A final rule amending the Medicare conditions of participation regarding the use of restraints and seclusion requires that health care workers undergo more rigorous training to assure the appropriateness of the treatment and to protect patient rights. The rule also expands the category of practitioners who may conduct patient evaluations when a restraint or seclusion tactic has been implemented.
New requirements. The rule retains the requirement that a patient be evaluated "face-to-face" within an hour of a patient being restrained or secluded for the management of violent or self-destructive behavior; however, the final rule permits a trained registered nurse or physician assistant to review such actions in addition to a physician or other licensed independent practitioner. The basic rights specified in the final rule include a patient's right to notification of his or her rights in regard to care, privacy and safety, confidentiality of records, and freedom from the inappropriate use of all restraints and seclusion. Hospitals must provide the patient or family member with a formal notice of a patient's rights at the time of admission. These rights include freedom from restraints and seclusion in any form when used as a means of coercion, discipline, convenience for the staff, or retaliation. Stricter standards applicable when a health care facility must report the death of a patient associated with the use of restraints and seclusion also have been adopted with this rule.
According to Leslie V. Norwalk, acting administrator of CMS, the rule will allow CMS to "hold all hospitals accountable for the appropriate use of restraint and seclusion." The requirements apply to all participating hospitals including short-term, psychiatric, rehabilitation, long-term, children's and alcohol/drug treatment facilities. The final rule becomes effective on February 6, 2007.
Final rule, 71 FR 71378, Dec. 8, 2006, Health Care Compliance Reporter, ¶700,021.
For more information on this and related topics, consult the CCH® Healthcare Compliance Portfolio Deluxe..
Visit our News Library to read more news stories.
