CMS is currently developing comprehensive interpretive guidance focusing on reducing ligature risk (i.e., the risk posed by physical features, such as pipes and shower rails, that could be used by a patient to attach material for the purpose of hanging). The comprehensive guidance, which will apply to Hospitals and Critical Access Hospitals, and are most relevant to psychiatric hospitals/units, are targeted for publication in mid-2018. CMS issued immediately-effective interim guidance on the topic, noting that in the interim ROs, state agencies and AOs may use their judgment in identifying ligature and other safety risk deficiencies and determining the enforcement action to be taken.