Improper Use of Physical Restraints by Private Caregiver
Penalty
Summary
The deficiency involves the use of physical restraints on a resident without a medical indication and contrary to the facility’s restraint-free policy. The resident, who had diagnoses of unspecified intellectual disabilities, depression, and anxiety disorder, was admitted on an unspecified date. On one morning, a CNA notified the ADON and DON that the resident was restrained to the bed; when they arrived, they observed the resident’s arms tied to the bed rails with blankets while the resident’s developmental disability caregiver (DDC) was lying on the resident’s legs. The DDC stated he had restrained the resident because the resident was trying to hit and kick him and had said he was going to break the window. Further record review and interviews revealed that earlier the same morning, around 6:30–7:00 AM, an LPN had entered the resident’s room and found a sheet tied around the resident’s feet, which he then untied. The LPN reported educating the DDC at that time that the facility was restraint free and that the resident could not be restrained. Despite this, later that morning the resident was again found with arms tied to the bed rails. The DON confirmed that the facility does not allow residents to be restrained and that this resident should not have been restrained. The facility’s restraint policy stated that physical restraints shall only be used for the safety and wellbeing of residents, only after other alternatives have been tried unsuccessfully, and only to treat medical symptoms, never for discipline, staff convenience, or fall prevention.
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