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from most positive or least intrusive, to least positive or most intrusive;

Guidance §483.450(b)(1)(ii)

Policies and procedures must include a clear progression as to how staff implement

interventions to manage inappropriate client behavior.

Facility policy and procedures must define the entire hierarchy of possible interventions from

the most positive, functionally appropriate approaches to most intrusive approaches authorized.

The facility determines at what level in the hierarchy the IPP will begin for each client based on

their individual assessment. The plan must still begin at the least intrusive technique shown

effective for that client. Individual plans should specify the specific techniques that have been

determined through assessment to be least restrictive for each client.

The facility policy for unexpected behavioral incidents must provide direction for the staff in the

utilization of the hierarchy. For clients not on a behavior plan, staff must apply the appropriate

level of intervention per the established hierarchy, including emergency measures to prevent

harm to self or others.