(July 28, 2023) – On July 17, the Centers for Medicare & Medicaid Services issued updated
regulatory guidance regarding requirements for hospitals to assess patients and hospital environments for risks of patient harm. CMS memorandum QSO 23-19-Hospitals, states hospitals can demonstrate compliance with the Conditions of Participation on patient safety rights through appropriate patient assessments, adequate staffing and monitoring, and mitigation of environmental risks. CMS clarifies hospitals are not expected to apply the same ligature risk configuration throughout their facility. Instead, hospitals should focus on the specific needs and risks of individual patients based on their clinical or psychiatric assessments. The guidance will influence how surveyors evaluate hospital compliance with Medicare. Surveyors should focus corrective actions in response to deficiencies or adverse events on appropriately addressing particular findings or failures "rather than universal remedies."
--
Ron Marshall