Urgent Care Accreditation: Joint Commission or UCAOA

By Tom Charland and Tracy Patterson

One of the most common issues facing any hospital system operator of urgent care centers is how much of the hospital-oriented compliance, regulatory, and accreditation burdens should apply to their urgent care centers.  It is certainly one area that private operators have streamlined, thus making them far more nimble competitors.  In many cases, hospital urgent care operators have limited choices because of how they are credentialed with Medicare.  But what about centers under different tax IDs, part of joint ventures, or part of affiliated medical groups?

In this article, we focus on just one aspect of compliance: accreditation.  More specifically we will sort out the pros and cons for having your urgent care operation accredited by the Joint Commission as compared to the Urgent Care Association of America (UCAOA), and why organizations choose one over the other.

Joint Commission Accreditation

The Joint Commission is viewed as the gold standard for safety and quality.  The organization surveys virtually all types of health care delivery sites, from the most complex hospitals to surgery centers to urgent care and retail clinics.  But because the Joint Commission’s roots are in hospital safety, many believe it is overkill for an urgent care center or retail clinic.  It is not true that if your hospital or medical group is accredited by the Joint Commission you have no choice but to subject yourself to unannounced survey visits by the Joint Commission. 

“As of now the Joint Commission policy is to give hospital urgent care operators the choice on whether to be Joint Commission accredited,” says Michael Kulczycki, executive director of ambulatory care services at The Joint Commission.  “But if the urgent care facility bills under the same Medicare number as a facility that is accredited by the Joint Commission, then there is no choice.  Or if there is a high degree of functional integration.”

We find that the Joint Commission is costlier, especially for a one- or two-center operation, but certainly more robust than other approaches to accreditation.  There are 13 categories (chapters) of standards or requirements under the Joint Commission urgent care accreditation program, which is a subset of the full ambulatory care standards.  That urgent care subset was determined in part with input from urgent care operators who worked with the Joint Commission.  The Ambulatory Care Accreditation Overview is posted on their web site.  Many believe the Joint Commission Gold Seal carries with it a status that is worth the extra cost and effort.  MinuteClinic, the largest retail clinic operator, has been accredited by the Joint Commission since 2006, undergoing renewals every three years since then.

Payer recognition, referral recognition, and affiliation agreements are also factors to consider.  “The Joint Commission has dedicated payer relations experts to help providers,” says Kulczycki.  “We’ll work together with that provider and payer to get them recognized.”

Steps to Joint Commission accreditation can be found online. If you are not currently accredited and wish to apply, you need to fill out an electronic application, which will confirm that your center(s) are eligible for Joint Commission accreditation.  There is a deposit of $1,700 due with the application, which is a credit against future fees.  Some reasons for ineligibility would be: 1) If you are a new clinic and aren’t seeing any patients. 2) Your services don’t fall under the Joint Commission urgent care standards. 3) If there is no formal performance improvement process in place.  Unlike UCAOA accreditation, the Joint Commission does not have have minimum specifications on imaging.  There is an early survey process available for operators who are new and want to move ahead with payer enrollment/ contracting prior to opening their doors.

Pricing is based on the total patient volume of all centers in your operation, as well as the number of sites to be accredited.  The Joint Commission urgent care pricing worksheet details this information.  For a five-center urgent care operation with each center averaging 12,000 visits per year, Joint Commission accreditation would cost $23,960 plus travel and expenses for surveyors.  For a 12-center operation each with 12,000 visits per year the cost would be $33,400 plus travel and expenses.

Once the application is vetted by Joint Commission, the organization is assigned an account executive and the first survey is scheduled to accommodate both parties.  At that point the urgent care operator has access to the electronic version of Joint Commission standards, referred to as E-dition.  The operator also has access to the Joint Commissions gap analysis tool to help identify areas that need correction.

Surveyors are employees of the Joint Commission and receive a minimum of 10 days of training each year.  The Joint Commission is a large organization, so surveyors have access to significant resources, including a group of experts dedicated to ambulatory care standards.

Surveyor(s) will come visit your site(s), interview staff and patients, and validate that you meet the published standards for your type of setting.  For example, there are different standards for urgent care versus retail clinics.  The average survey lasts two to three days.  Preliminary findings are provided on-site in a written report at the end of the survey.  If there are findings that need correction, the organization works with Joint Commission staff to correct findings.  Upon completion you receive the accreditation decision.  Although the dates of the first survey are fully known ahead of time, follow-up surveys are unannounced and take place between 18 and 36 months after the initial survey. 

The Joint Commission accredits, under the Ambulatory Care accreditation program, more than 25 freestanding urgent care operators, representing more than 200 sites of care.  This count does not include urgent care centers accredited as owned or affiliated with hospitals or health systems.

Jessica Pendola is chief administrative and compliance officer at FastMed Urgent Care, a large, multistate urgent care operator backed by private equity.  FastMed chose to go the Joint Commission route, receiving initial accreditation in March 2014.  Fastmed was reaccredited by the Joint Commission in January 2017.

“We evaluated all of the accreditation options,” says Pendola.  “We went with Joint Commission because it had more strenuous requirements and forced us to a more standard approach to quality in all of our centers.”

Pendola said the process was a lot of work, especially the initial preparation in 2014.  But she felt it definitely paid off.

“It was difficult, but at the same time it was rewarding for everyone,” she says.  “And since then has become an ongoing process, so the reaccreditation survey process in 2017 wasn’t nearly as difficult. Joint Commission helps make sure this isn’t a one-and-done kind of process, so the follow up after the reaccreditation survey was much easier.”

UCAOA Accreditation

This program is viewed as focused and streamlined for urgent care-only operations.  It has become an extremely popular alternative, with nearly 600 urgent care centers now under the UCAOA accreditation seal.  “It has grown rapidly both in the number of participants and sophistication,” says Laurel Stoimenoff, CEO of the UCAOA.  “The wide payer acceptance would indicate that we’ve captured the right scope, quality and safety standards, which is really the result of the team of urgent care operators and physicians behind the standards who know the nuances of urgent care practice.”

The UCAOA has a dual “certification” and “accreditation” program.  The certification part is where the UCAOA qualifies your center as having minimum scope, x-ray and laboratory services, and quality and safety programs for patients and employees.  Detailed accreditation standards are provided once the application process is completed.

There is also an introduction of their accreditation program, which includes an excellent “Getting Started” section to prepare you for the application process.

Pricing is based on the number of centers.  For a five-center urgent care operation UCAOA accreditation would cost $7,565 ($6,050 for members) plus travel and expenses for surveyors.

For a 12-center operation the cost would be $11,960 ($9,350) plus travel and expenses. For operators with more than 25 centers pricing is negotiated at the time of application.  There is an Early Accreditation process for those with new centers.  This program carries a surcharge of $275 per location, which is added to the per-center pricing.  All fees are due at the time of application.  The UCAOA pricing chart and UCAOA application are available online.

Once your application is complete and you pay applicable fees, the UCAOA schedules your survey date.  At this time, you receive a copy of the UCAOA Accreditation Standards and Preparation Manual.

The UCAOA site visit experience is both facilitative and collaborative.  Surveyors are not necessarily employees of the UCAOA but have significant experience with urgent care operations.  There are six categories of standards.  The surveyor will provide the organization with every opportunity to demonstrate how it implements the standards within its organization.

On an initial survey, it is not necessary to demonstrate a ‘history’ within the organization for most standards.  The expectation is that a process has been put in place to demonstrate compliance with the standard.  If a history is not evident but a process or policy meets the criteria, it will be assumed that the center has met the standard.  If a process is new to the organization on the initial visit, there will be follow up on the next survey to ensure that what was observed and represented is in place has indeed been implemented.

The UCAOA accreditation program is on a three-year cycle, which means organizations must submit a renewal application prior to the three-year anniversary.  The UCAOA also has an Annual Compliance Review program, which is optional program to help organizations stay on track maintaining documentation demonstrating compliance during the three-year period.  Some organizations are issued a conditional accreditation, which requires a re-survey after six to eight months.  An FAQ on the program is available as well as a webinar on accreditation.

“We considered all of our options and determined that UCAOA accreditation was the most appropriate for our urgent care networks,” says Todd Latz, CEO of Go Health Urgent Care, which has joint venture partnerships with a number of large hospital systems around the country.  “We certainly considered Joint Commission accreditation, especially since all of our health system partners are Joint Commission accredited across their acute facilities and many of their ambulatory service lines.  And while we have tremendous respect for what the Joint Commission does and stands for, after a comparative review, we determined that the UCAOA accreditation was simply better tailored for urgent care and our health system partners’ compliance teams agreed.”


The bottom line on either approach to accreditation is that it is costly, both in terms of the financial commitment and the human resource commitment.  In other words, it will take time and money to get this done properly. 

The chart below compares the Joint Commission accreditation with that of the UCAOA.  The major difference if you go the Joint Commission route is cost and some additional physical space requirements in each center.  Which way you decide to go is a matter of organizational preference.

Joan Thiel is vice president of ambulatory services at Banner Health.  She has been a supporter of the Joint Commission’s efforts for many years, but does not have Banner’s urgent care centers accredited.

“Having JC accreditation is a proxy for quality,” says Thiel.  “I think it forces any organization to have a rigorous standard and maintain that standard.  For hospitals, there’s no question that you should be accredited.  It is expensive but I think the Joint Commission has heard that and put concerted effort into making it more affordable and more collaborative than punitive.”

But when it comes to urgent care she questions whether the extra cost is worth it?

“I think the jury is still out on urgent care,” she says.  “I don’t see the Joint Commission accreditation as much of a differentiator.  Payers don’t pay any more.  The general public doesn’t understand it in such a way that they choose one over the other because of the Gold Seal.”





Urgent Care

Ambulatory Care (modified for urgent care)


Meet UCAOA Urgent Care Certification Criteria

Meet the Joint Commission Certification Criteria

Pre-Opening Accreditation Available



Written Standards

Yes (sent via email in PDF form)

Yes (e-version included in price)




Pricing Structure

Number of Centers

Patient Volume + Number of Centers

Price for 5 centers @ 12,000 visits per year (member price)

Price for 12 centers @ 12,000 visits per year

·  $7,565 ($6,050) plus travel and expenses for surveyors

·  $11,960 ($9,350) plus travel and expenses for surveyors

·  $23,960 plus travel and expenses for surveyors

·  $33,400 plus travel and expenses for surveyors


UCAOA Membership

(Entity Membership = $600)


Renewals (How often/price)

Every 3 years, Same as Initial

Every 3 years, Same as Initial







Written Application



Additional Documents Required




Due Upon Application

Spread over three years


·  Surveys typically 90 to 180 days post completed application

·  UCAOA recommends 90-day minimum after receipt of Standards before survey





Time Limit

Required within 6 months of application



·  Applicant provides date (soon as) for survey

·  Post request, applicant receives a time frame from UCAOA

·  Applicant is allowed to block 5 days within the timeframe provided

·  Initial survey date jointly determined; follow-up visits over three years without notice.

Onsite Process

·  Surveyor begins at the administrative location designated by the applicant

·  Post administrative review, surveyor will visit a percentage of the total centers

·  Survey length depends on the number of centers reviewed and geographical dispersion.  A single center can typically be reviewed in one day.

·  Findings are informally reviewed at the end of the survey.

·  Two or three days on site; collaborative process; written report of gaps provided at end of site visit; collaborative follow-up on corrective actions.


Post Survey

·  Applicant receives either 1) letter stating they zero corrective action or 2) a letter outlining the necessary corrective action. 

·  Applicant is given 45 days to complete corrective action including the acceptance of the corrective action by UCAOA.

·  Once all corrective action is completed and accepted by UCAOA, and, the surveyor’s travel expenses are paid, accreditation is granted.

·  Follow-up visits over three years without notice.





·  Governance (GOV)

·  Human Resources (HR)

·  Patient Care Processes (PCP)

·  Physical Environment (PE)

·  Quality Improvement (QI)

·  Health Record Management (HRM)

·  Patient Privacy, Rights, Responsibilities (PRR)

·  Environment of Care (EC)

·  Emergency Management (EM)

·  Human Resources (HR)

·  Infection Prevention and Control (IC)

·  Information Management (IM)

·  Leadership (LD)

·  Medication Management (MM)

·  National Patient Safety Goals (NPSG)

·  Provision of Care, Treatment, and Services (PC)

·  Performance Improvement (PI)

·  Record of Care, Treatment, and Services (RC)

·  Rights and Responsibilities of the Individual (RI)

·  Waived Testing (WT)





·  Surcharge per center, $200 ($275)



Standard application, plus

·  Notarized Attestation Statement

·  Documentation of Tax ID

·  Documentation of Physical Address

·  Floor Plan