As the healthcare industry continues expanding into areas beyond essential patient care, different certification systems have become necessary. Different accreditations are required depending on the level of care provided at a given facility. In Texas, state accreditation is required for facilities that offer procedures requiring significant anesthesia. For medical facilities that offer lower-risk services that require little to no anesthesia, accreditation at the state level is not required.
How does a facility that does not require state accreditation show that the quality of its facility follows safety protocols? Please welcome to the stage, QUAD A. QUAD A is an alternative accreditation program that offers a variety of certifications based on the type of facility. Programs can adapt to numerous types of facilities, including outpatient treatment, medical programs, international programs, and office-based surgeries.
In Texas, facilities must be certified through Texas Health and Human Services or QUAD A to perform certain healthcare procedures.
QUAD A is recognized by Centers for Medicare and Medicaid Services (CMS), the federal agency that administers the federal health insurance programs, which allows QUAD A accredited facilities to accept Medicare and Medicaid payments.
Why Pursue QUAD A Accreditation?
There are several reasons facility owners and tenants choose QUAD A certification:
- Stringency – QUAD A has fewer standards than state-sponsored certification.
- Speed – Due to the fewer standards to meet, QUAD A certification is usually quicker than state-sponsored certification.
- Cost – QUAD A accreditation is typically more economical than state-sponsored certification. With the combined costs of permitting, review, and inspections ,QUAD A is often less expensive.
- Consistency – If expanding an existing QUAD A accredited facility, it can be advantageous to maintain the same accreditation throughout the entire facility.
When to Get QUAD A Accreditation
The first step is for the owner and the design team of the facility to determine if the facility must licensed at all. If the answer is no, then the requirements of the facility design falls back to the required codes of the Authority Having Jurisdiction (AHJ). There are additional guidelines that can be followed to inform the design, but there is no other required certification.
If the answer is yes, then there are several options for accreditation in Texas, including:
- Texas Department of State Health Services (DSHS) using the Texas Health and Safety Code (current version)
- QUAD A – Varies based on facility type, including Office-Based Surgery (OBS), Ambulatory Surgery Centers (ASC) etc.)
In addition to patient health, safety, and welfare, the requirements for licensing facilities also have billing implications. If providers want the ability to bill insurance for payment of patient services, the building in which the procedure takes place needs to meet certain requirements. In addition to state-sponsored DSHS licensure, QUAD A is an alternate method of accreditation recognized by CMS to perform procedures, and where Medicare and Medicaid insurance payments can be authorized.
QUAD A Architecture Requirements
QUAD A requirements for architects depend on the type of QUAD A accreditation being sought. For Office-Based Surgery (OBS) key elements include:
- Life safety
- Programming (required areas, sizing)
- Finishes (walls, floors etc.)
- Access control
QUAD A MEP Engineering Requirements
Typical Quad A standards for MEP Engineers under OBS include:
- Mechanical- ventilation standards
- Electrical – emergency power requirements, lighting standards
- Plumbing – medical gases, including oxygen
More Questions about QUAD A?
Want to learn more about QUAD A or traditional state accreditation? Schedule a call with David Bourassa, PE, Principal of Healthcare to learn more.
