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)

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.