US · guidance
CMS SOM App. M, Tag L845
§418.110(n)(5 ) – Orders for the use of restraint or seclusion must never be written
as a standing order or on an as needed basis (PRN).
Interpretive Guidelines §418.110(n)(5)
This regulation prohibits the use of standing or PRN (Latin abbreviation for pro re nata -
as needed; as circumstances require) orders for the use of restraint or seclusion. The
ongoing authorization of restraint or seclusion is not permitted. Each episode of restraint
or seclusion must be initiated in accordance with the order of a physician. If a patient
was recently released from restraint or seclusion, and exhibits behavior that can only be
handled through the reapplication of restraint or seclusion, a new order would be
required. Staff cannot discontinue a restraint or seclusion intervention, and then re-start it
under the same order. This would constitute a PRN order.
History
Rev. 210; Issued:02-03-23; Effective:02-03-23; Implementation:02-03-23
Provenance
- Source
- cms.gov
- Retrieved
- 2026-07-22
- Edition
- som-2026-07-22
- Content hash
5c4d00f240eb75b0afe1fbb99d4c502b0e72fd7860bc398dc830b724ef070d43
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