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The AHA today commended the Centers for Medicare & Medicaid Services for issuing proposed guidance to clarify ligature risk requirements, which pertain to environmental safeguards for patients at risk of harm to self or others, and urged the agency to consider additional clarifying language. “In its proposed guidance, CMS has struck the appropriate balance, emphasizing safety for both patients and the providers who care for them while requiring meaningful assurances that hospitals are equipped to navigate these situations successfully,” AHA said in comments on the proposed guidance. “… Specifically, differentiating between locked and unlocked units will provide an important distinction and demonstrates the agency’s commitment to ensuring patient safety, while also understanding the work required of hospitals. Further, we support CMS’s proposed ligature risk extension request process and encourage CMS to use a similar process for regulations and guidelines where construction or acquisition of additional resources requires additional time for compliance. We also urge the agency to consider additional clarifying language around some of the proposed requirements in order to better direct and prepare hospitals for implementing the necessary changes. Specifically, we recommend additional clarification around behavioral health assessments, health care staff, surveyor education and training, and dedicated emergency department psychiatric beds.”