CARF Accreditation Requirements Checklist (2026)

Current manual: 2026 Behavioral Health Standards ManualFor surveys July 1, 2026 to June 30, 2027
Two layers of standards: ASPIRE to Excellence plus program standardsBusiness practices sit in Section 1 of every manual
Manual price, 2026 BH: $214 printed, from $322 electronicCARF online store, November 4, 2026
Not yet open?: Inaugural One-Year AccreditationFull survey about six months after services start
New from July 1, 2026: Written AI policies and procedures if you use AI in your servicesAdded to ASPIRE, so it reaches every CARF manual

Working toward CARF accreditation? Book a free consultation or call 561-396-0813.

Who can apply for CARF accreditation

CARF accredits programs and services, not a building or a license. You choose which programs to put forward, and a CARF resource specialist confirms the manual that covers them after you submit the New Organization Questionnaire.¹ This page is a CARF accreditation requirements checklist. For the process and timeline, read our CARF accreditation guide.

Programs that match a CARF description. Each program must fit a description in your area's manual.^{5, 6}
A complete survey application. It asks for a two-month survey window, your leadership, the programs to accredit and every location.¹
Every Accreditation Condition met. A positive decision requires satisfying all of CARF's Accreditation Conditions; failing one can mean Nonaccreditation.² CARF's free CCRC manual shows those conditions include delivering each program for a minimum period before a regular survey. That is a different manual, so confirm your period with CARF.³²
New organizations. Inaugural One-Year Accreditation lets a new organization show the standards are in place before it serves anyone, with a full survey about six months after services begin.² See how to open a treatment center for the license work alongside it.
Opioid treatment programs. Federal OTP certification requires accreditation from an approved body; a new OTP that has applied for accreditation and for SAMHSA certification can get provisional certification for up to one year.⁸

Your license is a separate track; our state licensing guides show where states require or recognize accreditation.

How the CARF accreditation standards are organized

Each CARF manual sets standards for business practices, program structure and the service process in one area of accreditation.³

ASPIRE to Excellence. The business practice and quality improvement framework, published in Section 1 of the manuals.³ CARF's free CCRC manual names its sections: Leadership, Governance, Strategic Planning, Input from Persons Served and Other Stakeholders, Legal Requirements, Financial Planning and Management, Risk Management, Health and Safety, Workforce Development and Management, Rights of Persons Served, Accessibility, Performance Measurement and Management, and Performance Improvement.³²
Program standards. Standards for each program type you run, plus optional specialty designations such as Children and Adolescents or the Integrated Primary Care designation new in 2026.⁵
Supporting material. The manual also carries accreditation policies, intent statements, changes from the prior year and appendices on required written documentation and operational timelines.¹²

ASPIRE step	What CARF says it covers	What to have ready
Assess the environment	Leadership studies the social, economic, competitive, legal, regulatory and political setting³	A written environmental review leadership discussed
Set strategy	A top-level plan that turns the assessment into goals, priorities and resources³	A current strategic plan with dated goals and owners
Persons served and stakeholders	Input from persons served and others, used in planning and services³	Feedback records and proof the input changed something
Implement the plan	Legal and regulatory planning, fiscal practice, risk, health and safety, workforce, technology, rights and removing barriers⁴	The plans and records in the checklists below
Review results	Tracking results against set targets and finding what to improve³	Indicators, targets and a dated performance report
Effect change	Acting on what the results show, and revising strategy if needed³	Improvement actions tied to specific results

The checklists below follow the order of CARF's public course description for its 2025 standards, the latest it lists.⁴ Our CARF accreditation consultants page has a shorter area summary.

Checklist: leadership, governance and planning

The areas come from CARF's public descriptions. ASPIRE gained an AI standard for 2026, and CARF's CCRC materials show its technology standards moved, so check your edition.¹⁸ The items are our plain-language list of what programs usually prepare; the required written documentation appendix in your manual governs.¹²

Organization chart. Current, with names and titles; CARF asks you to give one to the survey team.¹⁹
Mission, vision and purpose. Written and used in planning, since the environmental assessment is read against them.³
Leadership. How leaders stay involved in outcomes and quality, which CARF's 2025 course material stresses.⁴
Governance. Who holds authority and oversight; check how this section applies in your manual.³²
Legal obligations. CARF names planning for the legal and regulatory environment.⁴ Know which laws and licenses apply to you.
Ethics and corporate compliance. CARF's CCRC manual covers ethical conduct and, for US organizations with federal funding, corporate compliance. Confirm the details in your manual.³²
AI policy, if you use AI. From July 1, 2026: how you use AI, disclosure to persons served, privacy, human oversight, what counts as an incident, and review at least yearly.¹⁷
Strategic plan and stakeholder input. Goals, priorities and resources, plus a routine for gathering input and a record of what you did with it.³
Financial planning. A budget and fiscal practices that leadership reviews.⁴

Checklist: risk, health and safety, and workforce

Risk management. A way to find your risk exposures and reduce them.⁴
Health and safety. CARF treats a healthy, safe setting as a core topic.⁴ Keep written emergency and safety procedures that staff actually use.
Workforce aligned to strategy. CARF ties workforce development to strategic objectives.⁴ Keep hiring, credential, training and supervision records together for each person.
Program staffing and peer support. CARF's 2025 Behavioral Health course on program structure covers how staffing supports participation and outcomes, plus training, ethics and service design roles for peer support specialists.²⁰

Checklist: technology, data, rights and accessibility

CARF's 2019 update put technology standards in ASPIRE in every manual.¹⁰ For 2026, its CCRC page says the old Technology subsection was folded into other ASPIRE areas or eliminated.¹⁸ The Behavioral Health manual is not public, so check the changes section of yours.

Technology in planning. CARF's 2026 CCRC manual brings technology and data use, gaps and opportunities into strategic planning. Confirm in yours.³²
Technology and data policies. That manual puts these under risk management, and shows the older technology plan and continuity testing standards as deleted. Confirm how yours treats them.³²
Staff training. That manual puts cybersecurity and job-technology training under workforce. Confirm in yours.³²
Security risk analysis. HIPAA requires a thorough assessment of risks to electronic health information and measures to reduce them.²⁵ Plan EHR, email and telehealth tools around it.
AI oversight. CARF highlights human oversight, staff training and a governance group that reviews AI vendors and data.¹⁷
Rights of persons served. A CARF business practice topic.⁴ Make sure people know their rights and staff honor them.
Complaints. CARF tells the public to use a provider's formal grievance process, and to contact CARF if there is none.²² Keep a formal process people can find and use.
Substance use records. 42 CFR Part 2 restricts use and disclosure of records from federally assisted substance use disorder programs.²⁴
Accessibility. CARF lists barrier removal as a topic.⁴ ADA Title III rules list a health care provider's professional office as a public accommodation.²³

Checklist: performance measurement and improvement

CARF's free 2017 performance management workbook says its standards describe a measurement system without dictating your indicators. It frames service delivery indicators around effectiveness, efficiency, satisfaction and access, alongside business function indicators.²¹

Indicators and targets. For each program, indicators in those four areas with a target for each, plus business indicators such as finances.²¹
Data collection. Who collects each measure, when and from whom, and why the data is reliable.²¹
Reporting and action. A dated report comparing results with targets, shared with stakeholders, and improvement steps you can trace to it.^{3, 21}
Annual commitment. Accredited organizations review new and revised standards each year, and leadership signs an Annual Conformance to Quality Report.¹¹

Keeping this cycle running between surveys is what our continuing compliance and mock survey work covers. For the run-up to a survey, see how to prepare for a CARF survey.

Checklist: program, service delivery and records

Check each program against CARF's own description of it first.

CARF program	How CARF describes it, in brief	Check
Outpatient Treatment	Individual, group and family counseling; coordinated, defined services of varying intensity⁶	Service menu and schedule written down
Intensive Outpatient	A separate, distinct program of scheduled sessions tied to person-centered plans; more intensive than outpatient⁶	Own schedule, staffing and admission criteria
Partial Hospitalization	Time-limited, medically supervised, available at least five days a week, identifiable as its own program⁶	Medical oversight and days match
Residential Treatment	Nonhospital interdisciplinary services 24 hours a day, 7 days a week, involving family where possible⁶	Round-the-clock staffing plan
Withdrawal Management	Time-limited care staffed for biomedical and psychosocial assessment, observation and referral⁶	Medical protocols and referral agreements

Admission, assessment and planning. Set out who you admit, who assesses them and when. Build person-centered plans with each person.⁶
Transition and discharge. How people move between levels of care and leave, with referrals documented.
Records. One record per person showing assessment, plan, services, progress and transition, with releases that meet Part 2 where it applies.²⁴

CARF policies and procedures: the plans most programs need

Use this table as a starting inventory and check it against the required written documentation appendix in your manual.¹² We write these to match how a program really runs; see our policies and procedures service.

Document	What it should show
Strategic plan	Goals, priorities and resources, informed by your environmental review and stakeholder input
Ethics and corporate compliance policy	Ethical conduct and, if you have federal funding, corporate compliance; confirm in your manual³²
Budget and financial plan	How you plan, monitor and review finances
Risk management plan	Your exposures and how you reduce them
Health and safety procedures	Emergency and safety procedures staff actually use
Workforce policies	Hiring, credentials, training, supervision and evaluation
Technology and data policies and HIPAA risk analysis	Security, acceptable use, backup and continuity, per CARF's CCRC manual; confirm in yours.³² The risk analysis is a separate federal duty.²⁵
AI policy	Use, disclosure, privacy, oversight, incidents and annual review, if you use AI¹⁷
Rights and grievance policy	The rights you promise and your grievance process
Accessibility plan	How you identify and address barriers to services
Performance measurement plan	Indicators, targets, data sources and reporting
Program descriptions	Scope, population, hours, staffing and admission criteria
Records and confidentiality policy	Record contents, privacy and Part 2 consent

Most of these also serve your state license, so build them once. Our licensing consultants map state rules alongside CARF.

Which CARF manual applies to your program

CARF publishes a manual for each area of accreditation.²⁶

Manual or option	Who it is for
Behavioral Health	Mental health, substance use, psychosocial rehabilitation and family services: outpatient, IOP, PHP, residential, withdrawal management, crisis and more. Sobering Center is new in 2026^{5, 26}
Opioid Treatment Program	Medication treatment for opioid use disorder; choose one core program (withdrawal management, outpatient or residential) and add others such as IOP⁷
CCBHC	In the Behavioral Health manual when surveyed with other programs, or its own manual when it is the only one⁵
Other areas	Child and Youth Services, Aging Services, Continuing Care Retirement Communities, Employment and Community Services, Medical Rehabilitation, Vision Rehabilitation Services²⁶
ASAM Level of Care Certification	Adult residential Levels 3.1, 3.5 and 3.7; a certification with its own rating elements manual²⁷

How to get the CARF manual and what it costs

Manuals are sold through CARF's online store and follow a survey year; the 2026 editions cover surveys from July 1, 2026 to June 30, 2027.¹⁶

List your programs and locationsThey decide which manual you need.¹
Confirm the editionThe store sends unsure buyers to their resource specialist or (888) 281-6531.¹⁶ Match the edition to your survey date.
Choose printed or electronicElectronic is a locked PDF plus Word files; the link expires after three downloads or 90 days.¹³
Buy enough licensesElectronic files are for employees of the buyer, up to the users purchased.¹³
Add self-assessment toolsThe workbook gauges readiness; the conformance checklist tracks conformance and gaps.^{14, 15}

2026 Behavioral Health product	Listed price, November 4, 2026
Standards Manual, printed (484 pages)	$214¹²
Standards Manual, electronic	$322 for one user, up to $3,542 unlimited¹³
Survey Preparation Workbook, printed	$132³¹
Standards Conformance Checklist (610 pages)	$66¹⁴
Package #2: manual, workbook and checklist	$412¹⁵

Manual prices are separate from the survey fee. See CARF accreditation cost and survey process.

How CARF requirements differ from Joint Commission

Both accredit behavioral health programs and both are SAMHSA-approved for OTPs.⁹

Topic	CARF	Joint Commission
Structure	ASPIRE business practices, then program standards³	Chapters by function, such as Leadership, Human Resources Management, Record of Care and Performance Improvement³⁰
Getting the standards	Bought from the CARF store¹²	Free E-dition once accredited; 90-day free trial before applying²⁹
Minimum activity	A set period of delivering services before a regular survey in its CCRC manual; confirm yours.³² Inaugural route before services start²	Non-OTP: three people served, at least two active during survey; a license where law requires²⁸
Survey notice	You pick a two-month window; no surprise visits¹¹	Initial non-deemed surveys announced; later surveys usually unannounced, some with seven days' notice²⁹

For a full comparison read CARF vs. The Joint Commission, or see our Joint Commission guide and Joint Commission consulting.

CARF accreditation requirements FAQ

Is there an official CARF standards checklist?

CARF sells a Standards Conformance Checklist for each manual; the 2026 Behavioral Health one lists at $66.¹⁴ This page is a planning aid, not a substitute.

Do the requirements change every year?

Yes. Manuals are updated yearly, and accredited organizations review the changes.¹¹

What are the CARF IT requirements?

Technology runs through CARF's business practice standards. Its 2019 update named leadership planning, risk assessment, continuity testing, cybersecurity training and delivering services by technology.¹⁰ For 2026, CARF's CCRC page says the old Technology subsection was folded into other ASPIRE areas or eliminated.¹⁸ Its CCRC manual now places technology in strategic planning, technology and data policies in risk management, and cybersecurity training in workforce.³² Check the changes section of your own manual. Written AI policies apply from July 1, 2026 if you use AI.¹⁷ Plan systems around the HIPAA Security Rule too.²⁵

Want this checklist turned into a plan?

We match your programs to the right manual, find the gaps and build the documents your survey needs. See how our CARF consulting works.

Book a free consultation

Confirm these with CARF before you apply

How long each program must have delivered services before a full survey, or whether Inaugural One-Year Accreditation fits your start date.
Which program description fits each level of care, and whether a specialty designation applies.
The exact required written documentation list in your manual's appendices.
How your manual now treats technology planning, data policies, continuity and technology-based services.
How many surveyors and days you need, to estimate the survey fee.
For residential, PHP and withdrawal management, what your manual and state expect on medication handling, infection control and any use of restraint or seclusion.
Whether your state wants its license first, and how your state and payers recognize CARF.
For OTPs, the SAMHSA and state opioid treatment authority steps that run alongside accreditation.

Sources

CARF, Steps to accreditation. carf.org
CARF, Accreditation decisions. carf.org
CARF, Our standards. carf.org
CARF eLearning, ASPIRE to Excellence Standards Course (2025 standards). surveyorenhance.carf.org
CARF, Behavioral Health. carf.org
CARF, 2026 Behavioral Health Program Descriptions. carf.org
CARF, Opioid Treatment Program. carf.org
42 CFR 8.11. ecfr.gov
SAMHSA, Approved Accreditation Bodies. samhsa.gov
CARF, CARF significantly expands technology guidelines (2019, updated 2023). carf.org
CARF, Answering Your Questions About CARF. carf.org
CARF Online Store, 2026 BH Standards Manual (printed). bookstore.carf.org
CARF Online Store, 2026 BH Standards Manual (electronic). bookstore.carf.org
CARF Online Store, 2026 BH Standards Conformance Checklist. bookstore.carf.org
CARF Online Store, 2026 BH Survey Preparation Package #2. bookstore.carf.org
CARF Online Store, 2026 Standards Manuals and Workbooks. bookstore.carf.org
CARF, CARF implements first AI standard (April 21, 2026). carf.org
CARF, Publications for CCRCs (2026; not Behavioral Health). carf.org
CARF, Preparing for an accreditation survey. carf.org
CARF eLearning, Program/Service Structure (BH) course (2025 standards). surveyorenhance.carf.org
CARF, Six Steps to Building a Performance Management System (2017). carf.org
CARF, For the public. carf.org
28 CFR 36.104 (ADA Title III). ecfr.gov
42 CFR Part 2. ecfr.gov
45 CFR 164.308 (HIPAA Security Rule). ecfr.gov
CARF, Programs. carf.org
CARF, ASAM Level of Care Certification. carf.org
The Joint Commission, Behavioral Health Care and Human Services. jointcommission.org
The Joint Commission, Accreditation Process. jointcommission.org
Joint Commission Resources, 2026 CAMBHC sample pages. store.jcrinc.com
CARF Online Store, 2026 BH Survey Preparation Workbook (printed). bookstore.carf.org
CARF, 2026 Continuing Care Retirement Community Standards Manual (public copy; not Behavioral Health). carf.org

This checklist summarizes CARF's public information and federal rules as of the date above. It is general information, not legal or accreditation advice, and does not reproduce CARF's licensed standards. Your survey-year manual and CARF govern; confirm with CARF and your state agency.