CMS SOM App. A, Tag A-0201

knowledge based on the specific needs of the patient population in at least the following:]

§482.13(f)(2)(iii) - Choosing the least restrictive intervention based on an individualized

assessment of the patient's medical, or behavioral status or condition.

Interpretive Guidelines §482.13(f)(2)(iii)

The underpinning of this regulation is the concept that safe patient care hinges on looking at the patient

as an individual and assessing the patient’s condition, needs, strengths, weaknesses, and preferences.

Such an approach relies on caregivers who are skilled in individualized assessment and in tailoring

interventions to individual patient’s needs after weighing factors such as the patient’s condition,

behaviors, history, and environmental factors.

Resources are available to assist clinicians in identifying less restrictive interventions. For example, the

American Psychiatric Association (APA), American Psychiatric Nurses Association (APNA), and the

National Association of Psychiatric Health Systems (NAPHS), with support from the American Hospital

Association (AHA), have sponsored the publication of a document entitled, “Learning from Each

Other—Success Stories and Ideas for Reducing Restraint/Seclusion in Behavioral Health.” This

document, published in 2003, was developed through dialogue with the field and extensive input from

behavioral healthcare providers throughout the country who have been working to reduce the use of

restraint and seclusion, and to improve care within their facilities. To access this document and other

useful resources, visit the web sites of the sponsoring organizations: http://www.naphs.org;

http://www.psych.org; http://www.apna.org; http://www.aha.org

Survey Procedures §482.13(f)(2)(iii)

• Does the hospital educational program address choosing the least restrictive intervention based

on an individualized assessment of the patient’s medical or behavioral status or condition?

• Does the hospital educational program address how to conduct an assessment of a patient’s

medical and behavioral conditions?

• Does the hospital educational program address types of interventions appropriate to the specific

needs of the patient population(s) served and ranging from less to more restrictive?

• Interview staff to determine if they are able to demonstrate the abilities addressed in this

requirement.