CMS SOM App. N, Tag N0188

an emergency safety intervention and the resident must have a face-to-face discussion.

This discussion must include all staff involved in the intervention except when the

presence of a particular staff person may jeopardize the wellbeing of the resident.

Other staff and the resident’s parent(s) or legal guardian(s) may participate in the

discussion when it is deemed appropriate by the facility. The facility must conduct

such discussion in a language that is understood by the resident and by the resident’s

parent(s) or legal guardian(s). The discussion must provide both the resident and staff

the opportunity to discuss the circumstances resulting in the use of restraint or

seclusion and strategies to be used by the staff, the resident, or others that could

prevent the future use of restraint or seclusion.

Interpretive Guidelines§ 483.370(a)

The purpose of the debriefing is to provide both the resident and the staff an opportunity

to analyze the events surrounding the emergency safety situation and intervention. It is

essential that facilities include all four factors of §§483.370 (b)(1)-(4) in their debriefing,

as well as review the emergency safety situation and intervention, in order to improve the

resident’s treatment plan.

Review of sample resident records to verify that the documentation of both the resident

debriefing and the staff debriefing include:

a. That a face to face debriefing was held within 24 hours of the conclusion of the

restraint or seclusion episode;

b. Appropriate staff (and their names) were involved in the face to face debriefing (if

one or more of the staff involved in the restraint or seclusion does not attend the face

to face, there must be documentation to justify their absence):

c. That the resident was present for the debriefing;

d. If the resident is a minor, the parents or legal guardians were notified and given an

opportunity to participate in the debriefing;

e. The meeting discussion includes documentation of how an restraint or seclusion may

be prevented in the future based upon information learned from the episode; and

f. Any changes to the resident’s treatment plan as a result of each debriefing.