Part H - Requirement Relating to the Rights of Residents of Certain Facilities

42 USC 290ii - Requirement relating to the rights of residents of certain facilities

(a) In general 
A public or private general hospital, nursing facility, intermediate care facility, or other health care facility, that receives support in any form from any program supported in whole or in part with funds appropriated to any Federal department or agency shall protect and promote the rights of each resident of the facility, including the right to be free from physical or mental abuse, corporal punishment, and any restraints or involuntary seclusions imposed for purposes of discipline or convenience.
(b) Requirements 
Restraints and seclusion may only be imposed on a resident of a facility described in subsection (a) of this section if
(1) the restraints or seclusion are imposed to ensure the physical safety of the resident, a staff member, or others; and
(2) the restraints or seclusion are imposed only upon the written order of a physician, or other licensed practitioner permitted by the State and the facility to order such restraint or seclusion, that specifies the duration and circumstances under which the restraints are to be used (except in emergency circumstances specified by the Secretary until such an order could reasonably be obtained).
(c) Current law 
This part shall not be construed to affect or impede any Federal or State law or regulations that provide greater protections than this part regarding seclusion and restraint.
(d) Definitions 
In this section:
(1) Restraints 
The term restraints means
(A) any physical restraint that is a mechanical or personal restriction that immobilizes or reduces the ability of an individual to move his or her arms, legs, or head freely, not including devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or any other methods that involves the physical holding of a resident for the purpose of conducting routine physical examinations or tests or to protect the resident from falling out of bed or to permit the resident to participate in activities without the risk of physical harm to the resident (such term does not include a physical escort); and
(B) a drug or medication that is used as a restraint to control behavior or restrict the residents freedom of movement that is not a standard treatment for the residents medical or psychiatric condition.
(2) Seclusion 
The term seclusion means a behavior control technique involving locked isolation. Such term does not include a time out.
(3) Physical escort 
The term physical escort means the temporary touching or holding of the hand, wrist, arm, shoulder or back for the purpose of inducing a resident who is acting out to walk to a safe location.
(4) Time out 
The term time out means a behavior management technique that is part of an approved treatment program and may involve the separation of the resident from the group, in a non-locked setting, for the purpose of calming. Time out is not seclusion.

42 USC 290ii1 - Reporting requirement

(a) In general 
Each facility to which the Protection and Advocacy for Mentally Ill Individuals Act of 1986[1] [42 U.S.C. 10801 et seq.] applies shall notify the appropriate agency, as determined by the Secretary, of each death that occurs at each such facility while a patient is restrained or in seclusion, of each death occurring within 24 hours after the patient has been removed from restraints and seclusion, or where it is reasonable to assume that a patients death is a result of such seclusion or restraint. A notification under this section shall include the name of the resident and shall be provided not later than 7 days after the date of the death of the individual involved.
(b) Facility 
In this section, the term facility has the meaning given the term facilities in section 102(3) of the Protection and Advocacy for Mentally Ill Individuals Act of 1986[1] (42 U.S.C. 10802 (3)).
[1] See References in Text note below.

42 USC 290ii2 - Regulations and enforcement

(a) Training 
Not later than 1 year after October 17, 2000, the Secretary, after consultation with appropriate State and local protection and advocacy organizations, physicians, facilities, and other health care professionals and patients, shall promulgate regulations that require facilities to which the Protection and Advocacy for Mentally Ill Individuals Act of 1986[1] (42 U.S.C. 10801 et seq.) applies, to meet the requirements of subsection (b) of this section.
(b) Requirements 
The regulations promulgated under subsection (a) of this section shall require that
(1) facilities described in subsection (a) of this section ensure that there is an adequate number of qualified professional and supportive staff to evaluate patients, formulate written individualized, comprehensive treatment plans, and to provide active treatment measures;
(2) appropriate training be provided for the staff of such facilities in the use of restraints and any alternatives to the use of restraints; and
(3) such facilities provide complete and accurate notification of deaths, as required under section 290ii–1 (a) of this title.
(c) Enforcement 
A facility to which this part applies that fails to comply with any requirement of this part, including a failure to provide appropriate training, shall not be eligible for participation in any program supported in whole or in part by funds appropriated to any Federal department or agency.
[1] See References in Text note below.