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HFAP no longer holds Medicare deeming authority for hospitals. The accrediting organization that hospital patient-safety and quality teams knew as HFAP — most recently branded AAHHS-HFAP, and before that AOA/HFAP — has let its hospital and Critical Access Hospital deeming approvals lapse, is absent from CMS’s current list of approved accrediting organizations, and its own domain now redirects to ACHC’s website. For a hospital deciding who should survey it for Medicare deemed status today, HFAP is not one of the live options.
This page lays out what HFAP was, exactly when its CMS deeming authority expired (with the Federal Register citations), what its domain redirect to ACHC actually shows and doesn’t show, and how the accreditors that do currently hold hospital deeming — The Joint Commission (TJC), DNV, CIHQ and ACHC — compare, as verified against CMS’s own records on 29 August 2026.
What HFAP was
HFAP began as a program of the American Osteopathic Association (AOA/HFAP), accrediting hospitals — originally osteopathic hospitals specifically, later general acute-care hospitals — under Medicare’s deemed-status framework. It was later restructured as an independent nonprofit, the Accreditation Association for Hospitals and Health Systems (AAHHS-HFAP), while keeping the HFAP name for its accreditation programs. At its most recent CMS approvals, HFAP held Medicare deeming authority for hospitals and Critical Access Hospitals, plus separate CLIA accreditation-organization status for clinical laboratories (a different statute from hospital deeming — see CASRAI’s ACHC accreditation guide for why that distinction matters generally).
The deeming timeline: when HFAP’s CMS approval actually expired
Deeming approvals are not open-ended. Under 42 CFR 488.5(e)(2), a CMS final notice approving (or renewing) an accrediting organization’s program sets a fixed term, capped at six years, and the organization must apply for renewal before it lapses. Federal Register final notices document HFAP’s last two approvals, and no renewal notice for either has been published since:
- Hospital accreditation program: approved for a term running 25 September 2019 through 25 September 2023 (Federal Register final notice 2019-05037, published 18 March 2019, as “Accreditation Association for Hospitals and Health Systems/Healthcare Facilities Accreditation Program”). That term expired more than two years before this page was written, and no continued-approval notice has followed it.
- Critical Access Hospital (CAH) accreditation program: approved for a term running 27 December 2019 through 27 December 2025 (Federal Register final notice 2019-27836, published 26 December 2019, filed under “AAHHS-HFAP”). That term has also now lapsed, again with no renewal notice published.
Consistent with both terms having expired unrenewed, HFAP does not appear anywhere on CMS’s own current roster. CMS’s Accrediting Organizations (AOs) page — fetched live on 29 August 2026 — lists exactly nine currently CMS-approved AOs: Accreditation Commission for Healthcare (ACHC), American Association for the Accreditation of Ambulatory Surgery Facilities (Quad A), Accreditation Association for Ambulatory Health Care (AAAHC), Center for Improvement in Healthcare Quality (CIHQ), Community Health Accreditation Partner (CHAP), DNV Healthcare (DNV), Joint Commission (JC), National Dialysis Accreditation Commission (NDAC), and The Compliance Team (TCT). HFAP is not on it, under any of its former names.
hfap.org now redirects to ACHC — what that does and doesn’t confirm
Requesting https://www.hfap.org/ returns an HTTP 301 permanent redirect straight to https://www.achc.org/ (confirmed live, 29 August 2026). ACHC’s own site carries a persistent “Transitioning to ACHC” navigation link aimed at organizations moving their accreditation over. That is solid, directly observable evidence that HFAP’s public-facing operation has wound down in favor of ACHC.
What it does not establish, and what this page deliberately does not claim, is the specific legal mechanism behind that — whether it was an acquisition, an asset transfer, a licensing arrangement, or simply HFAP ceasing independent operations while steering its remaining customers toward ACHC. No corporate filing or joint announcement documenting the mechanism was found. Readers who need that level of corporate detail should treat it as an open question and go directly to ACHC or CMS for confirmation; what is verifiable, and is what actually matters for a Medicare deemed-status decision, is that HFAP itself is no longer a route to it.
What this means if your hospital is still HFAP-accredited
An expired HFAP accreditation certificate does not satisfy the Medicare Conditions of Participation on its own. Deemed status under section 1865(a)(1)(A) of the Social Security Act requires current accreditation by an accrediting organization CMS has approved right now — a lapsed HFAP approval does not carry forward. A hospital in this position has the same choice set as any hospital seeking deemed status today: accreditation from TJC, DNV, CIHQ or ACHC, or survey directly by the State Survey Agency instead of accreditation at all. There is no HFAP-specific transition requirement published by CMS; the practical step is the same one any hospital changing accreditors takes — apply to the new AO with enough lead time to complete a survey before the old certificate’s coverage question becomes live with your State Survey Agency or Medicare Administrative Contractor.
How TJC, DNV, CIHQ and ACHC compare for hospitals today
All four currently operate under the same federal floor: 42 CFR 488.5(a)(4)(i) requires an unannounced re-survey no later than 36 months after the prior accreditation’s effective date. Where they differ is survey frequency above that floor, and how much runway is left on their current CMS approval term.
| Accreditor | Current hospital approval term | Federal Register citation | Survey cycle |
|---|---|---|---|
| The Joint Commission (TJC) | 15 Jul 2025 – 15 Jul 2030 (5 years) | 90 FR 26587 | Unannounced, within the 36-month federal floor; uses tracer methodology (see CASRAI’s tracer methodology guide) |
| DNV | 26 Sep 2022 – 26 Sep 2026 (4 years); continued-approval application pending, 91 FR 17970 | 87 FR 54511 | Annual — DNV’s own choice, above the 36-month floor, tied to its NIAHO/ISO 9001-aligned model (see CASRAI’s DNV vs Joint Commission comparison) |
| CIHQ | 1 Jan 2023 – 1 Jan 2028 (5 years) | 87 FR 77615 | Unannounced, within the 36-month federal floor; also separately deemed for CAH and psychiatric hospital programs |
| ACHC | 25 Sep 2023 – 25 Sep 2027 (4 years) | 88 FR 60949 | Unannounced, within the 36-month federal floor (see CASRAI’s ACHC accreditation guide) |
Term length by itself is not a quality signal, but it is a usable, citable signal of how recently — and how closely — CMS has reviewed an accreditor’s hospital program: CMS gave ACHC and DNV shorter four-year terms explicitly tied to closer ongoing review, versus five years for TJC and CIHQ. None of the four is “the” right choice independent of your hospital’s own survey history, service lines and prior CMS findings; this is a starting comparison, not a recommendation.
Frequently asked questions
Is HFAP still a CMS-approved accrediting organization for hospitals?
No. Its hospital deeming term expired 25 September 2023 and its Critical Access Hospital deeming term expired 27 December 2025; no renewal notice has been published for either, and HFAP does not appear on CMS’s current AO list.
Did HFAP become ACHC?
hfap.org now redirects to achc.org, and ACHC’s site carries active “Transitioning to ACHC” messaging aimed at organizations moving their accreditation over — clear evidence HFAP’s public operation has wound down in ACHC’s favor. The specific legal mechanism (acquisition, asset transfer, licensing, or simple wind-down) has not been independently confirmed and this page does not assert one.
Can a hospital still use an HFAP certificate to satisfy Medicare’s deemed-status requirement?
No. Deemed status requires accreditation by an AO CMS has approved as of now, not a certificate from a program whose CMS approval has since expired.
What should a hospital do if it was relying on HFAP accreditation?
Apply to a currently CMS-approved hospital accreditor — TJC, DNV, CIHQ or ACHC — or arrange survey directly by the State Survey Agency, with enough lead time to complete the new survey before any coverage question arises.
How does HFAP compare to TJC, DNV, CIHQ and ACHC today?
It doesn’t, in the sense of being a live alternative: HFAP isn’t a currently CMS-approved accreditor a hospital can choose. TJC, DNV, CIHQ and ACHC are the actual current hospital-deeming options; see the comparison table above for how they differ from each other.
Sources and verification note
Primary sources, checked directly on 29 August 2026: Federal Register final notices 2019-05037 (HFAP hospital, term and citation above) and 2019-27836 (HFAP CAH, term and citation above), both at federalregister.gov; CMS’s Accrediting Organizations (AOs) page at cms.gov (current AO roster, fetched live); and a direct HTTP request to hfap.org confirming the 301 redirect to achc.org. TJC, DNV, CIHQ and ACHC term/citation data in the comparison table is drawn from Federal Register final notices verified for CASRAI’s companion pages on those accreditors. This page reports what these primary sources state as of the verification date; CMS approval terms and AO rosters change, so re-verify before relying on this beyond roughly six months out, and before assuming any renewal or new HFAP approval has not since been filed.
