Fact Sheets

CMS Issues New Patient Safety Standards for Community Mental Health Centers

CMS Issues New Patient Safety Standards for Community Mental Health Centers

Overview  
On October 28, 2013, the Centers for Medicare & Medicaid Services (CMS) announced a final rule [CMS 3202-F] establishing a formal set of community mental health center (CMHC) conditions of participation, which are the health and safety regulations Medicare providers must meet to participate in the Medicare program.

The new conditions of participation will help raise standards for the 100 CMHCs that participate in Medicare and ensure high quality and safe care for the more than 13,000 Medicare beneficiaries they serve.  CMHCs must continue to follow already-existing Medicare program integrity and payment regulations and are still required to comply with applicable provisions of the Public Health Service Act.  

A 2012 report by the Department of Health and Human Services’ Inspector General concluded that conditions of participation would strengthen Medicare’s ability to oversee the quality, effectiveness, and safety of care provided in CMHCs.  In addition to delineating rights and safety protections that must be provided to all clients of Medicare-participating CMHCs,  this final rule adopts contemporary standards of practice for the community behavioral health setting, and incorporates public recommendations made by national associations.  

Under the new conditions of participation, all clients will have a treatment team, an active treatment plan, and coordination of services providing individualized client care.  Clients must be provided with an initial evaluation, a comprehensive assessment, and a discharge or transfer plan that identifies each client’s needs and how those needs will be met on a timely basis.  In addition, CMHCs must use outcome and client satisfaction data to identify specific program needs and improve the quality of care provided to clients. The regulations also promote continuity of care by emphasizing the need for communication with other service providers regarding client needs at the time of discharge or transfer.

To ensure that the mental health centers are meeting the new health and safety requirements, CMS will survey community mental health centers at least once every 5 years although surveys may occur more frequently if a complaint is received by CMS or the state survey agency.

The final rule went on display at the Federal Register on October 28, 2013.  It can be downloaded at: http://www.ofr.gov/(X(1)S(k2ix35hm3bpvmg3c4h1uuy5f))/inspection.aspx?AspxAutoDetectCookieSupport=1.

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