This letter from CMS outlines the requirements for nursing homes and healthcare facilities to ensure a safe environment free from accident hazards. It defines terms related to providing supervision and other interventions to prevent accidents and outlines a systems approach to identify, evaluate, and analyze hazards and risks, implement interventions to reduce hazards and risks, and monitor for effectiveness and modify interventions when necessary. The letter emphasizes the importance of developing a culture of safety, engaging all staff, residents and families in safety training, and encouraging the use of data to identify potential hazards, risks, and solutions related to specific safety issues. Nursing homes and healthcare facilities must take steps to identify environmental hazards and individual resident risks of an accident, including the need for supervision and/or assistive devices, and implement interventions, including adequate supervision and assistive devices, consistent with a resident’s needs, goals, care plan and current professional standards of practice in order to eliminate or reduce the risk of an accident.

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