Private Organization Accreditation

CSS Healthcare Services provides Community based health services to the young, the elderly and to Individuals with Developmental Disability. Founded in 1997, we have the ability to offer a variety of quality community-based services to our clients, which has greatly contributed to our growth and success.


Bonnie Bagley

Volunteer Roles: Evaluator; Lead Evaluator; Peer Reviewer; Team Leader

I have found that being a COA Volunteer builds my professional skills and experience in ways that more traditional workshops do not. The opportunity to learn about best practices through the COA standards and then see how agencies implement them is truly a growth experience.
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Residential Treatment Services provide individualized therapeutic interventions and a range of services, including education for residents to increase productive and pro-social behavior, improve functioning and well-being, and return to a stable living arrangement in the community.

PA-RTX 12: Crisis Stabilization

The agency provides residents in crisis with structured, trauma-informed stabilization and treatment services in order to help them return to their previous level of functioning.

Interpretation: Children and adults seeking crisis stabilization services may be experiencing an acute psychiatric crisis, a substance use related crisis, or severe emotional or mental distress.

NA The agency does not operate a crisis stabilization unit.

Rating Indicators
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions; exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement. 
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.  
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.  
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  
  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.   
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner. 
  • Service quality or agency functioning may be compromised.   
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.  
Please see Rating Guidance for additional rating examples. 

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Procedures for delivering crisis stabilization services
    • Table of contents for training curricula specific to crisis stabilization
    • Documentation of training specific to crisis stabilization
    • Interview:
      1. Program director
      2. Relevant personnel
      3. Residents
    • Review case records

  • PA-RTX 12.01

    Crisis stabilization services focus on crisis resolution and are delivered in a trauma-informed, developmentally appropriate, and culturally and linguistically responsive manner by qualified personnel.

  • PA-RTX 12.02

    Agencies that offer crisis stabilization provide the following services on a 24/7 basis: 
    1. emergency reception; 
    2. assessment and evaluation; 
    3. observation and monitoring; 
    4. crisis counseling; 
    5. medication management;  
    6. structured, therapeutic activities; 
    7. support services and psycho-education for family members; and 
    8. referrals to specialists and other community-based services, as needed.

    Interpretation: In regards to element (a), emergency reception means that individuals in crisis are accepted on a 24-hour basis without undue delays or barriers. 
    Interpretation: Structured, therapeutic activities may be recreational, social, and/or educational in nature, and are consistently provided in accordance with the resident’s service plan. Agencies can also address these services in PA-RTX 8.

  • PA-RTX 12.03

    Residents receive a crisis assessment within 24 hours of admission to determine the appropriate level of care.

    Note: Agencies that operate a crisis stabilization unit will complete the applicable assessment standards in PA-RTX 4.

    Research Note: A crisis assessment is an immediate, face-to-face evaluation that is conducted by a physician or licensed mental health professional to: determine the level of crisis; identify any immediate need for emergency services; and provide immediate intervention to de-escalate the resident’s distress and/behavior.

  • PA-RTX 12.04

    Residents participate in the development of an initial service plan within 24 hours of admission and a comprehensive service plan within five days.

    Interpretation: When care extends beyond thirty days the agency must review and update the resident’s service plan according to the change in the individual’s clinical condition.

    Note: This standard is specific to service planning timeframes. Agencies that operate a crisis stabilization unit will also complete the applicable service planning and monitoring standards in PA-RTX 5.

  • PA-RTX 12.05

    Residents and their families participate in the development of a crisis plan to identify strategies and interventions that may be employed to prevent or minimize the escalation of a crisis and promote stabilization.

    Interpretation: The crisis plan should specify interventions that may or may not be implemented by personnel in order to help the resident de-escalate his or her behavior. The plan can be part of, and reviewed with, the resident’s overall service or treatment plan.

  • PA-RTX 12.06

    Agencies arrange educational services and supports, as appropriate, to ensure that residents can pursue their educational goals once they achieve a crisis resolution.

  • PA-RTX 12.07

    During the first 48 hours a resident is in care, a minimum of two staff members must be on-duty 24 hours per day to ensure that adequate care and supervision are provided.

    Note: For care ratio requirements, please see PA-RTX 18.04.

  • PA-RTX 12.08

    Personnel who provide crisis stabilization services participate in ongoing training that addresses:
    1. assessing needs in crisis situations;
    2. special issues regarding age, gender identity/crisis, substance use and mental health conditions, developmental disabilities, and other needs typically presented by the service population;
    3. de-escalation techniques for crisis situations;
    4. culturally-sensitive, trauma-informed engagement techniques; and
    5. procedures for making referrals.

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