Consumers easily assume that a Joint Commission “Gold Seal of Quality” is a promise of a high standard of behavioral and therapeutic care, when most often no such accreditation has been earned or given. 

Misrepresentation of licensing and accreditation

Sad GirlInvestigate thoroughly the licensing and accreditation claims of residential programs for teens as they are often not what they seem.

Many programs advertise their membership in the National Association of Therapeutic Schools and Programs (NATSAP), the National Association of Independent Schools (NAIS) or other organizations. These are trade associations, and membership is based on the payment of membership dues. These groups may outline recommended practices, but they do not evaluate, monitor or enforce standards for child safety, educational quality, or therapeutic effectiveness. (A disclaimer on the NATSAP website specifically states that “NATSAP does not provide oversight of our member programs, believing that responsibility lies with the licensing and accrediting agencies.”)

There are several types of licensing you may see advertised, including licenses for educational institutions, and mental or behavioral health facilities. These are usually issued through a state agency, such as the Department of Education or the Department of Health and Human Services.

If the program claims to be licensed, find out which agency has issued the license and contact them to confirm the license is valid and current. Determine if the facility has licensing violations on its record.

A licensing system is only as good as the quality and resources of the agencies tasked with enforcement.  If possible, determine if the licensing agency actually has the manpower to enforce state regulations: ask how many facilities the agency oversees, how many inspectors it employs, how often inspections are conducted, and how violations are reported, recorded and resolved.  If you are not satisfied with the answers, avoid the facility.

There are several types of accreditation you may see advertised, including academic accreditation.

Academic accreditation for private, for-profit facilities is often provided through non-government organizations, such as the Northwest Association of Accredited Schools (NAAS), the Northwest Accreditation Commission (NAC) or other organizations. Be aware that this type of accreditation does not examine or certify the effectiveness of mental health or behavioral aspects of the program.  You will want to investigate whether mainstream colleges and universities recognize diplomas from facilities with this type of private accreditation, and whether high school credits from the program are transferrable to your child’s home school.  If not, steer clear.

Programs may claim mental, behavioral or medical accreditation through organizations such as the Council on Accreditation, the Council on Accreditation of Rehabilitation Facilities, and the best known, the Joint Commission (previously known as the Joint Commission on Accreditation of Healthcare Organizations, or JCAHO).

The Joint Commission, for example, accredits large and small institutions, from major hospitals to residential programs, with varying levels of compliance; the Joint Commission receives significant fees from facilities for evaluating them. On its website, the Joint Commission promotes accreditation as a way to increase a facility’s business, offering a “Certification Publicity Kit” with sample press releases and Gold Seal logo downloads to encourage facilities to promote the Joint Commission name and brand.  

It is important that families evaluating residential programs for teens understand what is, or is not, included in an accreditation. You must dig deeply to understand exactly what standard of compliance the residential program for teens has met—and most accrediting agencies do not make it easy to find specific information. 

Because the Joint Commission is a widely used form of accreditation, let’s look at how to find specifics about their “Gold Seal of Quality.”

Visit the Joint Commission Quality Check website at (You may also go to, click on “Accreditation,” and select “Behavioral Care.”)

  • Type in the name of the facility in the search box.
  • If your search shows that the facility is listed, click on “View Accreditation Quality Report.”
  • Now keep hunting by clicking “See Detail” under “National Patient Safety Goals and National Quality Improvement Goals.”
  • Now you will see in what areas the facility is, and is not, accredited or certified.

Read carefully: the Gold Seal of Quality for behavior health awarded by the Joint Commission may show that the program meets only a very minimal standard, such as:

  • The facility checks two forms of identification before administering medication, and otherwise controls medications;
  • It complies with hand washing guidelines; and
  • It identifies individuals at risk for suicide.

These are all important health care procedures, but consumers easily assume that a Joint Commission “gold seal of quality” is a promise of a high standard of behavioral and therapeutic care, when no such accreditation has been earned or given.

ASTART recommends that all claims of accreditation, licensing and certification should all be investigated personally and in detail by parents.

Last updated 3/1/13.