The Centers for Medicare & Medicaid Services Friday 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. The draft guidance updates 2017 guidance to clarify what constitutes a ligature risk and the agency’s expectation for locked, as well as unlocked psychiatric units.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 ligature resistant standard. The guidance also updates the process for psychiatric hospitals and units to request an extension to remedy identified ligature risks. CMS will accept comments on the draft guidance through June 17.

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