|(a) Safety-Based Seclusion beyond Four Hours.
(1) An initial safety-based seclusion review shall
be held no later than four hours after a resident is placed in safety-based
seclusion. If the fourth hour of seclusion occurs during non-program
hours, the review shall be held no later than two hours after the
start of the ensuing day's program schedule.
(2) The initial safety-based seclusion review shall
be held by the facility administrator or designee.
(3) The initial safety-based seclusion review shall
determine whether the alleged behavior meets criteria for safety-based
seclusion as established in §343.288 of this title and whether
continued seclusion is appropriate.
(A) If the review results in a finding that the alleged
behavior does not meet criteria for placement in safety-based seclusion
or that continued seclusion is not appropriate, the seclusion shall
be immediately discontinued.
(B) If safety-based seclusion is continued, documentation
shall be maintained that shows the resident was notified of the reason
for continued seclusion.
(b) Safety-Based Seclusion beyond 24 Hours. A safety-based
seclusion review is required before the end of each 24-hour period
of seclusion. If the 24th hour of seclusion occurs during non-program
hours, the review shall be conducted no later than two hours after
the start of the ensuing day's program schedule.
(1) The review shall be held by a staff member who
was not directly involved in the decision to place the resident in
seclusion. The resident shall be present for the review.
(2) The review shall determine if continued seclusion
is warranted. Seclusion shall not be continued unless:
(A) there is a reasonable belief that the resident
continues to meet criteria in §343.288(a) of this title; and
(B) the facility administrator approves the continued
(3) Documentation of each review shall be retained
in the resident's file.
(c) Safety-Based Seclusion beyond Five Days.
(1) A resident shall not be secluded beyond five consecutive
calendar days unless:
(A) the chief administrative officer or administrative
designee determines the resident continues to meet criteria in 343.288(a)
of this title; and
(B) the placing agency, if different from the agency
operating the facility, is notified of the resident's status.
(2) The finding and notice requirements in paragraph
(1) of this subsection apply to every 24-hour period beyond five calendar