• a pre-visit analysis of discharge data
• a comprehensive community awareness, image, attitude and reference study 
• a review of policies/procedures
• a review of clinical outcomes/performance
• a review of physician/employee perceptions

Hospital staff members, selected patients and community members participate in the certification process, and each member of the hospital is involved in earning and maintaining a CMCHO certification. Following initial certification, Post-Survey Measurement provides annual updates of hospital performance and regularly scheduled return visits every three years. An annual listing of culturally competent hospitals will be published in trade journals, peer-review literature and consumer magazines.