DaveIFM Asked September 2015
The law says NH must allow patients to be free from restraints, do they comply?
Follow
Share
Nursing homes can't use any physical restraints (like side rails) or chemical restraints (like drugs) to discipline you or for the staff's own convenience.
This question has been closed for answers. Ask a New Question.
21 Answers
This question has been closed for answers. Ask a New Question.
Popular Questions
- My mom has Alzheimer's and she is in a nursing home. I get physically ill at the thought of going to see her and I have to force myself to go. Does anyone else have this problem?
- Nursing home neglect! My mothers is in ICU, now what?
- Do you feel that putting someone in a nursing home is just giving them a place to die in?
Ask a Question
any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms. Restraints may only be imposed—
(I) to ensure the physical safety of the resident or other residents, and
(II) only upon the written order of a physician that specifies the duration and circumstances under which the restraints are to be used.”
42 U.S.C. § 1395i-3(c)(1)(A)(ii) and 42 U.S.C. § 1396r(c)(1)(A)(ii).
Guidance issued to Surveyors for Long Term Care Facilities by the Centers for Medicare & Medicaid Services lists the serious conditions that justify antipsychotic use, and the inadequate indications for administering antipsychotic medications. They should not be used if the only indication is one or more of the following:
1) wandering;
2) poor self-care;
3) restlessness;
4) impaired memory;
5) mild anxiety;
6) insomnia;
7) unsociability;
8) inattention or indifference to surroundings;
9) fidgeting;
10) nervousness;
11) uncooperativeness; or
12) verbal expressions or behavior that are not due to the conditions listed under “Indications” and do not represent a danger to the resident or others. Guidance issued by the Centers for Medicare & Medicaid Services, State Operations Manual, Appendix PP at 387 [PDF document page 434]. When antipsychotics are used without monitoring they may be considered unnecessary medications because of inadequate monitoring. Id. at 389.
In my state, Massachusetts, the legislature has enacted a law that requires all nursing homes to get consent from a resident, or a Health Care Agent or Guardian, before administering any psychotropic medication. This informed consent law requires the nursing home to give notice to the resident that includes (i) the purpose for administering a psychotropic drug, (ii) the prescribed dosage, and (iii) any known effect or side effect of the psychotropic medication. This law is codified as Mass. Gen. Laws ch. 111, §72BBB, but it is up to family members to be aware of the needs of the dementia patient, and the alternatives to antipsychotic medications.
Sources:
www.law.cornell.edu/uscode/text/42/1395i-3
www.law.cornell.edu/uscode/text/42/1396r
www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf
www.malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Chapter111/Section72BB
Anytime the facility calls me about a fall I take it stride because Mom could just as easily be falling at home. And these falls can happen in a split second even with you in the room.
At the facility, the bed is lowered, there are bumpers along side her bed, and thick fall mats on the floor next to the bed. The facility is trying out different sleeping pills for night but so far nothing is working as of yet... [sigh].
"chemical restraints" ie: medications that sedate.
See All Answers