Feds Finally Issue New Institution Restraint And Seclusion
Rules
By Dave Reynolds, Inclusion Daily Express
December 12,
2006
WASHINGTON, DC--The federal government has issued its final rules
governing the use of restraints and seclusion on patients in Medicare- and
Medicaid-funded hospitals and psychiatric facilities.
The U.S. Centers for Medicare and Medicaid Services published the rules
on the 8th of December, seven years after the agency formed a committee to
study restraint-related deaths, and eight years after the Hartford Courant ran
an important exposé on the restraint-related deaths of adults and
children -- as young as 6 years of age -- in institutions housing people with
mental illness and developmental disabilities.
The new rules, which go into effect February 6 of next year, include
limiting physical restraints and seclusion to four hours for adults, two hours
for children and adolescents ages 9 to 17, and one hour for patients younger
than 9 years of age; requiring facilities to document why an intervention was
needed, along with any attempts to use less restrictive methods, and how the
patient responded to the intervention; requiring specialized training in
non-physical interventions; and specific requirements regarding how and when
restraint-related deaths are reported.
In 1998, the Courant published a series entitled "Deadly Restraint,"
which revealed that 142 patients across the country had died while or after
being improperly restrained from 1988 to 1998. A later investigation by the
Inspector General for the Department of Health and Human Services revealed that
another 104 patients died between August 1999 and December 2004 in
CMS-regulated facilities. That report recommended allowing CMS to impose
financial penalties to facilities who do not properly report a restraint death.
U.S. Senators Christopher Dodd and Joseph Lieberman, both from Connecticut, had
included civil penalties in their original proposal, but penalties failed to
make it into the final rules because of pressure from hospital associations,
the Courant noted.
Also on Friday, members of Connecticut's Congressional delegation wrote
to CMS acting director Leslie Norwalk, calling for the agency to better enforce
the rules. Senator Dodd has reportedly said it might be time for lawmakers to
revisit the issue of financial penalties.
Related:
"CMS Publishes Final Patients' Rights Rule On Use Of
Restraints And Seclusion Better" (U.S. Centers for Medicare & Medicaid
Services)
http://www.inclusiondaily.com/news/06/red/1212a.htm
"Restraints
Rules Get New Scrutiny" (Hartford Courant)
http://www.inclusiondaily.com/news/06/red/1212b.htm
"Deadly
Restraint: Hartford Courant Investigative Report" (Hartford Courant)
http://www.charlydmiller.com/LIB/1998hartfordcourant.html
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with Inclusion Daily Express international disability rights news service.
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