ACS Geriatric Surgery Verification (GSV) is the American College of Surgeons program that verifies a hospital's surgical care for older adults against the ACS geriatric surgery standards, at one of three levels. This page is for surgical and geriatric program leaders preparing an initial application, adding a level or getting ready for renewal. Integral Healthcare Solutions (IHS) turns your agreed geriatric surgery pathways into documented responsibilities and verification evidence; your clinicians own the pathways.
Last reviewed: October 2026.
What is ACS Geriatric Surgery Verification?
ACS states that it "developed the Geriatric Surgery Verification (GSV) Program with the generous support of The John A. Hartford Foundation to optimize surgical care for older adult patients" (ACS, Geriatric Surgery Verification). The same page states: ">40% Of inpatient surgery recipients are older adults." GSV is one of the accreditation and verification programs ACS lists on its program index (ACS, Accreditation and Verification).
The governing text is Optimal Resources for Geriatric Surgery, which sets 30 required standards for the Focused Excellence and Comprehensive Excellence levels. A separate six-standard set applies to the Age-Friendly level (ACS, GSV Standards). ACS says the Age-Friendly level "consists of six program standards and aligns with the requirements of the new CMS Age Friendly Hospital Measure." The standards page we read on 2 October 2026 does not show a version year or an effective date, so check the current edition on that page before your team starts work against it.
The three GSV levels
ACS defines three levels of participation (ACS, GSV Levels of Participation):
| Level | Standards | Patients in scope | Site visit |
|---|---|---|---|
| Level 1, Age-Friendly | "6 GSV Program standards are in place across surgery" | "eligible surgical patients aged 65 years and older" | "A 3-hour virtual site visit" |
| Level 2, Focused Excellence | All "30 GSV Program standards are in place" | "between 25 and 49 percent of the hospital's total population of eligible surgical patients aged 75 years or older" | "A full-day site visit, conducted either on-site or virtually" |
| Level 3, Comprehensive Excellence | All 30 standards | "50 percent or more of the hospital's total population of eligible surgical patients aged 75 years or older" | "A site visit, conducted either on-site or virtually" |
For Level 1, ACS says the virtual visit "will confirm the hospital complies with the required structure, processes, and standards of care."
Who needs it and what triggers it
The buyer is a hospital's surgical and geriatric leadership. The usual triggers:
- An initial application. New participants register through an Initial Application and receive "a login to the ACS Quality Portal (QPort) once a submitted application has been processed" (ACS, GSV Online Application Portal).
- The CMS Age Friendly Hospital Measure. ACS states that its Age-Friendly level "aligns with the requirements of the new CMS Age Friendly Hospital Measure" (ACS, GSV Standards). We have not read the CMS measure text for this page, so we do not describe what CMS requires.
- Moving up a level. A hospital at Level 1 may plan for the 30-standard levels, which reach patients aged 75 or older in the shares shown above.
- Renewal preparation. The pages we reviewed did not state the verification term or the re-verification cycle; ACS's program materials govern that.
How IHS helps
IHS works on the documentation side of verification. The process:
- Gap assessment. IHS reads your current structure and records against the GSV standards for the level you choose, using the standards document your hospital obtains from ACS.
- Questionnaires. IHS sends questionnaires on your agreed older-adult pathways, staff training and multidisciplinary review.
- Document and evidence mapping. IHS builds a crosswalk from each standard to the evidence that shows it is in place.
- Drafting. IHS drafts responsibility documents, training records and multidisciplinary review procedures, built from pathways your surgical and geriatric clinicians approve.
- Mock review. IHS reviews the file against the standards as a reviewer would and lists what is missing.
- Readiness support. IHS drafts responses to findings for your hospital to submit.
What you supply: the standards, the care pathways your clinicians have agreed, staff training data, and the decisions of your surgical and geriatric leaders.
The limit: the older-adult care pathways are clinical decisions. IHS documents them; it does not design them. Your hospital submits the application and all materials to ACS and handles every exchange with the program.
What to have ready
Each item ties to the ACS GSV pages read on 2 October 2026.
- A decision on the level you are pursuing: Age-Friendly, Focused Excellence or Comprehensive Excellence (levels page).
- The current edition of Optimal Resources for Geriatric Surgery, with its version confirmed on the standards page.
- For Level 1, the six GSV standards and a way to show they are "in place across surgery for eligible surgical patients aged 65 years and older" (levels page).
- For Level 2 or 3, a count of the hospital's "total population of eligible surgical patients aged 75 years or older" and the share your program reaches against the 25 to 49 percent or 50 percent thresholds (levels page).
- Documentation of "the required structure, processes, and standards of care" that the site visit will confirm (levels page).
- The agreed older-adult care pathways, signed off by your surgical and geriatric clinicians, that the standards evidence will rest on.
- Staff training records for the people who deliver those pathways.
- A plan for the visit format: a 3-hour virtual visit at Level 1; a full-day visit, on-site or virtual, at Level 2; an on-site or virtual visit at Level 3 (levels page).
- A named person to complete the Initial Application and receive the QPort login (application portal page).
The introductory call is the place to walk through this list against where your program stands today.
How it compares
| Option | What it involves | Basis |
|---|---|---|
| GSV Level 1, Age-Friendly | Six standards across surgery for patients 65 and older; a 3-hour virtual visit | ACS levels and standards pages |
| GSV Level 2 or 3 | All 30 standards, reaching 25 to 49 percent or 50 percent or more of eligible patients 75 and older; a full-day visit at Level 2 or a site visit at Level 3, on-site or virtual | ACS levels page |
| CMS Age Friendly Hospital Measure reporting without ACS verification | ACS says Level 1 aligns with the measure; we have not read the CMS measure text | ACS standards page |
| No verification | IHS's reading (October 2026): the pages we reviewed present GSV as a program a hospital applies to, so a hospital can run its geriatric surgery work without ACS verification | ACS program page |
Other ACS surgical programs IHS supports include ACS Quality Verification Program readiness, which spans all surgical specialties, and MBSAQIP bariatric surgery accreditation. See all Accreditation Consulting services.
What it costs
The cost has two parts: any ACS program fee and your own staff and clinician time. ACS does not publish a fee schedule on the pages we reviewed. IHS prices its own work after a free introductory call.
What this is not
- IHS is not part of ACS. It does not grant, influence or predict a verification decision.
- IHS does not submit to ACS or act for your hospital before it. Your hospital applies, submits and corresponds.
- IHS does not design clinical care. Pathways, patient selection and care decisions belong to your clinicians, and this page is not clinical advice.
Frequently asked questions
What is ACS Geriatric Surgery Verification?
It is the American College of Surgeons program that verifies a hospital's surgical care for older adults. ACS developed it "with the generous support of The John A. Hartford Foundation to optimize surgical care for older adult patients" (ACS). The governing standards are Optimal Resources for Geriatric Surgery.
What are the three GSV levels?
Level 1 is Age-Friendly, with six standards in place across surgery for eligible patients aged 65 and older. Level 2 is Focused Excellence and Level 3 is Comprehensive Excellence; both require all 30 standards and differ in the share of eligible patients aged 75 or older the program reaches.
How does GSV Age-Friendly relate to the CMS Age Friendly Hospital Measure?
ACS states that the Age-Friendly level "consists of six program standards and aligns with the requirements of the new CMS Age Friendly Hospital Measure" (ACS, GSV Standards). That is ACS's description. We have not read the CMS measure text for this page and do not describe what CMS requires.
What do the 30 GSV standards require of a hospital?
They are the required standards in Optimal Resources for Geriatric Surgery for the Focused and Comprehensive levels. ACS says the site visit confirms "the required structure, processes, and standards of care." This page does not summarize each standard; your hospital works from the standards document itself.
What share of older surgical patients must the program reach?
For Focused Excellence, the 30 standards must reach "between 25 and 49 percent of the hospital's total population of eligible surgical patients aged 75 years or older." For Comprehensive Excellence, the figure is "50 percent or more" of that population (ACS levels page).
Is the GSV site visit virtual or on-site, and how long is it?
Level 1 has "A 3-hour virtual site visit." Level 2 has "A full-day site visit, conducted either on-site or virtually." Level 3 has "A site visit, conducted either on-site or virtually" (ACS levels page).
How do we apply for Geriatric Surgery Verification?
New participants register through an Initial Application. ACS issues "a login to the ACS Quality Portal (QPort) once a submitted application has been processed" (ACS application portal page). Your hospital completes and submits the application.
How much does GSV cost and how long does verification last?
ACS does not publish a fee schedule on the pages we reviewed, and those pages did not state the verification term. Check both with ACS before budgeting. IHS prices its own work after a free introductory call.