US · guidance
CMS SOM App. A, Tag A-0167
[The use of restraint or seclusion must be --]
§482.13(e)(4)(ii) - implemented in accordance with safe and appropriate restraint and seclusion
techniques as determined by hospital policy in accordance with State law.
Interpretive Guidelines §482.13(e)(4)(ii)
Restraint or seclusion must be implemented appropriately and safely, and reflect hospital policy in
accordance with State law.
The use of restraint or seclusion must never act as a barrier to the provision of other interventions to
meet the patient’s needs.
Survey Procedures §482.13(e)(4)(ii)
• Review the hospital’s policies and procedures to determine if they reflect current standards of
practice regarding safe and appropriate restraint and seclusion techniques. Are there any
references to State law statutes or any indication State laws were reviewed and incorporated?
• Review a sample of patient medical records that include patients who required the use of
restraint or seclusion for the management of both violent, self-destructive behaviors, and non-violent, non-self-destructive behaviors.
• After restraints were applied, was an assessment immediately made to ensure that restraints were
properly and safely applied?
• Were the hospital policies and procedures followed?
• Was the use of restraint or seclusion effective in achieving the purpose for which it was ordered?
If not, were timely changes made?
• Was there any evidence of injury to the patient?
History
Rev. 37, Issued: 10-17-08; Effective/Implementation Date: 10-17-08
Provenance
- Source
- cms.gov
- Retrieved
- 2026-07-22
- Edition
- som-2026-07-22
- Content hash
f883cbbfdfd2507db794fda8586bc437ba007f39b628267c4cf0d4d7ac15dbfe
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