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Various Healthcare Institutions

Behavioral Health Anti-Ligature Prevention Upgrades

Construction Management

Delivery Method



Chicago-Metro, Illinois


In 2019, the Centers for Medicare and Medicaid Services (CMS) issued new guidelines to clarify ligature risks that compromise patients’ right to receive care in a safe setting. The memorandum required that hospitals achieve a ligature “resistant” environment in psychiatric units of acute care hospitals, locked emergency department psychiatric units, and psychiatric hospitals.

To achieve compliance with this new standard, the scope of work for this project includes:

  • Removal and replacement of handrails, doorknobs, door hinges, shower curtains, exposed plumbing/pipes, soap, and paper towel dispensers on walls, power cords on medical equipment or call bell cords, and light fixtures or projections from ceilings

  • Replacement of drop ceilings with solid ceilings

  • Installation of security screens over windows that can be opened or broken.

  • Replacement of unprotected lighting fixtures with tamper-proof fixtures

  • Installation of video cameras to provide one on one monitoring of all patient areas

  • Reconfiguring nurses’ stations to provide line of sight to all patient room corridors

  • Replacement of patient room furnishings with anti-ligature features

The most challenging aspect of this project was working within an occupied behavioral health unit. All workers received specific training regarding safety requirements for personnel working in Behavior Health Locations. Tool-in-hand and “buddy system” protocols were implemented to mitigate adverse patient outcomes.

Quality controls were put in place to certify that all tamper-proof screws were torqued within specified tolerances, and work areas were “swept” at the end of each shift to ensure that no materials or tools were left within the work areas.

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