Accreditation: Consultant or In-House Comparison

Accreditation: Consultant or In-House Comparison

by Tom Sefcik, ACSW, MBA

A consultant can be a huge asset to an organization to manage various aspects of a business. Areas such as personnel, accounting, and for rehabilitation facilities, accreditation preparation and aftercare, are all valuable.

CARF and Joint Commission accreditation are increasingly becoming more important to clients and insurance carriers, and state requirements as well. To become accredited has an impact on the current staff, even with a consultant, so to hire an additional person on staff can be expensive. So, what is the cost to becoming accredited, or staying accredited in the next three years before accreditation rolls around again?

Hiring an in-house accreditation specialist

When an organization tries to meet accreditation standards with an in-house team, the demands of hiring an individual will come at the cost of recruitment, salary, and fringe benefits including healthcare, payroll taxes and potential annual bonus or 401K participation. Other likely indirect costs in hiring an employee are the infrastructure costs of running a facility that are shared by all employees including computer hardware, dues and subscriptions, insurance, furniture and equipment, meals and entertainment, vacation and sick days, and a host of other overhead and general administration fees.

The employee that was hired at a rate of around $45/hour for 2080 annual work hours actually costs much closer to $90/hour, using Cost Accounting Standards established by the US government. If the employee remains employed, he or she can also be responsible for the aftercare needed for re-accreditation in three years, but if not, and a new employee must be hired, recruiting time and fees are incurred again, increasing the cost per hour of the employee.

Using current staff for accreditation

For organizations that feel they cannot afford to even hire a full or part time staff person, they may use existing staff to accomplish the tasks of preparing for and undergoing the accreditation survey.

“If someone is tasked within the organization to oversee and prepare for an accreditation survey who doesn’t have  knowledge of the standards or the experience of the survey process, and he or she already has regular full-time responsibilities, planning it out and completing tasks to be ready for the CARF or TJC survey is often stressful to the entire organization and often doesn’t yield the survey results the organization was seeking,” says Robertson.

Becoming accredited with a consultant

For CARF or TJC accreditation readiness, PowderHorn charges a fee at a fraction of the cost of hiring a full-time employee, and develops a detailed analysis of where the client is with the 1,500-2,000 accreditation organization’s standards.

“In using a PowderHorn CARF or TJC consultant, an organization has an expert on the team who is focused only on the accreditation task, armed with the knowledge and experience that allows an organization to receive a 3-year accreditation. PowderHorn consultants have over 180 years of experience and a 100% success rate over our 15 years of providing consulting services to our clients,” says Robertson.

In-house vs. consultant reality

If an organization that prepares for accreditation in-house does not pass, or receives a 1-year accreditation only, which leads to the same process one year later, due to the inexperience, lack of knowledge, or just time constraints, going through the process again can begin to affect the normal operation of the organization.

“When you take the Executive Director or other critical team members away from their regular jobs to do a project like survey preparation, it nearly always takes a toll on the program,” adds Robertson. 

Becoming accredited, whether mandated by the state or decided by the organization, is an intensive process that takes a great investment of time, and some money.

“The reality is that by hiring a PHC consultant, you will likely receive a 3-year accreditation,” says Robertson. “Everyone on your team gets to do their regular job, and you have an expert at your facility that is well-versed in all the standards, to accomplish your goal of accreditation,” he adds.


PowderHorn Consulting is staffed by professionals who have served as providers, executives on treatment organizations and have an extensive history as CARF surveyors and can assist and answer any questions you may have in the CARF accreditation process.