CMS SOM App. J, Tag W286

Guidance §483.450(b)(3)

No intervention, whether as a part of a formal program or in emergency situations (see W289)

may be used as punishment, retaliation or retribution. A staff member cannot employ a

behavior management technique simply because a client refuses to follow a staff request.

The implementation of all interventions, except in emergency situations, must be administered

consistent with the IPP and the specific behaviors identified in the IPP requiring the

intervention. Instances where an intervention is done as a punishment because the client did

not comply with staff instructions and not associated with the IPP include:

• Personal property confiscated for behavior at staff discretion;

• Rights restricted without approved plans; and

• Punitive house rules, such as prohibiting reentry into the kitchen for snacks if a meal is

not eaten completely.