South Carolina Code of Regulations › Chapter 61 - DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL › Subchapter 61-103 - Residential Treatment Facilities for Children and Adolescents › Sec2 61-103.900 - RESIDENT CARE AND SERVICES › Section 61-103.900.904 - Restraints and Seclusion (I)

Current through Register Vol. 48, No. 6, June 28, 2024
A.
				The facility shall have current written policies and procedures for using
				seclusion or any form of restraint. Seclusion or other forms of restraint shall
				not be used for staff convenience or as a substitute for treatment.
B. Periodic or continuous mechanical,
				physical, or chemical restraints or seclusion during routine care of a resident
				shall not be used, nor shall residents be restrained for staff convenience or
				as a substitute for care and/or services. However, in cases of extreme
				emergencies when a resident is a danger to him or herself or others, mechanical
				and/or physical restraints may be used as ordered by a physician or other
				authorized healthcare provider, and until appropriate medical care can be
				secured. All forms of restraint or seclusion shall be documented when
				used.
C. Only those devices
				specifically designed as restraints may be used. Makeshift restraints shall not
				be used under any circumstance.
D.
				Emergency restraint or seclusion orders shall specify the reason for the use of
				the restraint, the type of restraint to be used, the maximum time the seclusion
				or restraint may be used, and instructions for observing the resident while
				restrained, if different from the facility's written procedures. Residents
				certified by a physician or other authorized healthcare provider as requiring
				restraint for more than twenty-four (24) hours shall be transferred to an
				appropriate facility.
E. During
				emergency restraint or seclusion, residents shall be monitored at least every
				fifteen (15) minutes, and provided an opportunity for motion and exercise at
				least every thirty (30) minutes. Prescribed medications and treatments shall be
				administered as ordered, and residents shall be offered nourishment and fluids
				and given bathroom privileges.
F.
				The use of mechanical restraints or seclusion shall be documented in the
				resident's record. Documentation shall include the date and time implemented,
				length of time restrained or secluded, specific behaviors necessitating
				restraint or seclusion, pertinent observations while resident is restrained or
				secluded, checking of the resident for adequate circulation and comfortable
				position, and the offering, provision, or refusal of range of motion, bathroom
				privileges, fluids, and nourishment.
G. The use of mechanical restraints or
				seclusion shall be evaluated as part of the next treatment plan review. Program
				staff shall consider alternative strategies to handle the behavior that
				necessitated the use of mechanical restraint or seclusion. Consideration shall
				be documented in the resident's record. If mechanical restraints or seclusion
				are needed more than twenty-four (24) hours, the resident shall be transferred
				to a facility capable of providing proper care.
H. A room used for seclusion shall have at
				least forty (40) square feet of floor space and be free of safety hazards,
				adequately ventilated during warm weather, adequately heated during cold
				weather, and appropriately lighted. All parts of the room shall be clearly
				visible from the outside.
I. All
				items or articles that a resident might use to injure him or herself shall be
				removed from the room used for seclusion.
J. At least a mat and bedding shall be
				provided in the seclusion room except when a physician's orders are to the
				contrary.