1. (1) If a service recipient is injured as a result of the use of isolation, mechanical restraint, or physical holding restraint, staff must immediately obtain medical treatment. Staff must document in the service recipient’s record all injuries that occur as a result of isolation, mechanical restraint, or physical holding restraint.
2. (2) The mental health residential treatment facility must report serious occurrences that result from the use of isolation, mechanical restraint, or physical holding restraint to the Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS), the Disability Law & Advocacy Center of Tennessee (DLAC), and the Centers for Medicare and Medicaid Services if applicable. Occurrences include a service recipient’s death, serious injury, suicide attempt, or injuries to staff and must be reported no later than close of business the next business day after the serious occurrence.
3. (3) The mental health residential treatment facility must notify immediately the parent, guardian, temporary caregiver, or legal custodian, as appropriate, of an unemancipated child or the conservator, attorney-in-fact under a durable power of attorney which authorizes health care, or surrogate decision-maker of an adult selected under T.C.A. §§ 33-3-219 and 220 when a serious injury occurs as the result of the use of isolation, mechanical restraint, or physical holding restraint.
4. (4) Staff must document in the service recipient’s record that appropriate entities have been notified, the date notified, and the name of the person spoken to or sent a notice.
5. (5) In addition to any other required notices, each mental health residential treatment facility that uses isolation, mechanical restraint, or physical holding restraint must annually report information specified by the Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) as required under T.C.A. §§ 33-1-307 and 33-3-120.

Authority: T.C.A. §§ 4-4-103, 4-5-202, 4-5-204, 33-1-302, 33-1-305, 33-1-309, and 33-3-120; and 42 C.F.R. §§ 483.372(c), 483.374(b), 483.374(b)(2), and 483.374(c). Administrative History: Original rule filed March 3, 2008; effective May 17, 2008. Administrative corrections made to agency names in December 2022 pursuant to Public Chapter 575 of 2012.