§ 2800.201. Safe management techniques.
The residence shall use positive interventions to modify or eliminate a behavior that endangers the resident himself or others. Positive interventions include
improving communications, reinforcing appropriate behavior, redirection, conflict the resolution, violence prevention, praise, deescalation techniques and alternative
techniques or methods to identify and defuse potential emergency situations.
§ 2800.202. Prohibitions.
The following procedures are prohibited:
(1) Seclusion, defined as involuntary confinement of a resident in a room or living unit from which the resident is physically prevented from leaving, is
prohibited. This does not include the admission of a resident in a secured dementia care unit in accordance with § 2800.231 (relating to admission).
(2) Aversive conditioning, defined as the application of startling, painful or noxious stimuli, is prohibited.
(3) Pressure point techniques, defined as the application of paint for the purpose of achieving compliance is prohibited.
(4) A chemical restraint, defined as use of drugs or chemicals for the specific and exclusive purpose of controlling acute or episodic aggressive behavior, is prohibited.
A chemical restraint does not include a drug ordered by a physician or dentist to treat the symptoms of a specific mental, emotional or
behavioral condition, or as pretreatment prior to a medical or dental examination or treatment.
(5) A mechanical restraint, defined as a device that restricts the movement or function of a resident or portion of a resident’s body, is prohibited.
Mechanical restraints include geriatric chairs, handcuffs, anklets, wristlets, camisoles,
helmet with fasteners, muffs and mitts with fasteners, poseys, waist straps, head straps, papoose boards, restraining sheets, chest restraints and other types of
locked restraints. A mechanical restraint does not include a device used to provide support for the achievement of functional body position or proper balance
that has been prescribed by a medical professional as long as the resident can easily remove the device or the resident or his designee understands the need
for the device and consents to its use.
(6) A manual restraint, defined as a hands-on physical means that restricts, immobilizes or reduces a resident’s ability to move his arms, legs, head or
other body parts freely, is prohibited. A manual restraint does not include prompting, escorting or guiding a resident to assist in the ADLs or IADLs.
§ 2800.203. Bedside rails.
(a) Bedside rails may not be used unless the resident can raise and lower the rails on his own. Bedside rails may not be used to keep a resident in bed. Use of
any length rail longer than half the length of the bed is considered a restraint and is prohibited. Use of more than one rail on the same side of the bed is not permitted.
(b) Half-length rails are permitted only if the following conditions are met:
(1) The resident’s assessment or support plan, or both, addresses the medical symptoms necessitating the use of half-length rails and the health and safety
protection necessary in order to safely use half-length rails.
(2) The residence has attempted to use less restrictive alternatives.
(3) The resident or legal representative consented to the use of half-length rails after the risk, benefits and alternatives were explained.