For someone struggling with addiction to drugs and/or alcohol, the decision to pursue a treatment program can be an incredibly positive first step. However, with the recent rise in opiate addiction in the United States, there has been a corresponding rise in for-profit treatment centers.
Many deeply troubling reports have come out about such treatment centers. An investigative piece released earlier this year profiles a young woman struggling with opiate addiction who went through "the Florida shuffle," which is a term given to the cycle wherein recovering users are wooed aggressively by rehabs and freelance “patient brokers” in an effort to fill beds and collect insurance money. "Patient brokers" are current or former drug users, who search for potential customers on social media, at Narcotics Anonymous meetings, and on the streets in locations with a high concentration of rehab centers, such as coastal Florida.
The rise of these unscrupulous providers raises the risk that patients can receive substandard care or worse. How do potential patients and their loved ones locate trustworthy treatment facilities? One important criteria is accreditation.
What is Rehab Accreditation?
All treatment facilities must meet certain standards, set by the state government in which the rehab is located, in order to operate. These can cover a wide variety of factors, including liability insurance, occupancy certificates, inspection requirements, specific qualifications and certifications if medication will be dispensed, and much more. Additionally, these centers have to follow certain federal guidelines, including the Americans with Disabilities Act (ADA) and Occupational Safety and Health Administration(OSHA) regulations.
However, many treatment facilities meet these minimum guidelines and still wind up breaching the duty of care owed to their patients. An additional layer of patient protection can come from the accreditation of a treatment facility. If the addiction treatment program is “accredited,” the facility has gone through a series of evaluations related to the standards of excellence in client care.
CARF and the Joint Commission
The majority of rehab accreditation in the United States is handled by two majors organizations: CARF and the Joint Commission. The Commission on Accreditation of Rehabilitation Facilities (CARF) is an independent, nonprofit organization focused on advancing the quality of treatment services. Their mission statement is "to promote the quality, value, and optimal outcomes of services through a consultative accreditation process and continuous improvement services that center on enhancing the lives of persons served."
The Joint Commission is also an independent nonprofit organization. Focusing on a variety of rehabilitation programs, it certifies nearly 21,000 health care organizations and programs in the United States. The mission statement of the organization is "to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value." The organization asserts that Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization's commitment to meeting certain performance standards.
There are some other organizations that may provide accreditation to a treatment center, but CARF and the Joint Commission accredit the vast majority of centers in the United States.
The accreditation process involves investigations, training, audits, site visits, evaluations, and more. These seek to ensure that the treatment center meets the standards put forth by the accreditation body regarding (but not limited to):
- Staff credentials, training, and educational requirements
- Program practices
- Treatment outcomes
- Efficiency of program of addiction and co-occurring mental health disorders treatment
- Standards of care for client addiction therapy
- Confidence of family and loved ones of clients in treatment
- Safety Standards for clients and staff
- Training on policies pertaining to HIPAA compliance
- Sensitive to all populations with cultural sensitivity and inclusion for culturally diverse clients including minorities, LGBT, elderly, non-English speaking, disabled, and other minority groups
Types of Accreditation
There are different types of accreditation statuses that a center may achieve. CARF may grant the following statuses to a facility:
- Preliminary accreditation
- Accreditation with stipulations
The Joint Commission Levels of Accreditation are:
- Preliminary accreditation
- Accreditation with Follow-Up Survey
- Contingent Accreditation
- Preliminary Denial of Accreditation
- Denial of Accreditation
Accreditation can have multiple benefits for the patient as well as the organization, including reimbursement from insurance companies and governmental insurance programs. Despite these benefits, the majority of treatment organizations in the United States do not carry any form of accreditation. Around 57% of treatment facilities are not accredited.
Can an Accredited Rehab Still be Liable?
If a treatment facility has been accredited by an independent body, it is a sign that the organization is seeking to provide the best possible care to patients. However, just because a facility has been accredited does not mean that it will never breach a duty of care that it owes to patients, visitors, and staff.
For example, a facility may have accreditation regarding its policies and practices for caring for patients who are going through the withdrawal process. However, employees of the facility may make mistakes or fail to follow all steps set out in the policy when actually caring for a patient. In this type of scenario, the facility would likely still be liable if a patient was harmed due to the actions (or the failure to act) of an employee under the theory of vicarious liability, which holds that an employer can be liable for certain behaviors of its employees.
Representation in Rehab Lawsuits
The team at Gilman & Bedigian understand that when a loved one falls ill or is injured during a stay in a rehab facility, determining exactly what happened can be overwhelming and incredibly complex. We have the resources to thoroughly investigate complex cases and take on major organizations. Contact our legal team for a free consultation.