Webinar: Ligature Risks & Preventing Impatient Suicide - Compliance with CMS & TJC Standards

Tuesday, July 16, 2024 10:00 AM - 12:00 PM   iCalendar Eastern Standard Time

This educational activity is provided jointly by AXIS Medical Education and North Carolina Healthcare Association
This webinar is being offered in cooperation with the Georgia Hospital Association

Suicide is the third most frequently reported sentinel event. Suicide prevention and protecting patients from harm or strangulation is a major focus of accreditation surveys. The Centers for Medicare & Medicaid Services (CMS) has promulgated requirements for hospitals to prevent ligature risk and self-harm from patients who exhibit suicidal behaviors. Any hospital that receives Medicare and/or Medicaid payments must implement these changes for all patients. CMS tag number 144 in patient rights and tag number 701 in facility services discuss what units need to be ligature resistant. These tags cover patient assessments, environmental assessments, education and policy, and procedure requirements. The Joint Commission (TJC) has multiple requirements to ensure compliance with their standards regarding ligatures and suicide prevention. These standards will be discussed to include psychiatric hospitals, behavioral health units, general acute care inpatient units, and emergency departments. The webinar will provide resources and tools that can be used to assess patients to determine if they have suicidal ideations.

Learning Objectives: At the conclusion of this webinar, participants should be able to:
  • Recite that CMS now has two tag numbers that set forth requirements to prevent ligature and suicide risks for patients with suicidal ideations.
  • Discuss that the Joint Commission has requirements hospitals must follow to prevent patients from self-harm, including hanging or strangulation.
  • Describe that CMS recommends education when policies change and every two years.
  • Recall that CMS has recently updated guidelines.

    Target Audience:
    Chief Medical Officer, Chief Nursing Officer, Compliance Officer, Emergency Department Personnel, Joint Commission Coordinator, Medical Records, Quality Improvement personnel, Risk Manager, Legal Counsel.
Register and receive the Zoom registration link to share with your hospital or facility staff.
$199 NCHA Member Facilities
$400 Non Members

Register your group for the webinar and share the zoom registration link. Zoom requires each participant to authenticate by pre-registering at the zoom registration link. Once registered in Zoom, individuals will receive a confirmation email containing instructions to join the webinar and view the recording. Please register prior to the webinar start time to avoid delay in joining the session.
Registration fees must be paid at time of registration.


Laura Dixon, BS, JD, RN, CPHRM, President of Healthcare Risk Education and Consulting, has more than 20 years of clinical experience in acute care facilities, including critical care, coronary care, peri-operative services, and pain management. She has served as Director, Facility Patient Safety and Risk Management and Operations for COPIC, and as the Director,Western Region, Patient Safety and Risk Management for The Doctors Company. As a registered nurse and attorney, Laura holds a Bachelor of Science degree from Regis University of Denver, a Doctor of Jurisprudence degree from Drake University College of Law, Des Moines, Iowa, and a Registered Nurse Diploma from Saint Luke’s School Professional Nursing, Cedar Rapids, Iowa.