete report issued by an accrediting organization within thirty (30) days of receipt by the hospital from an accrediting organization.

(d) No hospital shall be required to submit accreditation by an accrediting organization, but whenever a hospital does not submit an accreditation certificate, the personnel of the department shall conduct such surveys as are prescribed by regulation.

NOTE: “Accrediting organization” means an organization that awards accreditation or certification to hospitals or managed care organizations and has been recognized by the Centers for Medicare & Medicaid Services for deemed status, including without limitation The Joint Commission.


State: Arkansas
Program: Laboratory
Agency: Department of Health
State Reference:
Setting/Service: Laboratory
Type of Recognition: Licensure

CLIA Certification

State: Arkansas
Program: Critical Access Hospitals
Agency: Department of Health and Safety
State Reference: A.C.A. § 20-9-219 
Setting/Service: All Hospitals
Type of Recognition: Licensure

(c) Each hospital accredited by an accrediting organization shall be deemed by the department to be licensable without further survey by the personnel of the division if:

(1) The hospital holds current, full accreditation; and

(2) The division receives a copy of the hospital's official accreditation certificate and the complete report issued by an accrediting organization within thirty (30) days of receipt by the hospital from an accrediting organization.

(d) No hospital shall be required to submit accreditation by an accrediting organization, but whenever a hospital does not submit an accreditation certificate, the personnel of the department shall conduct such surveys as are prescribed by regulation.


State: Arkansas
Program: Behavioral Health Care
Agency: Department of Human Services
State Reference: AR ADC 016.06.44-202.100  
Setting/Service: Rehabilitative Services for Persons with Mental Illness
Type of Recognition: Medicaid

Providers of RSPMI Services must furnish documentation of certification from the Division of Behavioral Health Services (DBHS) establishing that the provider is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Commission on Accreditation of Rehabilitation Facilities (CARF), the Council on Accreditation (COA), or other national accreditation approved by DBHS and that the accreditation encompasses the RSPMI services to be furnished. Providers must meet all other certification requirements in addition to accreditation.

State: Arkansas
Program: Behavioral Health Care
Agency: Department of Human Services
State Reference: AR ADC 016.06.26-202.200
Setting/Service: Inpatient Psychiatric Residential Treatment Facilities for Individuals Under 21
Type of Recognition: Medicaid

To enroll as a freestanding residential treatment center or as a residential treatment unit within an inpatient psychiatric hospital, the inpatient psychiatric provider must meet both of the conditions listed below: A. The provider must meet the child and adolescent standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and be accredited by JCAHO.

State: Arkansas
Program: Behavioral Health Care
Agency: Department of Human Services
State Reference: AR ADC 016.06.50-201.100 
Setting/Service: Residential Rehabilitation Centers for Persons with Physical Disabilities
Type of Recognition: Medicaid

Residential rehabilitation centers must meet licensure, accreditation and enrollment requirements to participate as RSPD providers in the Arkansas Medicaid Program.

B. A residential rehabilitation center must meet one of the following accreditation requirements:

1. Accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF).

2. Accredited by the Joint Commission on Accreditation of Healthcare Organization (JCAHO) as a Residential Treatment Program for Post Acute Head Injury Rehabilitation.


State: Arkansas
Program: Behavioral Health Care
Agency: Department of Human Services
State Reference: AR ADC 016.06.26-202.200
Setting/Service: Freestanding Residential Treatment Facility or Residential Treatment Unit Within an Inpatient Psychiatric Hospital
Type of Recognition: Medicaid

To enroll as a freestanding residential treatment center or as a residential treatment unit within an inpatient psychiatric hospital, the inpatient psychiatric provider must meet both of the conditions listed below:

A. The provider must meet the child and adolescent standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and be accredited by JCAHO.


State: Arkansas
Program: Behavioral Health Care
Agency: Department of Human Services
State Reference: AR ADC 016.04.4-6
Setting/Service: Alcohol and/or Drug Abuse Treatment Programs
Type of Recognition: Licensure

CARF, JCAHO AND COA ACCREDITED PROGRAMS - Programs meeting the alcohol and/or drug abuse treatment standards of the Commission on Accreditation of Rehabilitation Facilities (CARF), Joint Commission on the Accreditation of Health Care Organizations (JCAHO), or the Council on Accreditation (COA) shall automatically receive a concurrent license, if the CARF, JCAHO or COA award specifically notes that the alcohol and/or other drug treatment component has been accredited and upon presentation of the award to ADAP.

State: Arkansas
Program: Behavioral Health Care
Agency: Department of Human Services
State Reference: AR ADC 016.04.6-III  
Setting/Service: Alcohol and Drug Abuse Treatment Programs
Type of Recognition: Licensure

14. Programs meeting the alcohol and drug abuse treatment standards of the Joint Commission on Accreditation of Health Care Organizations (JCAHO), the Commission on Accreditation of Rehabilitation Facilities (CARF), or the Council on Accreditation (COA) will automatically receive Alcohol and Drug Abuse Prevention licensure as a licensed alcohol and drug abuse treatment program.--Such license shall be awarded by the Office of Alcohol and Drug Abuse Prevention upon presentation by the program of evidence of the Joint Commission of Health Care Organizations, the Council on Accreditation or the Commission on Accreditation of Rehabilitation Facilities' accreditation. Termination of licensure/accreditation by JCAHO, CARF or COA for alcohol and/or drug treatment services will result in a termination of OADAP licensure.

State: Arkansas
Program: Behavioral Health Care
Agency: Office of Alcohol and Drug Abuse Prevention
State Reference: A.C.A. § 9-28-407
Setting/Service: Child Welfare Agency (Residential Facility)
Type of Recognition: Licensure

(5)(A) Subdivisions (a)(3) and (4) of this section shall be construed to include a child welfare agency that is licensed or permitted by the board as a residential facility as of March 1, 2003, if the licensee then met and continues to meet the following criteria:

(i) The licensee is a nonhospital-based residential facility that specializes in providing treatment and care for seriously emotionally disturbed children under eighteen (18) years of age who have co-occurring substance abuse and psychiatric disorders;

(ii) The licensee possesses accreditation from at least one (1) of the following national accreditation entities:

(a) The Commission on Accreditation of Rehabilitation Facilities;

(b) The Council on Accreditation of Services for Families and Children; or

(c) The Joint Commission;

(iii) The licensee is licensed by the Office of Alcohol and Drug Abuse Prevention or its successor;

and

(iv) The licensee is operating a nontraditional program that is approved by the Department of Education.


State: California
Program: Home Care
Agency: Board of Pharmacy
State Reference: Cal.Bus. & Prof.Code § 4127.1
Setting/Service: Pharmaceuticals – Compounding of Sterile Drug Products
Type of Recognition: Licensure

(a) A pharmacy shall not compound injectable sterile drug products in this state unless the pharmacy has obtained a license from the board pursuant to this section. The license shall be renewed annually and is not transferable.

(d) Pharmacies operated by entities that are licensed by either the board or the State Department of Health Services and that have current accreditation from the Joint Commission on Accreditation of Healthcare Organizations, or other private accreditation agencies approved by the board, are exempt from the requirement to obtain a license pursuant to this section.

(e) The reconstitution of a sterile powder shall not require a license pursuant to this section if both of the following are met:

(1) The sterile powder was obtained from a manufacturer.

(2) The drug is reconstituted for administration to patients by a health care professional licensed to administer drugs by injection pursuant to this division.


State: California
Program: Office-Based Surgery
Agency: Dental Board
State Reference: Section 1638.1 of the Business and Professions Code
Setting/Service: Elective Facial Cosmetic Surgery
Type of Recognition: Licensure

(f) A licensee may not perform any elective, facial cosmetic surgical procedure except at a general acute care hospital, a licensed outpatient surgical facility, or an outpatient surgical facility accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the American Association for Ambulatory Health Care (AAAHC), the Medicare program, or an accreditation agency approved by the Medical Board of California pursuant to subdivision (g) of Section 1248.1 of the Health and Safety Code.


State: California
Program: Home Care
Agency: Department of Health
State Reference: Cal.Health & Safety Code § 1339.33
Setting/Service: Hospice
Type of Recognition: Licensure

Notwithstanding any other provisions of law, in order to be licensed as a special hospital: hospice, each project facility shall meet the requirements of Sections 70101 to 70137, inclusive, 70201 to 70219, inclusive, 70241 to 70279, inclusive, 70701 to 70707, inclusive, and 70708 to 70765, inclusive, of Title 22 of the California Code of Regulations; Sections 2-1001A to 2-1015A, inclusive, Section 2-1018A, Sections 2-1020A to 2-1024A, inclusive, Sections 2-1026A to 2-1028A, inclusive, Section 2-1040A, Section 2-1044A, and Section 2-1051A of Title 24 of the California Code of Regulations. In addition to complying with these regulations in Titles 22 and 24 of the California Code of Regulations, each facility shall meet, for the duration of the project, the hospice standards used by the Medicare program (42 C.F.R., Part 418, Sections 418.1 to 418.405, inclusive) the Medi-Cal program (subdivision (e) of Sections 51003 to 51543, inclusive, of Title 22, California Code of Regulations), and the Joint Commission on the Accreditation of Healthcare Organizations' “Hospice Standards Manual.”

State: California
Program: Home Care
Agency: Department of Health
State Reference: Cal.Health & Safety Code § 1728.7
Setting/Service: Home Health Agencies
Type of Recognition: Licensure

(a) Notwithstanding any other provision of this chapter, the state department shall issue a license to a home health agency that applies to the state department for a home health agency license and meets all of the following requirements:

(1) Is accredited as a home health agency by either the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or the Community Health Accreditation Program (CHAP), and the accrediting organization forwards to the state department copies of all initial and subsequent survey and other accreditation reports or findings.

(2) Files an application with fees pursuant to this chapter.

(3) Meets any other additional licensure requirements of, or regulations adopted pursuant to, this chapter that the state department identifies, after consulting with either the JCAHO or the CHAP, as more stringent than the accreditation requirements of either JCAHO or CHAP.

(b) The state department may require a survey of an accredited home health agency to ensure the accreditation requirements are met. These surveys shall be conducted using a selective sample basis.

(c) The state department may require a survey of an accredited home health agency to investigate complaints against an accredited home health agency for substantial noncompliance, as determined by the state department, with these accreditation standards.

(d) Notwithstanding subdivisions (a), (b), and (c), the state department shall retain its full range of authority over accredited home health agencies to ensure the licensure and accreditation requirements are met. This authority shall include the entire scope of enforcement sanctions and options available for unaccredited home health agencies.


State: California
Program: Behavioral Health Care
Agency: Department of Mental Health
State Reference: Cal.Welf. & Inst.Code § 4080
Setting/Service: Private Psychiatric Facilities
Type of Recognition: Licensure

(3)(A) When a private facility is accredited by a nationally recognized commission that accredits health care facilities, the department shall review and may approve the program aspects only if the average per diem charges or costs of service provided in the facility do not exceed approximately 75 percent of the average per diem charges or costs of similar psychiatric service provided in a psychiatric or general hospital.

State: California
Program: Ambulatory Health Care
Agency: Department of Public Health
State Reference: Section 1228 of Health and Safety Code
Setting/Service: Health Facilities, Primary Clinics
Type of Recognition: Licensure

(a) Except as provided in subdivision (c), every clinic for which a license or special permit has been issued shall be periodically inspected. The frequency of inspections shall depend upon the type and complexity of the clinic or special service to be inspected. Inspections shall be conducted no less often than once every three years and as often as necessary to ensure the quality of care being provided.

(c) This section shall not apply to any of the following:

(1) A rural health clinic.
(2) A primary care clinic accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Accreditation Association for Ambulatory Health Care (AAAHC), or any other accrediting organization recognized by the department.
(3) An ambulatory surgical center.
(4) An end stage renal disease facility.
(5) A comprehensive outpatient rehabilitation facility that is certified to participate either in the Medicare program under Title XVIII (42 U.S.C. Sec. 1395 et seq.) of the federal Social Security Act, or the Medicaid program under Title XIX (42 U.S.C. Sec. 1396 et seq.) of the federal Social Security Act, or both.


State: California
Program: Laboratory
Agency: Department of Public Health
State Reference: ACLL 16-01; Letter 5/23/2016
Setting/Service: Clinical Laboratories
Type of Recognition: L/C

Section 1223 of the California Business & Professions Code (BPC) requires the Department to approve accrediting organizations to inspect laboratories for the purpose of deeming them in compliance with California clinical laboratory law.  Laboratories licensed by the Department have to choose licensure or registration by the Department or certification of deemed status by an accrediting organization approved by the Department.  All laboratories seeking California licensure must apply to LFS.

Joint Commission approved in letter May 26, 2016.

 

 


State: California
Program: Home Care
Agency: Department of Public Health
State Reference: Letter
Setting/Service: Home Health Agency
Type of Recognition: L/C

Beginning October 1, 2017, HHAs have the option to hire a Centers for Medicare and Medicaid Services (CMS) approved accreditation organization (AO) to obtain an initial licensing survey. 

Due to the high volume of HHA initial licensing applications, there is currently a delay of between 3 months to 2 years for HHA initial application surveys depending on the workload of the district office (DO) where the HHA is located. HHAs seeking to expedite their licensing approval process are encouraged to take advantage of this new option.

A new HHA that is beginning the application process and wants an initial licensing survey conducted by an AO must:

  1. file an application with the Centralized Applications Unit (CAU) and include a cover letter indicating they intend to hire an AO, specifying which AO they have selected, 
  2. contact and hire an AO, 
  3. await an application approval letter from CAU, and
  4. contact the AO to schedule the initial survey.

Once the survey is complete, the AO will send the findings to the HHA and a copy to CAU. If the HHA passes the AO initial survey, CAU will issue a six-month provisional license. The DO will inform new HHAs awaiting survey of the option to have the AO conduct the survey.

A new HHA that has an approved application but is awaiting initial survey and wants a survey conducted by an AO must:

  1. inform the local DO of intent to use the AO option and specify an AO,
  2. hire the AO, and
  3. schedule the initial survey.

Once the survey is complete, the AO will send the findings to the HHA with a copy to CAU. If the HHA passes the AO initial survey, CAU will issue a six-month provisional license.

HHAs may use the following CMS-approved AOs for this new licensing process:

1. The Joint Commission

2.  ACHC

3.  CHAP


State: California
Program: Ambulatory Health Care
Agency: Medical Board
State Reference: Bus. & Prof.Code § 2216 and Health & Safety Code Section 1248.1.
Setting/Service: Outpatient settings using anesthesia
Type of Recognition: Criteria for Operation

On or after July 1, 1996, no physician and surgeon shall perform procedures in an outpatient setting using anesthesia, except local anesthesia or peripheral nerve blocks, or both, complying with the community standard of practice, in doses that, when administered, have the probability of placing a patient at risk for loss of the patient's life-preserving protective reflexes, unless the setting is specified in Section 1248.1.

§ 1248.1. Operation and maintenance of outpatient setting; restrictions, firm, partnership, or person shall operate, manage, conduct, or maintain an outpatient setting in this state, unless the setting is one of the following:

(a) An ambulatory surgical center that is certified to participate in the Medicare program under Title XVIII (42 U.S.C. Sec. 1395 et seq.) of the federal Social Security Act.

(b) Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1601 of Title 25 of the United States Code, and located on land recognized as tribal land by the federal government.

(c) Any clinic directly conducted, maintained, or operated by the United States or by any of its departments, officers, or agencies.

(d) Any primary care clinic licensed under subdivision (a) and any surgical clinic licensed under subdivision (b) of Section 1204. (e) Any health facility licensed as a general acute care hospital under Chapter 2 (commencing with Section 1250).

(f) Any outpatient setting to the extent that it is used by a dentist or physician and surgeon in compliance with Article 2.7 (commencing with Section 1646) or Article 2.8 (commencing with Section 1647) of Chapter 4 of Division 2 of the Business and Professions Code.

(g) An outpatient setting accredited by an accreditation agency approved by the division pursuant to this chapter. (The Joint Commission has been approved by the Medical Board)


State: California
Program: Office-Based Surgery
Agency: Medical Board
State Reference: C.G.S.A. § 19a-691
Setting/Service: Outpatient Surgery Settings
Type of Recognition: Requirement for Anesthesia Use

California law prohibits physicians from performing some outpatient surgery, unless it is performed in a licensed or accredited setting. Section 2216 of the Business and Professions Code (B&P) reads: "On or after, July 1, 1996, no physician and surgeon shall perform procedures in an outpatient setting using anesthesia, except local anesthesia or peripheral nerve blocks, or both, complying with the community standard of practice, in doses that, when administered, have the probability of placing a patient at risk for loss of the patient's life-preserving protective reflexes, unless the setting is specified in Section 1248.1. Outpatient settings where anxiolytics and analgesics are administered are excluded when administered, in compliance with the community standard of practice, in doses that do not have the probability of placing the patient at risk for loss of the patient's life-preserving protective reflexes." (Accrediting organizations cited by the California Medical Board include: AAAASF, AAAHC, TJC and IMQ)

State: Colorado
Program: Office-Based Surgery
Agency: Board of Medical Examiners
State Reference: Board of Medical Examiners Policy 40-12
Setting/Service: Office-Based Surgery and Anesthesia
Type of Recognition: Guideline

It is not recommended that a patient stay overnight in an office setting following a surgical procedure unless that facility is appropriately accredited. "Accredited ambulatory surgical centers" are accredited as a Class B or Class C facility by one of the following organizations: Joint Commission on Accreditation of Healthcare Organizations (JCAHO); American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF); Accreditation Association for Ambulatory Health Care, Inc. (AAHC); or the Colorado Department of Public Health and the Environment. If a patient does not meet discharge criteria and is not in a Class B or Class C facility, the patient should be transferred to an appropriately accredited ambulatory care center or a licensed hospital within reasonable proximity.


State: Colorado
Program: Laboratory
Agency: Department of Health
State Reference:
Setting/Service: Laboratory
Type of Recognition: Licensure

CLIA Certification

State: Colorado
Program: Behavioral Health Care
Agency: Department of Healthcare Policy and Financing
State Reference: 10 CO ADC 2505-10:8.373
Setting/Service: Inpatient Psychiatric Care for Individuals Under 21
Type of Recognition: Medicaid

Inpatient psychiatric care is a benefit of the Medicaid Program for individuals eligible for Medicaid benefits under the age of 21 only when

(A) provided in an institution which is accredited as a psychiatric hospital by the Joint Commission on Accreditation of Hospitals, or in a facility or program accredited by the Joint Commission of Accreditation of Hospitals;

(B) services are provided under the direction of a physician and involve active treatment which a team, consisting of physicians and other personnel qualified to make determinations with respect to mental health conditions and the treatment thereof, has determined are necessary on an inpatient basis and can reasonably be expected to improve the condition, by reason of which such services are necessary, or prevent further regression so that the services will no longer be needed;

and

(C) are provided prior to the date such individual attains age 21, or, in the case of an individual who was receiving such services in the period immediately preceding the date on which he/she attained age 21,

(i) the date such individual no longer requires such services

or

(ii) if earlier, the date such individual attains 22.


State: Colorado
Program: Hospitals
Agency: Department of Healthcare Policy and Financing
State Reference: 10 CO ADC 2505-10:8.373
Setting/Service: Inpatient Psychiatric Care for Individuals Under 21
Type of Recognition: Medicaid

Inpatient psychiatric care is a benefit of the Medicaid Program for individuals eligible for Medicaid benefits under the age of 21 only when

(A) provided in an institution which is accredited as a psychiatric hospital by the Joint Commission on Accreditation of Hospitals, or in a facility or program accredited by the Joint Commission of Accreditation of Hospitals;

(B) services are provided under the direction of a physician and involve active treatment which a team, consisting of physicians and other personnel qualified to make determinations with respect to mental health conditions and the treatment thereof, has determined are necessary on an inpatient basis and can reasonably be expected to improve the condition, by reason of which such services are necessary, or prevent further regression so that the services will no longer be needed; and

(C) are provided prior to the date such individual attains age 21, or, in the case of an individual who was receiving such services in the period immediately preceding the date on which he/she attained age 21,

(i) the date such individual no longer requires such services or

(ii) if earlier, the date such individual attains 22.


State: Colorado
Program: Behavioral Health Care
Agency: Department of Labor and Employment
State Reference: 7 CO ADC 1101-3:17 EXHIBIT 10
Setting/Service: Acute Rehabilitation, Comprehensive Integrated Inpatient Rehabilitation, Outpatient Rehabilitation Services, Residential Rehabilitation, Home and Community-Based Rehabilitation, and Behavioral Programs
Type of Recognition: Insurance

b. Acute Rehabilitation: Acute rehabilitation hospitals should be accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and have components consistent with the Commission on Accreditation of Rehabilitation Facilities (CARF). CARF eligibility implies that programs meet specific care standards of design and efficacy.

a. Comprehensive Integrated Inpatient Rehabilitation: Inpatient programs should be accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and have components consistent with the Commission on the Accreditation of Rehabilitation Facilities (CARF). CARF eligibility or certification implies that programs meet specific care standards of design and efficacy.

b. Outpatient Rehabilitation Services: Outpatient rehabilitation programs should be accredited by JCAHO and have components consistent with certification by CARF. CARF eligibility or certification implies that programs meet specific care standards of design and efficacy.

c. Residential Rehabilitation: Residential programs should be accredited by JCAHO and have components consistent with CARF certification. CARF eligibility or certification implies that programs meet specific care standards of design and efficacy.

d. Home and Community-Based Rehabilitation: Programs should preferably be accredited by JCAHO and have components consistent with CARF certification. CARF eligibility or certification implies that programs meet specific care standards of design and efficacy.

e. Behavioral Programs: Behavioral programs generally use an interdisciplinary approach that may include behavior modification, medications, socialization skills training, substance abuse treatment, family therapy and physical management programs, as well as traditional interdisciplinary treatment. Length of stay may greatly vary depending on etiology and severity of the behavioral disorders and may typically range from one to six months or longer. Upon discharge from behavioral programs, disposition is either back to inpatient acute rehabilitation, inpatient programs, supported living programs or home and community-based programs. Use of psychiatric hospitals that are not experienced in brain injury rehabilitation is not recommended. Behavioral programs are also appropriate for severe behavioral problems due to other concomitant diagnoses, such as alcohol or substance abuse. Categorical adolescent inpatient hospital and residential programs may be appropriate for adolescent behavioral disorders due to TBI. Programs should be accredited by JCAHO.


State: Colorado
Program: Nursing Care Center
Agency: Department of Labor and Employment
State Reference:  7 CO ADC 1101-3:17 EXHIBIT 10 
Setting/Service: Long-Term Care, Nursing Care Facilities, and Subacute Rehabilitation Programs
Type of Recognition: Insurance

d. Subacute Rehabilitation Programs:

These programs are located on separate and specially licensed units of hospitals or nursing homes. Individuals appropriate for subacute care typically are medically stable, require skilled nursing care, and have either completed comprehensive inpatient rehabilitation, or are judged to not be able to benefit from inpatient rehabilitation. Subacute rehabilitation is generally accepted, but should not be used in lieu of categorical inpatient rehabilitation for individuals who may benefit from a comprehensive inpatient rehabilitation program. Subacute rehabilitation programs should be accredited by the JCAHO.

f. Long-Term Care:

The range of long-term outcomes following TBI is diverse from virtually complete independence and function to severe and permanent disability. Therefore, the range of needed services is complex and individualized. Some individuals with moderate/severe brain injury will require significant care and supervision, either at home by family or attendant care, or in a nursing care facility, or long-term supported living program. (Refer to sections G.1.g Supported Living Programs or Long-Term Care Residential Services). Individuals may also benefit from periodic re-evaluations, based on condition and needs (Refer to section I, Maintenance Management). Long-term care programs should be accredited by the JCAHO and have components consistent with certification by CARF. CARF eligibility or certification implies that programs meet specific care standards of design and efficacy.

f. Nursing Care Facilities: generally provide care in specialty-licensed units of nursing homes. Extended nursing facility care is generally accepted and widely used. Individuals appropriate for extended care are not able to be cared for in a private home, supported living program, group home or community setting. Individuals appropriate for this type of care do not generally require skilled nursing care, but require ongoing care that is supervised by RNs. Rehabilitation therapies may be necessary to supplement nursing care. Rehabilitation programs are established by appropriately licensed or certified therapists but may be delivered by paraprofessionals. The goal of care is to maintain and improve function if possible, this usually occurs at a slower rate over an extended period of time. Accreditation by JCAHO is recommended. g. Supported Living Programs (SLP) or Long-Term Care Residential Services: include licensed personal care boarding homes (group homes), supported apartment living programs, or supported inpatient programs designed for long-term living at the completion of the rehabilitation continuum. SLPs are designed for those who, due to their brain injury, are not able to safely and independently care of themselves in the community and for whom home placement is unavailable or inappropriate. Such programs are appropriate for individuals who are at risk for medical, physical and psychological complications, but who do not require a secured setting. Housing, food, supervision, activity programs, sheltered employment, transportation and case management are typical components of supported living programs. These programs are becoming more available and are generally accepted services for individuals with chronic brain injury who are moderately to severely disabled, and who require care, supervision and support services. Long-term residential services should be accredited by JCAHO and preferably have components consistent with CARF certification. CARF eligibility or certification implies that programs meet specific care standards of design and efficacy.


State: Colorado
Program: Disease-Specific Care
Agency: Department of Public Health & Environment
State Reference: 25-3-116
Setting/Service: Primary Stroke Center Comprehensive Stoke Center
Type of Recognition: L/C

(1) A hospital that has an accreditation, certification, or designation in stroke or stemi care from a nationally recognized accrediting body, including, but not limited to a certification as a Comprehensive Stroke Center or Primary Stroke Center by the Joint Commission or its successor organization...may send information and supporting documentation to the Department.  The Department shall make a hospital's national accreditation, certification, or designation availalbe to the public in a manner determined by the Department.

(2) The Department shall deem a hospital that is currently accredited, certified, or designated by a nationally recognizedaccrediting body as satisfying the requirements for recognition and publication by the Department,


State: Colorado
Program: Home Care
Agency: Department of Public Health and Environment
State Reference: 25-3-102.1
Setting/Service: Home Health, Hospice
Type of Recognition: Licensure

Deemed Status for certain facilities.

(b) (I) In the application for the renewal of a license for a health facility described in Section 25-3-101, other than an ambulatory surgical center, the Department of Public Health and Environment shall deem health facilities that are currently accredited by an accrediting organization recognized by the Federal Centers for Medicare and Medicaid Services as satisfying the requirements for renewal of the license.


State: Colorado
Program: Hospitals
Agency: Department of Public Health and Environment
State Reference: 25-3-102.1
Setting/Service: Hospital
Type of Recognition: Licensure

Deemed Status for certain facilities.

(b) (I) In the application for the renewal of a license for a health facility described in Section 25-3-101, other than an ambulatory surgical center, the Department of Public Health and Environment shall deem health facilities that are currently accredited by an accrediting organization recognized by the Federal Centers for Medicare and Medicaid Services as satisfying the requirements for renewal of the license.


State: Colorado
Program: Ambulatory Health Care
Agency: Department of Public Health and Environment
State Reference: C.R.S.A. § 25-3-102.1
Setting/Service: Ambulatory Surgical Center
Type of Recognition: Licensure

1) In the licensing of an ambulatory surgical center following the issuance of initial licensure by the department, the voluntary submission of satisfactory evidence that the applicant is accredited by the Joint Commission, the American association for accreditation of ambulatory surgery facilities, inc., the accreditation association for ambulatory health care, the American osteopathic association, or any successor entities shall be deemed to meet certain requirements for license renewal so long as the standards for accreditation applied by the accrediting organization are at least as stringent as the licensure requirements otherwise specified by the department. Upon submission of a completed application for license renewal, the department shall accept proof of the accreditation in lieu of licensing inspections or other requirements.


State: Colorado
Program: Home Care
Agency: Secretary of State
State Reference: 24-21-115. Durable medical equipment supplier license - definition - rules
Setting/Service: DME Suppliers
Type of Recognition: L/C

(b) A durable medical equipment supplier license is not required as a condition of enrollment as a provider in the medical assistance program described in title 25.5, C.R.S.

(3) An applicant for a durable medical equipment supplier license must:

(a) Complete the license application as directed by the secretary of state;

(b) Submit to the secretary of state a notarized affidavit attesting that:

(I) The applicant has at least one accredited physical facility that is staffed during reasonable business hours and is within one hundred miles of any Colorado resident medicare beneficiary being served by the applicant.

(II) The applicant has sufficient inventory and staff to service or repair products; and

(III) The applicant is accredited by an accrediting organization recognized and accepted by the federal centers for medicare and medicaid services;


State: Connecticut
Program: Nursing Care Center
Agency: Commissioner of Social Services
State Reference: C.G.S.A. § 17b-349e
Setting/Service: Respite Care Services
Type of Recognition: Insurance

(3) The commissioner may require an individual with Alzheimer's disease who participates in the program to pay a copayment for respite care services under the program, except the commissioner may waive such copayment upon demonstration of financial hardship by such individual.

(d) The commissioner shall adopt regulations in accordance with the provisions of chapter 54 to implement the provisions of this section. Such regulations shall include, but need not be limited to

(1) standards for eligibility for respite care services;

(2) the basis for priority in receiving services;

(3) qualifications and requirements of providers, which shall include specialized training in Alzheimer's disease, dementia and related disorders;

(4) a requirement that providers accredited by the Joint Commission on the Accreditation of Healthcare Organizations, when available, receive preference in contracting for services;

(5) provider reimbursement levels;

(6) limits on services and cost of services; and (7) a fee schedule for copayments.


State: Connecticut
Program: Hospitals
Agency: DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES
State Reference: Sec. 17a-453a-12 of the Connecticut General Statutes
Setting/Service: Inpatient Psychiatric Hospitals
Type of Recognition: Licensure

(1) Acute psychiatric hospitalization service as specified in section 17a-453a-4 of the Regulations of Connecticut State Agencies:

(A) Acute psychiatric hospitalization services shall be delivered in a facility that:

(i) is state-operated, a private freestanding psychiatric hospital, or a general hospital;

(ii) except as provided by state law, maintains professional liability insurance coverage of at least three million dollars ($3,000,000) per occurrence and ten million dollars ($10,000,000) in aggregate, or if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability; and

(iii) is JCAHO-accredited.


State: Connecticut
Program: Behavioral Health Care
Agency: Department of Motor Vehicles
State Reference: CT ADC § 14-227f-7 
Setting/Service: Substance Abuse Treatment Programs
Type of Recognition: Licensure

A treatment program shall be deemed substantial for purposes of the waiver requirements of Section 14-227f-6 of the Regulations of Connecticut State Agencies if it meets the following criteria:

(1) It is operated or funded by the Connecticut Department of Mental Health and Addiction Services, or a similar facility in another state, territory or province, or meets the standards of either the Joint Commission of Accredited Hospital Organizations, or the Commission of Accredited Rehabilitation Facilities;


State: Connecticut
Program: Office-Based Surgery
Agency: Department of Public Health
State Reference: C.G.S.A. § 19a-691
Setting/Service: Office-Based Surgery
Type of Recognition: Requirement for Anesthesia Use

(a) Any office or unlicensed facility operated by a licensed health care practitioner or practitioner group at which moderate sedation/analgesia, deep sedation/analgesia or general anesthesia, as such levels of anesthesia are defined from time to time by the American Society of Anesthesiology, is administered shall be accredited by at least one of the following entities:

(1) The Medicare program;

(2) the Accreditation Association for Ambulatory Health Care;

(3) the American Association for Accreditation of Ambulatory Surgery Facilities, Inc.; or

(4) the Joint Commission on Accreditation of Healthcare Organizations.

Such accreditation shall be obtained not later than eighteen months after July 1, 2001, or eighteen months after the date on which moderate sedation/analgesia, deep sedation/analgesia or general anesthesia is first administered at such office or facility, whichever is later. Upon the expiration of the applicable eighteen-month period, no moderate sedation/analgesia, deep sedation/analgesia or general anesthesia may be administered at any such office or facility that does not receive accreditation as required by this section. Evidence of such accreditation shall be maintained at any such office or facility at which moderate sedation/analgesia, deep sedation/analgesia or general anesthesia is administered and shall be made available for inspection upon request of the Department of Public Health.

The provisions of this section shall not apply to any such office or facility operated by a practitioner holding a permit issued under section 20-123b. (b) Notwithstanding the provisions of subsection (a) of this section, any office or unlicensed facility that is accredited as provided in subsection (a) of this section shall continue to be subject to the obligations and requirements applicable to such office or facility, including, but not limited to, any applicable certificate of need requirements as provided in chapter 368z [FN1] and any applicable licensure requirements as provided in chapter 368v [FN2].


State: Connecticut
Program: Hospitals
Agency: Department of Public Health
State Reference: CT ADC § 19-13-D1a 
Setting/Service: Hospital
Type of Recognition: Licensure

(a) Any institution as defined by sections 19-576 (b) through 19-576 (f) of the Connecticut General Statutes may apply to the department of health services to be deemed licensable without additional inspection or investigation if said institution:

(1) Has been certified as a provider of services by the United States Department of Health and Human Services within the immediately preceding 12 month period, except that with respect to institutions defined in subsection 19-576 (b) of the Connecticut General Statutes, the institution need only be currently so certified; ...

(4) Has agreed to allow the department of health services to inspect and review any reports issued by the reviewing or accrediting agency or by the subject institution related to the subject institution concerning certification as a provider by the department of health and human services;…


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Acute Psychiatric Hospitalization Services
Type of Recognition: Licensure

3) The designated agent shall collect and review documentation that includes, but is not limited to:

(A) Status of facility or professional licensure, certification or accreditation;

(c) Credentialing criteria that providers shall meet to qualify to deliver covered behavioral health services under the GABHP are as follows:

(1) Acute psychiatric hospitalization as specified in section 17a-453a-4 of the Regulations of Connecticut State Agencies:

(A) Acute psychiatric hospitalization shall be delivered in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least three million dollars ($3,000,000) per occurrence and ten million dollars ($10,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission-accredited.


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Ambulatory Detoxification Services
Type of Recognition: Licensure

(A) Ambulatory detoxification with on-site monitoring shall be delivered in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited or has a licensed physician with experience in providing behavioral health services for substance use disorders, who is responsible for supervising all medical services delivered by the program and is credentialed by DMHAS in accordance with credentialing criteria contained in this section;


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Chemical Maintenance Treatment Services
Type of Recognition: Licensure

(A) Chemical maintenance treatment shall be delivered in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

(iii) Meets conditions for the use of methadone or other SAMHSA-approved medications in chemical maintenance treatment of opiate dependence, as specified in 21 CFR 291 and other applicable federal regulations;

and

(iv) Is Joint Commission, CARF-accredited or accredited by the Council on Accreditation or has a clinical supervisor with authority over all behavioral health services. The clinical supervisor shall have a minimum of a master's degree in a behavioral health services-related field and at least three (3) years of full-time work experience in substance use disorders, be licensed by the state of Connecticut or certified, as appropriate in his or her respective discipline and be employed by or under contract with the facility in which chemical maintenance treatment is operated.


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Intensive Outpatient Mental Health Services
Type of Recognition: Licensure

(A) Intensive outpatient-mental health shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

(iii) Is Joint Commission or CARF-accredited or has a board-certified or board eligible psychiatrist who is responsible for supervising all medical services. If intensive outpatient-mental health is operated by a non-profit mental health agency, the psychiatrist shall be credentialed by DMHAS in accordance with credentialing criteria as specified in this section;

and

(iv) Includes a clinical supervisor with authority over all behavioral health services who is licensed in a behavioral health services field and has at least three


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Intensive Outpatient Substance Abuse Services
Type of Recognition: Licensure

(A) Intensive outpatient-substance use shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited or has a clinical supervisor with authority over all behavioral health services. The clinical supervisor shall have a minimum of a master's degree in a behavioral health services field, at least three (3) years of full-time work experience in substance use disorders treatment, be licensed by the state of Connecticut or certified, as appropriate in his or her respective discipline and be employed by or under contract with the facility;


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Intensive Residential Treatment Services
Type of Recognition: Licensure

(A) Intensive residential treatment shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited or has a clinical supervisor with authority over all behavioral health services;


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Intermediate or Long-Term Care Behavioral Services
Type of Recognition: Licensure

(A) Intermediate or long-term treatment or care shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited or has a clinical supervisor with authority over all behavioral health services. The clinical supervisor shall have a minimum of a master's degree in a behavioral health services field and at least three (3) years of full-time work experience in substance use disorder treatment, be licensed by the state of Connecticut or certified, as appropriate in his or her respective discipline and be employed by or under contract with the facility.


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Matrix Intensive Outpatient Services
Type of Recognition: Licensure

(A) Matrix intensive outpatient shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited or has a clinical supervisor with authority over all behavioral health services. The clinical supervisor shall have a minimum of a master's degree in a behavioral health services field and at least three (3) years of full-time work experience in substance use disorders treatment, be licensed by the state of Connecticut or certified, as appropriate in his or her respective discipline and be employed by or under contract with the facility.


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Medically Managed Inpatient Detoxification Services
Type of Recognition: Licensure

(A) Medically managed inpatient detoxification shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least three million dollars ($3,000,000) per occurrence and ten million dollars ($10,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited.


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Medically Monitored Residential Detoxification Services
Type of Recognition: Licensure

(A) Medically monitored residential detoxification shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited or has a physician with experience in providing substance use disorder services, who is responsible for supervising all medical services. The physician shall be credentialed by DMHAS in accordance with credentialing criteria as specified in this section.


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Observation Bed-Mental Health Services
Type of Recognition: Licensure

(A) Observation bed-mental health shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least three million dollars ($3,000,000) per occurrence and ten million dollars ($10,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission-accredited;


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Observation Bed-Substance Abuse Services
Type of Recognition: Licensure

(A) Observation bed-substance use shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

(iii) Is Joint Commission or CARF-accredited or has a physician with experience in providing substance use disorders services, who is responsible for supervising all medical services. The physician shall be credentialed by DMHAS in accordance with credentialing criteria as specified in this section.


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Outpatient Mental Health Services
Type of Recognition: Licensure

(A) Outpatient-mental health shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited or has a board-certified or board-eligible psychiatrist who is responsible for supervising all behavioral health services. If outpatient-mental health is operated by a nonprofit psychiatric facility, the psychiatrist shall be credentialed by DMHAS as specified in this section.


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Outpatient Substance Abuse Services
Type of Recognition: Licensure

(A) Outpatient-substance use shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited or has a clinical supervisor with authority over all behavioral health services. The clinical supervisor shall have a minimum of a master's degree in a behavioral health services field and at least three (3) years of full-time work experience in substance use disorders treatment, be licensed by the state of Connecticut or certified, as appropriate in his or her respective discipline and be employed by or under contract with the facility.


State: Connecticut
Program: Behavioral Health Care
Agency: Social and Human Services and Resources Agency
State Reference: CT ADC § 17a-453a-12
Setting/Service: Partial Hospitalization Mental Health Services
Type of Recognition: Licensure

(A) Partial hospitalization-mental health shall be in a facility that:

(i) Meets and maintains all applicable licensing and certification requirements of federal and state statutes or regulations;

(ii) Except as provided by state law, maintains professional liability insurance coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in aggregate or, if self-insured, provides documentation that it maintains a fiscally sound, dedicated trust or account funded for the purpose of covering professional liability;

and

(iii) Is Joint Commission or CARF-accredited or has a board-certified or board-eligible psychiatrist who is responsible for supervising all behavioral health services. The psychiatrist shall be credentialed by DMHAS as specified in this section.


State: Delaware
Program: Laboratory
Agency: Department of Health
State Reference:
Setting/Service: Laboratory
Type of Recognition: Licensure

CLIA Certification

State: Delaware
Program: Behavioral Health Care
Agency: Department of Health and Social Services
State Reference: 16 DE ADC 6001-3.0
Setting/Service: Substance Abuse Facilities
Type of Recognition: Licensure

“Deemed Status” means a licensure standing approved by DSMAH upon programs that have been accredited by an accreditation body approved by DSAMH. Programs that have been granted Deemed Status will be inspected in accordance with Section 4.3.2 of these standards.

State: Delaware
Program: Disease-Specific Care
Agency: Department of Health and Social Services
State Reference: 16 Del.C. § 1019 
Setting/Service: Primary Stroke Centers
Type of Recognition: Licensure/Designation

(a) The Secretary of Health and Social Services shall designate as a primary stroke center any hospital which has received a Certificate of Distinction for Primary Stroke Centers issued by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

(b) The Secretary shall suspend or revoke a hospital’s distinction as a primary stroke center if the JCAHO suspends or revoke’s a hospital’s Certificate of Distinction for Primary Stroke Center.


State: Delaware
Program: Hospitals
Agency: Department of Health and Social Services
State Reference: Title 16; 4000; 4007
Setting/Service: Hospital
Type of Recognition: Licensure

4.0 Governing Body, Organization and Staff 4.1 Under the authority of 16 Del.C. Ch. 10, as amended, the Department of Health and Social Services adopts as the official standards for the governing body, organization, and staff of hospitals the following parts of "Standards for Accreditation of Hospitals Plus Provisional Interpretations", published by the Joint Commission on Accreditation of Hospitals, dated 1981 Edition, and the "Requirements and Interpretative Guide for Accredited Hospitals", by the American Osteopathic Hospital Association, and all codes or standards referred to under these adopted parts. If any part of this section is in conflict with Section 2.0 "New Construction. Additions, and Alterations" or Section 3.0 "Physical Environment", this part shall be void and the preceding Sections shall apply. When a hospital that is required to be licensed under these rules and regulations does not normally provide a particular service or department the parts of the following which relate to such service or department shall not be applicable.

State: Delaware
Program: Office-Based Surgery
Agency: Department of Health and Social Services
State Reference: § 122, Title 16
Setting/Service: Office-Based Surgery
Type of Recognition: L/C

Facilities other than hospitals performing invasive medical procedures requiring anesthesia must maintain accreditation.


State: District of Columbia
Program: Advanced Disease-Specific Care Certification
Agency: Department of Health
State Reference: D.C. ACT 20-469 (11/2014)
Setting/Service: Acute Stroke Ready Primary Stroke Center Comprehensive Stroke Center
Type of Recognition: L/C

Sec.  3.  ASRH,  PSC, and CSC; designation.
(a) A hospital  seeking  designation as an ASRH, a PSC, or a CSC shall apply to DOH for that designation in accordance with procedures established by DOH pursuant  to subsection (d) of this section.
(b) The DOH shall designate an applicant hospital as an ASRH, a PSC, or a CSC if:

(1) The applicant  hospital has been certified as an acute stroke ready hospital, a primary stroke center, or a comprehensive stroke center by a certifying entity; and
(2) The applicant  hospital  meets any other requirements established by DOH
pursuant to subsection (d) of this section.
 


State: District of Columbia
Program: Ambulatory Health Care
Agency: Department of Health
State Reference: 44-505. Inspections
Setting/Service: Ambulatory Surgical Center
Type of Recognition: Licensure

(b) After initial licensure the Mayor shall conduct an on-site inspection as a precondition to licensure renewal, except that the Mayor may accept accreditation by a private accrediting body, federal certification for participation in a health-insurance or medical assistance program, or federal qualification of a health maintenance organization as evidence of, and in lieu of inspecting for, compliance with any or all of the provisions of this subchapter and rules adopted pursuant to this subchapter that incorporate or are substantially similar to applicable standards or conditions of participation established by that body or the federal government. Acceptance of private accreditation by the Mayor shall be contingent on the facility's or agency's:

(1) Notifying the Mayor of all survey and resurvey dates no later than 5 days after it receives notice of these dates;
(2) Permitting authorized government officials to accompany the survey team; and
(3) Submitting to the Mayor a copy of the certificate of accreditation, all survey findings, recommendations, and reports, plans of correction, interim self-survey reports, notices of noncompliance, progress reports on correction of noncompliances, preliminary decisions to deny or limit accreditation, and all other similar documents relevant to the accreditation process, no later than 5 days after their receipt by the facility or agency or submission to the accrediting body.


State: District of Columbia
Program: Hospitals
Agency: Department of Health
State Reference: 22 DC ADC § 2000  
Setting/Service: Hospital
Type of Recognition: Licensure

2000.2 In the absence of requirements in this chapter or in other applicable regulations, the management and operation of each hospital shall be in accordance with applicable Medicare Certificate of Participation requirements, and in the absence of other standards, in accordance with the Joint Commission standards, if applicable, and good medical, nursing and public health practices.

State: District of Columbia
Program: Behavioral Health Care
Agency: Department of Insurance, Securities and Banking
State Reference: 26-A DC ADC § 1903
Setting/Service: Residential Treatment Facilities and Outpatient Facilities as Providers for Drug and Alcohol Abuse, Mental Illnesses or Any Combination Thereof
Type of Recognition: Insurance

1903.1 Pursuant to § 7 of the Act, D.C. Code § 35-2306, the Director shall certify each nonhospital residential facility and out-patient facility as a provider of treatment for drug abuse, alcohol abuse, mental illness, or any combination thereof. 1903.3 In order to be certified pursuant to this section, an applicant shall meet at least one of the following criteria:

(a) Possess current certification from the Joint Commission on Hospital Accreditation (JCHAO) for the treatment of drug abuse, alcohol abuse, or mental illness


State: District of Columbia
Program: Behavioral Health Care
Agency: Department of Public Welfare: Medicaid Program
State Reference: 29 DC ADC § 948
Setting/Service: Inpatient Psychiatric Services for Individuals Under the Age of 22
Type of Recognition: Medicaid

948.1 Inpatient psychiatric services for individuals under the age of twenty-two (22) may be provided by:

(a) A psychiatric hospital or an inpatient psychiatric program in a hospital accredited by the Joint Commission on Accreditation of Healthcare Organizations


State: District of Columbia
Program: Behavioral Health Care
Agency: Department of Public Welfare: Medicaid Program
State Reference: 29 DC ADC § 949 
Setting/Service: Psychiatric Residential Treatment Facility
Type of Recognition: Medicaid

Psychiatric residential treatment facility- a psychiatric facility that is not a hospital and is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Commission on Accreditation of Rehabilitation Facilities, the Council on Accreditation of Services for Families and Children, or by any other accrediting organization with comparable standards that is recognized by the state in which it is located and provides inpatient psychiatric services for individuals under the age of twenty-two (22) and meets the requirements set forth in §§ 441.151 through 441.182 of Title 42 of the Code of Federal Regulations.

State: District of Columbia
Program: Home Care
Agency: Health Regulation and Licensing Administration
State Reference:   DC ST § 44-505
Setting/Service: Hospice and Home Care Organizations
Type of Recognition: Licensure

(b) After initial licensure the Mayor shall conduct an on-site inspection as a precondition to licensure renewal, except that the Mayor may accept accreditation by a private accrediting body, federal certification for participation in a health-insurance or medical assistance program, or federal qualification of a health maintenance organization as evidence of, and in lieu of inspecting for, compliance with any or all of the provisions of this subchapter and rules adopted pursuant to this subchapter that incorporate or are substantially similar to applicable standards or conditions of participation established by that body or the federal government. Acceptance of private accreditation by the Mayor shall be contingent on the facility's or agency's:

(1) Notifying the Mayor of all survey and resurvey dates no later than 5 days after it receives notice of these dates;

(2) Permitting authorized government officials to accompany the survey team; and

(3) Submitting to the Mayor a copy of the certificate of accreditation, all survey findings, recommendations, and reports, plans of correction, interim self-survey reports, notices of noncompliance, progress reports on correction of noncompliances, preliminary decisions to deny or limit accreditation, and all other similar documents relevant to the accreditation process, no later than 5 days after their receipt by the facility or agency or submission to the accrediting body.

(d)(1) If a facility or agency loses private accreditation or federal certification, it shall give the Mayor written notice of the loss within 5 calendar days. If in such a case accreditation or certification was accepted in lieu of an inspection under subsection (b) of this section, the Mayor shall immediately upon notification:

(A) Convert the facility's or agency's license to a provisional or restricted license under § 44-506 pending satisfactory completion of an inspection conducted by the Mayor; or

(B) Suspend the facility's or agency's license based upon a finding that loss of accreditation or certification was prompted by existing deficiencies that constitute an immediate or serious and continuing danger to the health, safety, or welfare of its patients/clients/residents


State: District of Columbia
Program: Behavioral Health Care
Agency: Mental Health Services
State Reference: DC ST § 44-901
Setting/Service: Community-Based Mental Health Programs, Inpatient and Outpatient Mental Health Care, Residential Treatment and Support Services
Type of Recognition: Licensure

(b) It is the intent of Congress that:

(1) The District of Columbia have in operation no later than October 1, 1991, an integrated coordinated mental health system in the District which provides:

(A) High quality, cost-effective, and community-based programs and facilities;

(B) A continuum of inpatient and outpatient mental health care, residential treatment, and support services through an appropriate balance of public and private resources;

and

(C) Assurances that patient rights and medical needs are protected;

(7) The District government establish and maintain accreditation and licensing standards for all services provided in District mental health facilities which assure quality care consistent with appropriate federal regulations and comparable with standards of the Joint Commission on Accreditation of Hospitals


State: Florida
Program: Disease-Specific Care
Agency: Agency for Health Care Administration
State Reference: 59 FL ADC 59A-3.2085 
Setting/Service: Primary Stroke Centers Comprehensive Stroke Centers
Type of Recognition: Licensure/Designation

The Agency has adopted administrative rules that provide criteria for designation of hospital programs as primary stroke centers or comprehensive stroke centers. This statutory section requires that the criteria be substantially similar to the criteria for stroke center certification established by the Joint Commission.

(15) Stroke centers.

(a) Primary Stroke Centers. A hospital program will be designated as a primary stroke center on the basis of that hospital providing to the Agency for Health Care Administration an affidavit on AHCA Form 3130-8009, December 2005, which is incorporated by reference, signed by the Chief Executive Officer of the hospital, attesting that the program has been certified by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) as a primary stroke center, or that the program meets the criteria applicable to primary stroke centers as outlined in the Joint Commission on Accreditation of Healthcare Organizations: Disease-Specific Care Certification Manual

(b) Comprehensive Stroke Center (CSC). Hospitals shall ensure that stroke centers establish specific procedures for screening patients that recognize that numerous conditions, including cardiac disorders, often mimic stroke in children. Stroke centers should ensure that transfer to an appropriate facility for specialized care is provided to children and young adults with known childhood diagnoses. A hospital’s program may be designated as a Comprehensive Stroke Center on the basis of that hospital providing to the Agency for Health Care Administration an affidavit signed by the Chief Executive Officer of the hospital that the program has received initial Primary Stroke Center designation as provided in paragraph 59A-3.2085(15)(a), F.A.C., and that the program meets specific criteria.


State: Florida
Program: Behavioral Health Care
Agency: Agency for Health Care Administration
State Reference: 59 FL ADC 59A-3.300 
Setting/Service: Intensive Residential Treatment Programs for Children and Adolescents
Type of Recognition: Licensure

Programs desiring licensure under this rule shall follow the procedure as described in Rule 59A-3.066, F.A.C., and shall comply with the provisions of Rules 59A-3.301 through 59A-3.312, F.A.C., which establishes the minimum standards for the voluntary licensure as a special hospital of Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accredited Intensive Residential Treatment Programs for Children and Adolescents. These rules emphasize the programmatic requirements designed to meet the needs of the patient in a safe therapeutic environment and are intended to be used in licensing intensive residential treatment facilities for children and adolescents as specialty hospitals pursuant to Section 395.002(16), F.S. Unless otherwise specified, Rules 59A-3.301 through 59A-3.312, F.A.C., supersede the requirements of Rules 59A-3.300 through 59A-3.312, F.A.C., for the purpose of licensing intensive treatment facilities for children and adolescents as specialty hospitals.

State: Florida
Program: Hospitals
Agency: Agency for Health Care Administration
State Reference: 59 FL ADC 59A-3.253
Setting/Service: Hospital
Type of Recognition: Licensure

(2) NON-ACCREDITED HOSPITALS. -- Hospitals which are not accredited by a hospital accrediting organization will be subject to a scheduled annual licensure inspection survey.

3) ACCREDITED HOSPITALS. -- The agency shall accept the survey report of an accrediting organization in lieu of an annual licensure inspection for accredited hospitals and for hospitals seeking accreditation by a hospital accrediting organization, provided that the standards included in the survey report of the accrediting organization are determined by the agency to document that the hospital is in substantial compliance with state licensure requirements, and the hospital does not meet the criteria specified under subparagraphs (e)1. and 2.


State: Florida
Program: Laboratory
Agency: Agency for Health Care Administration
State Reference: F.S.A. § 483.061
Setting/Service: Laboratory
Type of Recognition: Licensure

(4) The agency shall accept, in lieu of its own periodic inspections for licensure, the survey of or inspection by private accrediting organizations that perform inspections of clinical laboratories accredited by such organizations, including postinspection activities required by the agency.

State: Florida
Program: Nursing Care Center
Agency: Agency for Health Care Administration
State Reference: SB 2514 (2017)
Setting/Service: Nursing Facilities
Type of Recognition: Medicaid Value-Based Reimbursement

The Governor signed Senate Bill 2514 (2017) which includes the Medicaid Nursing Home Prospective Payment System (PPS).  SB 2514 includes funding of the quality incentive payment program under the PPS for nursing facilities that exceed quality benchmarks.  The new payment method contains several components for awarding “points” including a Quality Incentive Program, which uses quality metrics to increase reimbursement to high performing facilities. The Joint Commission’s nursing care center accreditation was one of the credentials recognized in a report prepared for Florida’s AHCA by an independent consultant for use under the new plan.  The report recommended that The quality measures selected for inclusion in the quality incentive include:

Process Measures – Flu Vaccine, Antipsychotic, Restraint

Outcome Measures – UTI’s, Pressure Ulcers, Falls, Incontinence, Decline in ADLs

Structural Measures – Staffing, CMS 5 Star, Florida Gold Seal, Joint Commission Accreditation, AHCA National Quality Award

 

The Prospective Payment System (PPS) will take effect October 1, 2018. 

 


State: Florida
Program: Home Care
Agency: Agency for Healthcare Administration
State Reference: F.S.A. § 400.933
Setting/Service: Home Medical Equipment Providers
Type of Recognition: Licensure

(2) The agency shall accept, in lieu of its own periodic inspections for licensure, submission of the following:

(a) The survey or inspection of an accrediting organization, provided the accreditation of the licensed home medical equipment provider is not provisional and provided the licensed home medical equipment provider authorizes release of, and the agency receives the report of, the accrediting organization; or

(b) A copy of a valid medical oxygen retail establishment permit issued by the Department of Health, pursuant to chapter 499.

Note:  AHCA requires all sites to have onsite survey to accept accreditation in lieu of its own periodic inspections for licensure


State: Florida
Program: Home Care
Agency: Agency for Healthcare Administration
State Reference: F.S.A. § 400.471
Setting/Service: Home Health Agencies
Type of Recognition: Initial Licensure

(h) In the case of an application for initial licensure, documentation of accreditation, or an application for accreditation, from an accrediting organization that is recognized by the agency as having standards comparable to those required by this part and part II of chapter 408. Notwithstanding s. 408.806, an applicant that has applied for accreditation must provide proof of accreditation that is not conditional or provisional within 120 days after the date of the agency's receipt of the application for licensure or the application shall be withdrawn from further consideration. Such accreditation must be maintained by the home health agency to maintain licensure. The agency shall accept, in lieu of its own periodic licensure survey, the submission of the survey of an accrediting organization that is recognized by the agency if the accreditation of the licensed home health agency is not provisional and if the licensed home health agency authorizes releases of, and the agency receives the report of, the accrediting organization.


State: Florida
Program: Home Care
Agency: Agency for Healthcare Administration
State Reference: 59 FL ADC 59A-8.003
Setting/Service: Home Health Agencies
Type of Recognition: Licensure

(3) Surveys of Accredited Home Health Agencies:

(a) It is the responsibility of the home health agency to request exemption from state licensure surveys pursuant to Section 400.471(9), F.S., by submitting documentation of accreditation by an approved accrediting organization and the most recent survey from the accrediting organization to the AHCA Licensed Home Health Programs Unit.

(b) Home health agencies that complete paragraph (a) will not be subject to licensure surveys by AHCA except under the following circumstances:

1. The HHA has been denied accreditation or has received a provisional accreditation report from the accrediting organization on its most recent survey, or

2. The HHA has received full accreditation but has not authorized the release of the report to the AHCA, or has not ensured that AHCA has received the accrediting organization's report.


State: Florida
Program: Nursing Care Center
Agency: Agency for Healthcare Administration
State Reference: 59 FL ADC 59A-4.107
Setting/Service: Nursing Homes: Minimum Standards
Type of Recognition: Licensure

(1) Each facility will have only one physician who is designated as Medical Director.

(2)

(a) The Medical Director must be a physician licensed under Chapter 458 or 459, F.S. The nursing home administrator may require that the Medical Director be certified or credentialed through a recognized certifying or credentialing organization.

(b) A Medical Director who does not have hospital privileges shall be certified or credentialed through a recognized certifying or credentialing body, such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the American Medical Directors Association, the Healthcare Facilities Accreditation Program of the American Osteopathic Association, the Bureau of Osteopathic Specialists of the American Osteopathic Association, the Florida Medical Directors Association or a health maintenance organization licensed in Florida.


State: Florida
Program: Ambulatory Health Care
Agency: AHCA
State Reference: F.S.A. § 400.9935  
Setting/Service: MRI Centers
Type of Recognition: Licensure

(7)(a) Each clinic engaged in magnetic resonance imaging services must be accredited by the Joint Commission on Accreditation of Healthcare Organizations, the American College of Radiology, or the Accreditation Association for Ambulatory Health Care, within 1 year after licensure.

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The Joint Commission maintains a listing of state agencies that recognize accreditation/certification. These lists have been compiled from a variety of sources and are intended to identify state regulatory agencies that recognize and/or rely on accreditation in lieu of specific state licensure or certification requirements. The Joint Commission makes no claims about the accuracy of this list and it should be considered a reference document. Joint Commission accredited organizations are strongly encouraged to inquire with their state regulatory agency for a full description of the recognition and any additional requirements the state agency may have.