CMS SOM App. FC, Tag M0152

corporal punishment. All clients have the right to be free from restraint or seclusion, of

any form, imposed as a means of coercion, discipline, convenience, or retaliation by staff.

Restraint or seclusion, defined in §485.902, may only be imposed to ensure the

immediate physical safety of the client, staff, or other individuals.

Interpretive Guidelines §485.910(e)(1)

Restraint and seclusion should only be used in very rare instances where documentation

clearly supports that a client continued to escalate to the point where no less restrictive

interventions could prevent them from hurting themselves or others. Restraint and

seclusion are used only in life-threatening situations that requires transfer of the client to a

hospital.

Generally, coercion is forcing a person to behave in an involuntary manner by use of

threats or intimidation (physical or psychological). For purposes of this regulation,

coercion includes the threat of the use of restraint or seclusion in order to force the client

to do something they do not want to do.

The use of a time out methodology, a technique for removing a client from positive

reinforcement, does not constitute restraint or seclusion. In these instances, the client is

offered the opportunity to withdraw from the immediate stimulation in order to regain

self-control. The client is not required to go to a particular location nor are they

prevented from leaving the alternate location.