In addition to the requirements found in §351.41, §351.42 and §351.43 of this chapter, the use of mechanical restraint, except the restraint chair shall be governed by the following criteria:

1. (1) Requirements.

   1. (A) mechanical restraints shall only be used in a manner consistent with their intended use;
   2. (B) there shall be provisions for the inspection and maintenance of mechanical restraint devices; and
   3. (C) mechanical restraints may be used when moving a resident from point to point within the facility. The mechanical restraint shall terminate upon completion of the resident's relocation.

2. (2) Prohibitions.

   1. (A) mechanical restraint devices shall not be altered from the manufacturer's design;
   2. (B) a resident shall not be placed face down while restrained in any mechanical restraint for a period of time longer than necessary to apply the restraint devices;
   3. (C) a mechanical restraint shall not secure a resident in a prone position with his or her arms and/or hands behind the resident's back and secured to the resident's legs;
   4. (D) mechanical restraint devices shall not be secured so tightly as to interfere with circulation nor so loosely as to cause chafing of the skin;
   5. (E) mechanical restraint devices shall not be secured to a stationary object except when complete immobilization is required by four-point restraint;
   6. (F) a resident in mechanical restraints shall not participate in any physical activity; and
   7. (G) plastic cuffs shall only be used in emergency situations.

Source Note:The provisions of this §351.45 adopted to be effective September 1, 2003, 28 TexReg 2953.