Understanding the differences between two leading healthcare accrediting organizations.
For home health and hospice agencies pursuing accreditation, one of the most common questions is: Should we choose ACHC or CHAP?
Both organizations have CMS-approved home health and hospice accreditation programs that can survey for compliance with Medicare participation requirements. CMS retains responsibility for final Medicare participation approval; accreditation alone does not grant Medicare billing privileges. Both evaluate compliance with federal Conditions of Participation, and both are widely recognized within the home health and hospice industries.
However, their accreditation standards, preparation resources, and approaches to organizing compliance requirements are not identical.
Understanding these differences can help agency owners make an informed decision.
What Is Accreditation, and Why Does It Matter?
Accreditation is an independent evaluation of an organization's compliance with established healthcare quality and safety standards.
For Medicare-certified home health and hospice agencies, accreditation through a CMS-approved organization is one pathway for demonstrating compliance with federal Conditions of Participation.
The applicable federal regulations include:
- Home Health: 42 CFR Part 484
- Hospice: 42 CFR Part 418
Accreditation can also demonstrate an organization's commitment to quality patient care, regulatory compliance, and continuous improvement.
It is important to distinguish accreditation from state licensure and Medicare enrollment. Accreditation does not automatically grant either. Agencies must satisfy the applicable requirements for each.
Understanding ACHC
Accreditation Commission for Health Care (ACHC) provides accreditation services across numerous healthcare settings, including home health, hospice, and non-medical home care.
ACHC organizes its standards around key operational and clinical functions, including administration, personnel management, service delivery, quality improvement, and risk management.
Its accreditation model emphasizes education, organizational improvement, and maintaining compliance throughout the accreditation cycle.
ACHC provides resources such as accreditation guidance, educational programs, regulatory information, and crosswalks that connect applicable accreditation standards with Medicare Conditions of Participation.
For agency administrators, this structure provides a way to evaluate the organization's operational systems alongside its clinical practices.
ACHC also assigns support personnel to assist agencies throughout the accreditation process and offers additional distinctions for certain specialized services.
Understanding CHAP
Community Health Accreditation Partner (CHAP) has a long history in home- and community-based healthcare accreditation, dating to 1965.
CHAP offers accreditation programs for home health, hospice, home care, and other community-based healthcare services.
One distinguishing feature of CHAP's standards is their emphasis on connecting accreditation requirements with federal regulatory expectations and evidence of compliance.
For example, CHAP's Home Health Standards incorporate applicable Medicare survey G-tags, helping agencies identify the federal requirements associated with accreditation standards.
CHAP also provides Evidence Guidelines that explain how compliance may be evaluated during the accreditation survey.
These guidelines can help agencies understand not only what a standard requires, but what types of operational practices and supporting evidence surveyors may examine.
CHAP's accreditation process includes a self-study, readiness activities, an on-site survey, and an accreditation determination. The organization also provides educational resources, standards interpretation assistance, and compliance guidance.
ACHC vs. CHAP: What Are the Main Differences?
Although both organizations evaluate compliance with the same underlying federal requirements for Medicare-deemed programs, several practical distinctions may influence an agency's selection.
1. Organization of Accreditation Standards
ACHC generally presents standards through an operational and organizational framework, with separate crosswalk resources linking standards to Medicare requirements.
CHAP’s home health standards connect accreditation requirements with federal survey references and supporting Evidence Guidelines. Review the current program-specific standards and guidance when evaluating how this format will work for your team.
These are differences in presentation and preparation resources, not an indication that only one accreditor addresses operations, clinical care, or federal requirements. Neither approach eliminates the need to understand the underlying regulations.
2. Survey Preparation and Educational Resources
Both organizations provide resources to assist agencies with accreditation readiness.
ACHC emphasizes education, access to accreditation professionals, and tools for evaluating organizational compliance.
CHAP offers standards-based self-study resources, Evidence Guidelines, and a final readiness call as part of its preparation process.
Agencies should consider which resources are most useful to their administrators, clinical leadership, and compliance personnel.
3. Accreditation Survey Experience
Both ACHC and CHAP surveys may involve personnel interviews, patient record reviews, policy and documentation reviews, examination of operational processes, and observation of care.
Both organizations describe their survey approaches as educational and improvement-focused.
However, an educational survey approach does not mean deficiencies will be overlooked.
Surveyors must evaluate compliance with applicable requirements, and agencies remain responsible for correcting identified deficiencies.
There is no reliable basis for assuming that one organization will consistently provide an easier survey or fewer deficiencies than the other.
4. Accreditation Costs
Accreditation costs can vary depending on the services being accredited, the organization's structure, locations, and other factors.
As of October 2026, CHAP describes an inclusive three-year accreditation pricing approach without annual accreditation fees and offers payment arrangements. Confirm the applicable terms in a current written proposal.
Request an ACHC proposal for the agency’s specific services, locations, and accreditation needs. The pricing structures and included services should be compared using current written terms.
Before selecting an organization, agencies should request current written proposals and compare the total cost, including applicable survey, location, renewal, and additional-service expenses.
5. Ongoing Compliance Support
Accreditation is not a one-time accomplishment.
Home health and hospice agencies must maintain compliance between accreditation surveys, including responding to regulatory changes, monitoring quality indicators, evaluating operational performance, and addressing identified deficiencies.
Both organizations provide ongoing education and regulatory resources.
Agencies should consider the availability of standards interpretation assistance, regulatory updates, and continuing education when evaluating long-term accreditation support.
Is One Accrediting Organization Better for Hospice or Home Health?
Not necessarily.
Both ACHC and CHAP offer CMS-approved Medicare-deemed accreditation programs for home health and hospice agencies. Select the appropriate program and confirm current approval status for the service line.
The federal Conditions of Participation do not change based on the accrediting organization selected.
A hospice agency must meet applicable federal hospice requirements, regardless of whether it chooses ACHC or CHAP. The same principle applies to a Medicare-certified home health agency.
Each accrediting organization also maintains its own additional standards and accreditation expectations, which agencies must understand and satisfy.
The more important consideration is whether the organization's leadership and staff can effectively implement and maintain the required standards.
What About Non-Medical Home Care Agencies?
Accreditation is not limited to Medicare-certified agencies.
Both ACHC and CHAP offer separate accreditation programs for home care organizations, including agencies providing non-medical services.
For these agencies, accreditation may be voluntary, required by certain payers or programs, or recognized under applicable state licensing provisions.
These home care accreditation programs should not be confused with Medicare-deemed home health accreditation.
The appropriate accreditation program depends on the agency's services, state requirements, and intended payer relationships.
How Should an Agency Choose?
Before committing to either accrediting organization, agency leadership should evaluate several factors:
- Whether the accreditation program is appropriate for the agency's services and regulatory requirements.
- How the standards are organized and interpreted.
- What preparation resources and ongoing support are available.
- The overall accreditation costs and anticipated timeline.
- Any state licensing or payer-specific recognition requirements.
- Whether the organization offers additional accreditation or specialty recognition relevant to the agency's future plans.
Agencies should review the current standards and discuss their specific circumstances directly with each accrediting organization before making a final decision.
Choose the Program Your Agency Can Sustain
The best accrediting organization is not necessarily the one perceived to have the easiest survey. It is the one that best supports an agency's ability to achieve and sustain compliance.
Whether an agency chooses ACHC or CHAP, successful accreditation depends on more than having a policy and procedure manual.
Policies must accurately reflect regulatory requirements, personnel must understand their responsibilities, clinical services must meet applicable standards, and the agency must be able to demonstrate that its operational practices support compliance.
Accreditation should be viewed not simply as a requirement to satisfy, but as an opportunity to establish reliable systems that support quality patient care and long-term organizational stability.
A well-prepared agency should be able to demonstrate compliance regardless of which accrediting organization conducts the survey.
Official Sources and Further Reading
Explore How Accreditation Standards Work
For a closer look at implementation flexibility and evidence of compliance, read Understanding Prescriptive and Non-Prescriptive Accreditation Standards.