/ en Fri, 25 Apr 2025 21:24:18 -0500 Mon, 17 Jul 23 15:16:20 -0500 /news/headline/2023-07-17-cms-updates-ligature-risk-guidance-hospitals <p>The Centers for Medicare & Medicaid Services July 17 released updated <a href="https://www.cms.gov/files/document/qso-23-19-hospitals.pdf">guidance</a> for state surveyors assessing ligature risk in hospitals, which pertains to environmental safeguards for patients at risk of harm to self or others. As <a href="/lettercomment/2023-05-18-aha-expresses-concern-lack-clear-and-actionable-guidance-environmental-risk-mitigation">urged</a> by the AHA, the guidance clarifies that hospitals can demonstrate compliance with certain patient safety standards by conducting appropriate patient assessments, adequately staffing and monitoring units, and mitigating environmental risks through risk assessments. AHA members will receive a Special Bulletin soon with more on the updated guidance.</p> Mon, 17 Jul 2023 15:16:20 -0500 Ligature Risk /lettercomment/2019-06-17-aha-comments-cms-proposed-guidance-ligature-risk <p>AHA comments on the Centers for Medicare & Medicaid Services’ proposed guidance on ligature risk. Specifically, our letter commends the agency for its work on this important issue and offers several recommendations aimed at providing increased clarity around these critical provisions.</p> Mon, 17 Jun 2019 13:46:09 -0500 Ligature Risk <p><strong>The Issue</strong><br /> The Centers for Medicare & Medicaid Services (CMS) April 19 released draft revised guidance to clarify its ligature risk policy, which pertains to environmental safeguards for patients at risk of harm to self or others.</p> <p>The draft guidance updates 2017 guidance to clarify what constitutes a ligature risk and the agency’s expectation for locked, as well as unlocked psychiatric units. Locked psychiatric units within psychiatric hospitals and acute care hospitals, as well as emergency departments with dedicated psychiatric beds within a locked unit, are required to achieve a ligature-resistant environment. Unlocked psychiatric units and general acute care beds designated for the treatment of physical diseases and disorders do not have to meet the expectation of ligature resistant, but they must have a plan for identifying and protecting patients who may intend harm to themselves or others.</p> <p><strong>Our Take</strong><br /> CMS has taken important steps to clarify the ligature risk interpretive guidelines. The proposed guidance is likely to help hospitals and health systems make important decisions relating to their psychiatric beds and units. This is an opportunity to engage with CMS on a critically important issue to ensure that the necessary safety protocol is in place for patients and the providers who care for them.</p> Fri, 03 May 2019 13:55:36 -0500 Ligature Risk <p>On behalf of our approximately 5,000 hospitals and health system members, the ���������� Association (AHA) requests immediate clarification of the Centers for Medicare & Medicaid Services’ (CMS) expectations regarding the actions hospitals must take to appropriately guard against ligature risks in our facilities. Our members are keenly aware of, and take extremely seriously, their responsibility to protect the patients in their care. For patients with suicidal thoughts, this includes keeping them safe from self-harm.</p> <p>Read the full letter below.</p> Tue, 23 Oct 2018 14:50:57 -0500 Ligature Risk /news/perspective/2017-12-20-ligature-risks-what-hospitals-need-know <p>Clarity is important in health care. It is particularly important when the Centers for Medicare & Medicaid Services (CMS) is spelling out the “rules of the road” for hospitals to be able to participate in Medicare and Medicaid. Hospitals and their employees are dedicated to patient well-being and safety, but unfortunately, since 2016, hospitals have not had clarity about what is expected of them when it comes to keeping patients with suicidal ideation safe while under their care. </p> <p>In 2016, CMS urged The Joint Commission and state agencies to improve their assessments of the ligature risks for patients with suicidal ideations, but provided no written information on what CMS wanted hospitals to do differently. This led to hospitals being advised that they needed to eliminate ligature risks, what parts of the hospital had to be ligature free or how they were expected to do that at the same time they were providing treatment for the physical and mental disorders that brought the patient to the hospital in the first place. </p> <p>Last week, CMS published a memorandum to <a href="https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-18-06.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending">surveyors</a> that takes a first step toward providing some clarity. Importantly, it distinguishes between specifically designated psychiatric units or hospitals and general acute care hospitals. CMS is focused on psychiatric hospitals and units where those who might be contemplating self-harm or harm to others are usually treated, and recognizes that other parts of general acute care hospitals that treat patients with a variety of disorders cannot be ligature free or ligature resistant and meet the wide variety of patient needs they must treat. The agency expects hospitals to take appropriate steps to mitigate the chance of harm when they have a patient who may be contemplating self-harm or harm to others. In contrast, CMS clarifies that hospitals and units designated expressly for the treatment of patients with psychiatric disorders are expected to be ligature resistant. </p> <p>For hospitals and those who work in these facilities, nothing is more important than the patients they serve each and every day. This means making sure they are safe from harm. We are glad that CMS has provided some clarity.  However, hospitals – and surveyors – need additional clarity around CMS’ expectations around ligature risk and other potential for harm and await the guidance CMS says will be published in six months.  </p> Wed, 20 Dec 2017 04:15:00 -0600 Ligature Risk