20 CAR § 400-402. Restraint of residents.

1. (a)

   1. (1) Patients shall not be unduly restrained.

   2. (2) Patients shall not be confined to rooms or restrained except when:

      1. (A) Necessary to prevent injury to the patient or others; and
      2. (B) Alternative measures are not sufficient to accomplish these purposes.
   3. (3) In any event, no locked doors or locked restraints are to be used at any time to restrain a patient.
   4. (4) Doors (screen type), or the lower one-half (1/2) of a dutch door or approved type louvered doors may be hooked on the hall side of the door.

   5. (5)

      1. (A) Restraints, of the nonlocking type, may be used only upon the order of a physician.
      2. (B) In the event the order is obtained by phone, the signature of a physician shall be obtained within five (5) days.

   6. (6)

      1. (A) Note. The aforementioned restraining type doors shall be installed in addition to the regular door to the room.
      2. (B) They shall be removed during periods when they are not needed for the restraint of patients.
   7. (7) Upon the advice of the attending physician, unruly or excessively noisy patients shall be transferred from the home to an institution equipped for such patient care, since this type patient creates a disturbance for other patients in the home.

2. (b) The written policy and procedures governing the use of restraints shall specify which staff member may authorize the use of restraints and clearly delineate at least the following:

   1. (1) Orders indicating the specific reasons for the use of restraints;
   2. (2) Their use is temporary, and the resident will not be restrained for an indefinite amount of time;
   3. (3) Orders for restraints shall not be enforced for longer than twelve (12) hours, unless the patient's condition warrants; and
   4. (4) Restraints must be checked every thirty (30) minutes and loosened every two (2) hours for range of motion to restrained extremities.