Ageing services providers around the world seek accreditation to demonstrate and certify their commitments to quality, best practices, and financial stability, but accreditation is not always a one-size-fits-all proposition. For insights into how accreditation differs around the world, we turned to CARF International, which accredits a variety of health and human services organizations in 26 countries on five continents.

An independent, nonprofit organization, CARF provides accreditation for providers of ageing services, behavioral health, child and youth services, medical rehabilitation, and several more service categories. Among CARF-accredited ageing services organizations, there are 190 (comprising 549 locations) outside of the U.S., and 126 (comprising 181 locations) in the U.S.

Global Ageing Network interviewed Terrence Carolan, CARF International managing director of medical rehabilitation and aging services. Here is an edited summary of the conversation.

Global Ageing Network: Does accreditation have high status in all of the countries you work in, and if not, how does it differ in different regions?

Terrence Carolan: “There is a value to accreditation and its relevant standards in countries of all income levels. In some, accreditation may not be  sought for  a number of reasons. In low- and middle-income countries, the focus is on infrastructure and the capacity of the health care system to provide services and care for individuals. And that’s a much steeper hill to climb. Usually when programs seek accreditation from an international accreditor, they are in an established system of care that they can build upon [to] enhance the quality of services. The standards created by CARF International can be used to help build infrastructure in business and care delivery practices, even if accreditation itself isn’t sought.

“In high-income [countries], CARF is better recognized, although some have no engagement with international accreditors. Others have in-country accreditations, although the depth and relevance to ageing services programs varies greatly. Some countries have robust and field-specific standards used in national accreditations, and others have a broader approach that may not drill down to the level of the individual health and human service program or community.”

Global Ageing Network: Given differences among countries around the world, how can programs find the best “accreditation fit” for their culture and needs? What is the value proposition they follow?

Terrence Carolan: “The value of accreditation to communities and programs is extraordinarily unique, but there is common ground. One of the greatest commonalities between all programs around the world is that they want to improve quality, to have an objective way to measure how they’re performing, and to identify what they can do to improve performance over time.

“When an accreditation uses person-centered standards, it means that accredited organizations seek input from the people that are served and other stakeholders, and want to improve how care is delivered over time. CARF is very focused on transparency and accountability. It’s about how the provider builds a stable business basis and care delivery program that ensures safety, effectiveness, and efficiency of services to enhance access and the experience of the person served. This type of accreditation reassures the field—all of its stakeholders and CARF—that the organization is viable and will continue to deliver services long into the future, and that the organization is able to seek feedback and input to make positive change over time.”

Global Ageing Network: You will present a session at the 2025 LeadingAge Annual Meeting & Global Ageing Network Conference November 1-5 in Boston, Massachusetts. What will your topic be?

Terrence Carolan: “Innovative and creative practices in ageing services in China. They’re recognizing the volume of [people] they’ll need to serve in the next 20 or 25 years. It’s amazing how fast the government recognized the need to ramp up ageing services quickly and then found ways to support older adults in the country. We’ll have representatives from three different Chinese ageing services programs, and an opportunity for a panel discussion on some of those approaches.”