For Immediate Release:
Friday, December 08, 2006
Contact: CMS Office of Public
Affairs 202-690-6145
CMS PUBLISHES FINAL PATIENTS’
RIGHTS RULE ON USE OF RESTRAINTS AND SECLUSION BETTER, MORE
EXTENSIVE TRAINING OF STAFF REQUIRED
Health care workers who employ
physical restraints and seclusion when treating patients must
undergo new, more rigorous training to assure the appropriateness of
the treatment and to protect patient rights, according to a
regulation published in the Federal Register today by the Centers
for Medicare & Medicaid Services (CMS).
The patients’ rights regulations
set forth, as a condition of participation (CoP) in the Medicare and
Medicaid programs, the expectation that health care facilities will
protect the rights of patients. These protections are part of
Medicare’s revised CoP requirements that hospitals must meet. The
requirements apply to all participating hospitals including
short-term, psychiatric, rehabilitation, long-term, children’s and
alcohol/drug treatment facilities.
“Through this regulation, CMS will
hold all hospitals accountable for the appropriate use of restraint
and seclusion,” said Leslie V. Norwalk, acting administrator of CMS.
“Today’s action reinforces this administration’s commitment to
patient safety and the delivery of high quality health care
services.”
“These new rules demonstrate our
commitment to advancing patient safety and patient rights in health
care facilities,” said Eric B. Broderick, D.D.S., M.P.H., Acting
Deputy Administration at HHS’ Substance Abuse and Mental Health
Services Administration. “Today we are taking needed steps to
solidify training requirements and essential reporting to reduce and
ultimately eliminate seclusion and restraints.”
To address concerns about the
improper use of restraints and seclusion and in response to the
4,000 public comments received on the interim final rule, the final
regulation strengthens the staff training standard and specifies
components of the training. The rule also expands the category of
practitioners who may conduct patient evaluations when a restraint
or seclusion tactic has been implemented.
CMS currently requires 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. Prior to this rule, these actions had to
be reviewed within that hour by a physician or “other licensed
independent practitioner (LIP).” Today’s action expands that list to
include a trained registered nurse (RN) or physician assistant (PA).
The rule requires, however, that when an RN or PA performs the
1-hour-rule evaluation, the physician or other LIP treating that
patient be consulted as soon as possible.
The basic rights specified in the
regulation include a patient’s right to notification of his or her
rights in regard to their care, privacy and safety, confidentiality
of their records, and freedom from the inappropriate use of all
restraints and seclusion, in all hospital settings.
In the development of this final
rule, CMS has been sensitive and responsive to the comments of the
provider communities, protection and advocacy associations, private
citizens, and the health care community in general. The intent of
this regulation is to ensure the protection of each patient’s
physical and emotional health and safety. In this final rule, CMS
has addressed public comments without compromising these
protections.
Under the new regulations,
hospitals must provide the patient or family member with a formal
notice of their 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 for when a
healthcare facility must report the death of a patient associated
with the use of restraints and seclusion have also been adopted with
this rule.
The regulation is in today’s
Federal Register and will become effective on February 06, 2007. It
can be found at www.cms.hhs.gov (need to insert correct link when
avail)
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