CMS SOM App. N, Tag N0126

form, used as a means of coercion, discipline, convenience, or retaliation.

Interpretive Guidelines§ 483.356(a)(1)

Restraint or seclusion, including drugs/medications used as restraint, is not to be used as

coercion, discipline, convenience, or retaliation.

1. Discipline - Restraint and seclusion are never to be used as a means to punish or

penalize a resident for the purpose of controlling behavior.

2. Coercion – (depriving the resident of the exercise of his/her free will by the use or

threat of physical or emotional force.) Staff may not use intimidation to prevent an

individual from free movement or verbal expression.

3. Convenience – (for the staff or facility) Staff may not employ restraint or seclusion as

a compensation for inadequate number of trained staff or programming.

4. Retaliation- Staff or facility practice must never use restraint or seclusion as a means

to retaliate against a resident for any reason. The frequent use of emergency safety

interventions may raise serious questions about the resident’s right to be free from

unnecessary restraint or seclusion and indicate the need for further investigation by

the surveyor.