Background
The document, Accreditation Standards for Processing Reusable Textiles for Use in Healthcare Facilities, 2011 Edition, establishes the criteria for a laundry organization to become accredited by the Healthcare Laundry Accreditation Council (HLAC). HLAC is responsible for establishing and maintaining the Accreditation Standards, facilitating inspections, and accrediting those laundry organizations that pass inspection.

The Inspection Process
For complete HLAC accreditation details, please refer to the HLAC Accreditation Inspection Process Guide. Upon receipt of your HLAC Accreditation Inspection Agreement (the agreement is on the HLAC website as a PDF file) and deposit at the HLAC International Office, an inspection will be scheduled on a mutually agreeable date between the Laundry Organization and the HLAC Inspector. For new applications, this will usually be a month or more into the future. For laundry organizations due for reaccreditation, an inspection can be scheduled any time during the following timeframe: 60 days prior to and up to 30 days after the ending date of their current accreditation.

Laundry organizations that do not complete their reaccreditation during this timeframe will lose their accreditation. On the 31st day beyond their accreditation expiration date, the laundry organization’s name will be removed from the HLAC website and all marketing stating they are HLAC Accredited must be stopped immediately.

The inspection itself will take one day, and is in two parts: a physical walk-through of the entire plant, and conference time in a quiet room for review of documents. Your key managers will need to be available that day to answer questions the Inspector may have.

The Inspector will use a checklist that closely follows the Accreditation Standards for Processing Reusable Textiles for Use in Healthcare Facilities, 2011 Edition, published on the HLAC website. Each item is essentially a statement of fact. The inspector will mark “yes,” “no,” or “not applicable,” and add remarks as necessary.

A “must” statement is one for which compliance is required, and the directive of the statement is supported by any or all of the following resources:

1. Federal mandates, regulations (e.g., OSHA, U.S. Food and Drug Administration [FDA], U.S. Environmental Protection Agency [EPA]) that are law;
2. State and/or local government regulations;
3. Evidence-based, peer-reviewed best practices/recommendations for infection prevention and laundry procedures from federal agencies (e.g., Centers for Disease Control and Prevention [CDC]) and professional entities (e.g., Association for the Advancement of Medical Instrumentation [AAMI], Association of periOperative Registered Nurses [AORN], Association for Professionals in Infection Control and Epidemiology [APIC], Facilities Guidelines Institute [FGI], Textile Rental Services Association of America [TRSA]).

The “must” statements will be bold-face text in the Standards and compliance will be scored by the inspectors. The expectation is that all “must” Standards are met (i.e., 100% compliance).

A “shall” statement represents a best practice based on infection prevention and laundry industry consensus and compliance is strongly recommended. Such statements are intended to assist the healthcare laundry industry as it transitions to a higher standard of practice.

“Shall” statements will also be scored by the Inspectors, but will not be presented as bold-face text. The expectation is that at a minimum 90% of these “shall” Standards are met.

“Should” and “may” statements represent suggested courses of action for which a strong industry consensus is not available for all regions of the country, or are part of emerging practices and/or technology. “Should” and “may” statements are recommended for implementation, but are not scored.

At the end of the inspection, the Inspector will brief the laundry managers, highlighting both good aspects of the operation, and those items that require improvement. The Inspector will not provide a grade, and will not approve or disapprove accreditation on the inspection day. HLAC, not the Inspector, determine whether a laundry organization qualifies for accreditation.

After the inspection, the HLAC Inspector will forward a complete report to the HLAC Sub-Committee on Accreditation, which scores the report.

HLAC will send a formal letter to the laundry organization contact person with the results of the inspection.

Possible Outcomes

• Approval - The laundry organization has fewer than 10% “no” statements overall, and all “must” statements are marked “yes.” The laundry organization will be accredited.
• Remediation - The laundry organization has more than 10% “no” statements, and/or one or more “must” statements have been marked “no.” The laundry organization will not be accredited yet. The total “no” statements have to be reduced below 10%, and all “must” statements have to be corrected.
• Accreditation Denied/Revoked – If the Laundry Organization fails to satisfactorily correct deficiencies either in remediation and/or upon re-inspection, accreditation will be denied/revoked.

Remediation (Correction) Process

1. The laundry organization will have up to 15 business days from the date of the HLAC inspection results letter to correct the discrepancies. In special circumstances, the Accreditation Sub-Committee may provide the laundry organization up to 45 days to remediate based on the extent of the corrections. Time beyond the 15 business days is not unilaterally provided to all laundries that need to make changes.
2. Laundry organizations that do NOT submit remediation (corrections) within the designated timeframe will have their accreditation revoked and will not be able to re-apply for accreditation for a period of six months.
3. The laundry organization will submit documentation of the correction(s) implemented to the HLAC Accreditation Sub-Committee. The Accreditation Sub-Committee and the inspector who conducted the inspection will review the corrections implemented, considering any new documentation. This process may include a telephone conference to garner more details and, at the discretion of the Accreditation Sub-Committee, may require a follow-up inspection (re-inspection).
4. Pictures or videos will NOT be accepted for functional separation and airflow deficiencies.
5. Inspection failures for functional separation or airflow issues will require an automatic re-inspection which will be an expense incurred by the laundry organization.
6. Upon receipt of the corrections or the result of a follow-up visit, the Accreditation Sub-Committee will decide whether or not the laundry organization meets HLAC Accreditation Standards.
7. If a re-inspection is required, the laundry organization is responsible for paying an additional $2,500 for the re-inspection along with the inspector travel costs.
8. If the laundry organization fails to demonstrate that it has corrected the discrepancies within the 15 business days from the original inspection date or if granted in special circumstances the extended period of 45 days, accreditation will not be granted. No extensions are granted beyond the 15 business days remediation or, if allowed, the 45-day remediation process. The laundry organization will require another physical inspection to become qualified.
9. If the Inspector finds non-compliance in areas previously inspected as he walks through the laundry organization during the re-inspection, those non-compliant discrepancies will count against the laundry organization receiving accreditation.

Appeals Process

• If the laundry organization does not agree with the HLAC remediation determination, it has the right to appeal. The Laundry organization must submit an appeal within 15 business days of receipt of the notification of the Accreditation Sub-Committee’s decision. If the appeal is made by an accredited laundry organization, then accreditation will remain in force until the appeals process is completed. The laundry organization must also pay a non-refundable fee of $1,000 to cover the costs of the Appeals Process as well as a re-inspection fee of $2,500, if re-inspection is required. For complete information, please refer to the Appeal’s Process in the HLAC Accreditation Inspection Process Guide.
• After an appeal, if the laundry organization does not attain HLAC accreditation, the laundry organization cannot re-apply for accreditation for a period of six months.