| (a) All patients have the right to be free from restraint
or seclusion, of any form, imposed as a means of coercion, discipline,
convenience, or retaliation by staff. Restraint or seclusion may only
be imposed to ensure the immediate physical safety of the patient,
a staff member, or others and must be discontinued at the earliest
possible time.
(b) A limited services rural hospital (LSRH) may only
use restraint or seclusion when less restrictive interventions have
been determined to be ineffective to protect the patient, a staff
member, or others from harm.
(c) The type or technique of restraint or seclusion
used must be the least restrictive intervention that will be effective
to protect the patient, a staff member, or others from harm.
(d) The LSRH shall have written policies and procedures
regarding the use of restraint and seclusion that are consistent with
current standards of practice.
(e) An LSRH may only seclude a patient for the management
of violent or self-destructive behavior.
(f) The patient has the right to safe implementation
of restraint or seclusion by trained staff.
(1) The LSRH shall provide patient-centered competency-based
training and education on the use of restraint and seclusion to LSRH
personnel and staff, including medical staff and, as applicable, personnel
providing contracted services in the LSRH.
(2) The training must include de-escalation techniques
and other alternatives to the use of restraint or seclusion.
(g) An LSRH shall comply with the restraint and seclusion
documentation and reporting requirements under Code of Federal Regulations
Title 42 §485.534(g).
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