CMS SOM App. U, Tag R107

Interpretive Guidelines: §403.730(c)(2)

Each patient should receive care in an environment that a reasonable person would

consider to be safe. The RNHCI staff should follow current standards of practice for

patient environmental safety, infection control, and security. Staff should also provide

protection for the patient’s emotional health and safety as well as the patient’s physical

safety. Respect, dignity, and comfort would be components of an emotionally safe

environment.

The intention of this requirement is to specify that each patient receive care in an

environment that is considered to be reasonably safe. For example, RNHCI staff should

follow current standards of practice for patient environmental safety, infection control,

and security.

Other safe setting includes but is not limited to properly maintained assistive devices

(wheelchair, walker, cane, hearing aids), bathing facilities with non-slip surfaces,

electrical appliances without frayed wires or exposed heating elements, proper radiator

temperatures, proper water temperatures in hand sinks, and bathing facilities which

cannot scald or harm patients.

Since RNHCI’s only furnish nonmedical nursing items and services to beneficiaries who

choose to rely solely upon a religious method of healing, and for whom the acceptance of

medical services would be inconsistent with their religious beliefs; care in a safe setting

would also mean that the RNHCI should also have policies and procedures to report

public health concerns to the appropriate agencies. For instance, if the RNHCI has a

patient presenting with a communicable disease or there are situations which may pose

risk to all patients receiving care in the RNHCI, the RNHCI should have procedures in

place with a process for reporting the concern to the public health agencies in order to

ensure care in a safe setting is maintained for all patients.

Survey Procedures:

• What are the RNHCI’s policies and procedures for patient environmental safety,

infection control, and security?

• Does the facility notify appropriate agencies of public health concern as required?