CMS State Operations Manual Revision   

on the radar alert

In a transmittal dated July 21, 2023, the Centers for Medicare and Medicaid Services (CMS) provided an Update to the interpretive guidance on §482.13 (c)(2): The patient has the right to receive care in a safe setting (A-0144). CMS expounded on its guidance of the care of psychiatric patients in non-psychiatric settings by including expectations of evaluation, monitoring, and caring for patients related to potential harm. Terms such as “must” were replaced with “should,” and environmental risk assessments were denoted as a repeated process rather than a singular event. CMS also included the 2018 report from the National Action Alliance for Suicide Prevention that details recommendations and standards of care for people with suicide risk. Organizations are encouraged to read the full transmittal for details on identifying patients at risk, environmental safety risks, education and training, correction of environmental risks, and survey procedures that are now included in the State Operations Manual Interpretive Guidelines for Hospitals.

You can find current and past transmittals at the website – Transmittals.

Please contact Courtemanche and Associates for questions or assistance in maintaining continuous survey readiness at 704-573-4535 or

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