Medical respite care is short-term medical care for people experiencing homelessness who are too sick for the street or a shelter but not sick enough to stay in a hospital, and NIMRC certification is a voluntary review of a program against the 2026 Standards for Medical Respite Care Programs. This service is for hospital and community partnerships and funded recuperative care operators building or preparing a program. Integral Healthcare Solutions (IHS) builds the medical respite operating documents and partner responsibility map to the NIMRC standards; your clinicians approve the care content.
Last reviewed: October 2026. NIMRC certification and standards pages checked on October 2, 2026.
What is medical respite care and NIMRC certification?
The National Health Care for the Homeless Council (NHCHC) defines it: "Medical respite care is acute and post-acute medical care for people experiencing homelessness who are not ill enough to remain in a hospital, but are too ill to recover on the streets or in regular shelter settings" (NHCHC Standards resource page).
The governing text is the NHCHC / National Institute for Medical Respite Care (NIMRC) "Standards for Medical Respite Care Programs," 2026 Edition. NHCHC states: "In 2026, the Standards underwent a review process to reflect growth, changes, and newly established evidence to guide best practices in medical respite care," and calls the 2026 Edition "the basis for NIMRC Certification" (NHCHC program standards page). NIMRC also publishes a "Guidebook: Certification for MRC Programs," available through an access form on the certification page.
NIMRC describes the certification process this way: "The primary components and activities of the certification process involve completing assessments, submitting evidence, and hosting a site visit to demonstrate: Acceptable fidelity to the Guiding Principles for MRC. Acceptable fidelity to the Standards for MRC Programs. Meaningful engagement of clients, incorporating their perspectives into program operations" (NIMRC certification page).
NIMRC reports that it has certified 61 medical respite care programs across 27 states, representing a total of 2,040 beds (NIMRC).
The Council's own description of its role: "The Council is not a government regulator and has no legal authority over MRC operators" (NIMRC).
Who needs it and what triggers it
Two situations bring programs to this work.
An operating program seeking certification. NIMRC's eligibility criteria include: "The program has actively served MRC clients for a minimum of one year," and "The program has a current, accurate profile in NIMRC's Directory of MRC Programs" (NIMRC certification page).
A program under development. "NIMRC has also created a pathway toward readiness for certification for new MRC programs (i.e., programs under development or with less than three years of operation)" (NIMRC).
Joint programs have a specific rule. "NIMRC's certification applies to the MRC program, as a whole, and is not necessarily tied to the services of one specific organization," and NIMRC will "recommend that one organization take primary, formal ownership and responsibility for completing the certification process, while including the other organization as a Joint Venturer" (NIMRC).
How IHS helps
IHS works from the 2026 Standards and the NIMRC certification requirements. The process:
- Gap assessment. IHS compares your program, or your program design, against the 2026 Standards for Medical Respite Care Programs.
- Partner questionnaires and responsibility map. IHS sends questionnaires to the hospital and community partners and maps which organization holds each function.
- Drafted procedures. IHS drafts the referral, admission, discharge and care-coordination procedures. The program's clinicians review and approve the clinical content.
- Operating documents and evidence file. IHS drafts the operating documents and organizes a certification evidence file against the Standards.
- Mock review. IHS reviews the evidence file the way a reviewer reading the Standards would, and lists what is missing.
- Application text. IHS drafts application text for your program to submit when NIMRC opens a window.
What you supply: partner agreements, the site and staffing plan, your clinical and housing leads, and your copy of the Standards.
The limit: facility safety and housing operations belong to the operator. IHS does not assess the building. The certification decision is NIMRC's.
What to have ready
- The 2026 Edition of the Standards for Medical Respite Care Programs, "the basis for NIMRC Certification" (NHCHC).
- Records showing the program "has actively served MRC clients for a minimum of one year," or a decision to use the readiness pathway for programs "under development or with less than three years of operation" (NIMRC certification page).
- A current, accurate profile in NIMRC's Directory of MRC Programs (NIMRC eligibility).
- A named certification team with time set aside. NIMRC says the team "should be prepared to spend roughly 40-60 total hours on certification activities over a six-month period" (NIMRC).
- For a jointly run program, your partner agreements and a decision on which organization takes "primary, formal ownership" of the certification process and which is the Joint Venturer (NIMRC).
- Evidence of how clients take part in program operations, since certification looks for "Meaningful engagement of clients, incorporating their perspectives into program operations" (NIMRC).
- Your current referral, admission and discharge procedures, in whatever form they exist, to compare against the Standards, since certification looks for "Acceptable fidelity to the Standards for MRC Programs" (NIMRC).
- A plan for hosting a site visit, one of the named components of the process (NIMRC).
To go through the list with IHS, book the introductory call below.
How it compares
Programs choose among these routes. They are not exclusive.
| Route | What the sources say |
|---|---|
| Operate to the Standards without certification | The Standards "serve as a framework to help medical respite care programs operate safely" (NHCHC), and NIMRC describes certification as a "voluntary certification process" (NIMRC). |
| NIMRC readiness pathway | For "programs under development or with less than three years of operation" (NIMRC). |
| NIMRC certification | Assessments, evidence and a site visit; certification for "a period of three years," then renewal "every three years thereafter" (NIMRC). |
| IHS gap assessment and drafting | A partner responsibility map, drafted procedures and operating documents, an evidence file and a mock review. It does not replace your clinicians or your housing operator. |
What it costs
NIMRC states: "Currently, we are able to operate the certification program without charging any fees to MRC programs, thanks to the financial support of our sponsors." It adds: "We do anticipate that we will need to charge fees to MRC programs (or their funders) for certification and renewal at some point in the future" (NIMRC certification page, read October 2, 2026). Verify current fees with NIMRC. IHS scopes each engagement after a free introductory call.
What this is not
- IHS is not NIMRC and does not grant, predict or influence a certification decision.
- IHS does not contact, submit to or speak for your program to NIMRC. IHS drafts; your program submits.
- IHS does not assess buildings, housing operations or facility safety, and does not provide clinical care.
Frequently asked questions
What is medical respite care and who is it for?
NHCHC defines medical respite care as acute and post-acute medical care for people experiencing homelessness who are not ill enough to remain in a hospital but are too ill to recover on the streets or in regular shelter settings.
What is NIMRC certification for medical respite programs?
It is a voluntary process run by the National Institute for Medical Respite Care. Programs complete assessments, submit evidence and host a site visit to show acceptable fidelity to the Guiding Principles and the Standards for Medical Respite Care Programs, and meaningful engagement of clients in program operations.
What changed in the 2026 Standards for Medical Respite Care Programs?
NHCHC says the Standards went through a review in 2026 to reflect growth, changes and newly established evidence, and that the 2026 Edition is the basis for NIMRC Certification. This page does not summarize the individual changes; IHS works from the 2026 text your program holds.
Is our program eligible if we have operated for less than a year?
Certification eligibility includes actively serving medical respite clients for a minimum of one year and a current profile in NIMRC's directory. Programs under development or with less than three years of operation can use NIMRC's readiness pathway.
How long does NIMRC certification take, and how many staff hours does it require?
NIMRC says the program's certification team should be prepared to spend roughly 40 to 60 total hours on certification activities over a six-month period.
Does NIMRC certification cost anything?
As of October 2, 2026, NIMRC says it operates certification without charging fees to programs, thanks to sponsor support. It also says it anticipates charging programs or their funders for certification and renewal at some point. Verify current fees with NIMRC.
When does the next NIMRC application window open?
On October 2, 2026, the certification page said the application window was closed and invited programs to subscribe to NIMRC's mailing list for notice of the next window. No date was published there.
How does certification work when a hospital and a shelter or housing provider run the program together?
NIMRC certifies the program as a whole, not one organization's services. For joint programs it recommends that one organization take primary, formal ownership of the certification process, with the other included as a Joint Venturer.
How long does certification last?
NIMRC certifies programs for three years. Programs then renew, and renew every three years after that.