CMS SOM App. N, Tag N0130

safety and the safety of others can be ensured, even if the restraint or seclusion order

has not expired.

Interpretive Guidelines§ 483.356(a)(3)ii)

The resident in restraint or seclusion should be evaluated on a continual basis (see N-

0165 and N-0166 for continual monitoring criteria) and ended at the earliest possible

time based on the assessment and evaluation of the resident’s condition.

Restraint or seclusion intervention must be discontinued if the safety situation has ceased

and the safety of the resident and others can be ensured, even when the physician order

for the restraint or seclusion has not expired. For example, if a resident has recovered

from their unanticipated maladaptive behavior in 2-hours instead of the maximum 4-hour

time frame specified in the order, it is the expectation that the resident is released from

restraint or seclusion at the 2-hour point. The facility policy for restraints and seclusion

should outline the criteria for discontinuing ESI interventions.