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Inspiring Success on the Road to Recovery

Sunday, September 4, 2016

Which Rehabs are Legit?

By Jim Kreitler, CEO, Calvary Addiction Recovery Center

There are many factors to consider when choosing or referring to an addiction treatment program. Is it safe? Are their business practices fair and legitimate? Do they follow sound clinical guidelines in regards to therapy, documentation and confidentiality? Does the program have a track record of success?

These considerations take on added legal and ethical consideration when a licensed professional or program is referring a patient who has been under their care. If it ends tragically due to unsafe conditions or finances become problematic what is the liability for the referral source?

Buyer Beware

Many individuals look for treatment options on the internet, unfortunately this has drawbacks. Treatment program websites can make the cheesiest facility look like paradise. There are examples of programs paying unscrupulous online marketing companies to redirect searches. So I Google “Integrity Rehab” and it directs me to a page that provides some basic information about that program but the phone number is to a call center for a completely different company.
There are two criteria I propose should always be considered. Is it properly licensed? Is it accredited? While this may not be an iron clad guarantee — it speaks strongly to the professionalism and integrity of a program.


In Arizona there are several levels of licensure. 

Acute behavioral health hospitals handle the most serious cases and may offer detox and IOP but rarely residential rehab. Operated as hospitals they can handle higher medical and psychiatric acuity, i.e., Aurora, St. Luke’s, Banner, Valley Hospital, Quail Run.

Inpatient Behavioral Health Facility. For primary inpatient rehab and also detox. They are staffed 24/7 with RNs, offer physician and psychiatric visits usually onsite, facilities meet stringent safety and anti-ligature requirements. These are appropriate placement for those requiring 30 day inpatient due to risk of relapse, post-acute withdrawal, med-management, co-occurring disorders and an intensive program of treatment. They tend to be the most established programs such as The Meadows, Cottonwood, Sierra Tucson, Calvary, Valley Hope and River Source.

Recently several levels of residential have been combined into one for licensure. It may or may not include counseling. The licensure requirements while not onerous reflect a level of safety, client’s rights, record keeping, rules for medication management and reporting requirements. Examples in the valley include; A Better Today, Crossroads, Maverick House, Soba Mesa, Sundance, Unhooked and recently opened Blue Sky.

Outpatient. Very basic safety and proper storage of records. The easiest licensure but seems to be overused by programs really providing residential.

Laboratory License is mainly used in addiction treatment for urine drug testing. CLIA (Clinical Laboratory Improvement Amendments) is regulated by the federal government through the state agency, regional office and central office. This is not required for simple point of care test cups. If programs are CLIA licensed they are almost always billing insurance for this testing and this practice has been ripe with reported abuse.

It is very important folks use and refer to properly licensed programs. The recent phenomenon of “Florida Model” programs that license as outpatient but market and provide residential is troubling. ADHS is aware but lacks jurisdiction unless the facility helps manage medications or does counseling on site. 

Referring to programs that do not license their homes carries liability. A former state BH license regulator reports an instance where a family sent their son for Florida model treatment to AZ from Michigan. The young man relapsed, overdosed and died at the house. When the mother called the state for the detailed report she was told the facility was not licensed, had never been inspected and there was nothing the state could do. Check licensure at http://azdhs.gov/licensing/index.php#azcarecheck.


I am a big fan. It confirms you are operating at a high standard and always working to improve. If your program is not accredited, why not? Are you referring to non-accredited programs? Why? There are plenty of properly licensed and accredited options available. 
The two most widely held national and international accreditations for rehabilitation treatment centers and other behavioral health organizations are The Joint Commission (JCAHO) and CARF (Commission on Accreditation of Rehabilitation Facilities). 
The National Association of Addiction Treatment Providers NAATP recently said: "Accreditation matters. While no single factor is dispositive of high quality care, accreditation is strong indicia of such. When considered in conjunction with other factors a center might include in its prospectus, such as quality of staff, comprehensive programming, and years in operation, accreditation gives a consumer valuable information with which to assess options. Our consumer base needs and deserves that. We all do.”
Rebecca Flood, Executive Director/CEO of New Directions for Women writes in an article for Addiction Professional magazine “As an accreditation advocate, I advise all of our patients, inquiring families and friends, and referral sources such as therapists, hospitals and physicians who are looking for care to not only check licenses and state certifications, but also national and international accreditations, and to confirm that the facility is accredited for the level of care needed and wanted for the patient. Accreditation is the determinant for whether or not I would utilize its services, or send a family member there, and it should be for any family looking to place their loved one or any organization looking to refer a patient.”

For those programs concerned accreditation is expensive and onerous JCAHO reports cost as: “a small organization would pay about $1,689 in annual fees every year, plus a survey fee of around $2,835 in the year we do the on-site survey.” It doesn’t have to take forever. Foundations Recovery Network FRN recently opened Skywood Recovery a 100-bed inpatient facility in Michigan this past spring. They achieved Joint Commission Accreditation in less than 90 days. It would have been sooner but you have to have closed charts from discharged patients for JCAHO to review.
Accreditation can be checked at http://www.carf.org/providerSearch.aspx for CARF and https://www.qualitycheck.org/ for JCAHO.


If you are referring a loved one or client carefully consider the quality of a program by using the best tools at your disposal. Proper licensure gives you assurance the program meets appropriate regulations for safety, confidentiality and clinical standards. Remember if you are referring to residential to be sure that is the level of licensure. Accreditation is another tool to determine the quality of a program and gauge their commitment to professionalism. Insurance will not contract with any unaccredited program.
If you work, run or own a program, do it right! Get in the game! Get licensed and accredited properly. You can feel pride and your clients can feel confident, A winning combination!