The commission members review and discuss each applicant, its site visit report, and any responses to the report the applicant has elected to provide. The meeting is conducted using parliamentary procedure. The site visit team leader will present an overview of the site visit, address any outstanding limitations, and recommend an action to the full commission. Non-visiting COA peer reviewers' comments are also solicited.
Denials are rare.
There is no provision for COA to table or defer a decision to a future cycle or meeting. Following the meeting, accreditation program staff prepare informal notification letters, advising applicants of the outcomes. Formal notifications letters, listing any stipulations of accreditation, are prepared for the review and signature of the COA chair or, if the COA chair declares a conflict of interest or is presenting the applicant, the COA member who chaired the discussion of the applicant. These formal notification letters are generally sent within six weeks of the meeting date and are sent via certified, registered U.S. mail. Certificates of recognition are also prepared and sent to the organization in about the same time frame.