Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
Subchapter D - ADDITIONAL PROGRAM PROVIDER PROVISIONS
Section 260.217 - Restraints
Universal Citation: 26 TX Admin Code ยง 260.217
Current through Reg. 49, No. 38; September 20, 2024
(a) A restraint is a restrictive intervention that a program provider may use in accordance with this section.
(b) A program provider providing licensed assisted living must comply with § 553.267(a)(3)(A) and (D) of this title (relating to Rights).
(c) A program provider must ensure that a six-bed ICF/IID providing respite complies with § 551.42(e)(4) of this title (relating to Standards for a Facility).
(d) A program provider providing licensed home health assisted living:
(1) must not use
restraints:
(A) for disciplinary purposes,
retaliation, coercion, or retribution;
(B) for the convenience of a service provider
or other persons; or
(C) as a
substitute for an effective, less restrictive method;
(2) may use a restraint only:
(A) if the use is authorized, in writing, by
a physician and specifies:
(i) the
circumstances under which the restraint may be used; and
(ii) the duration for which the restraint may
be used; or
(B) if the
use is necessary in a behavioral emergency to protect an individual or others
from injury;
(3) except
in a behavioral emergency, must ensure:
(A)
that a service provider who uses a restraint has been trained in the use of the
restraint:
(i) before using the
restraint;
(ii) annually;
and
(iii) when the individual's
needs change; and
(B)
that the training is documented in the service provider's record;
(4) must not use a restraint under
any circumstance if it:
(A) obstructs the
individual's airway, including a procedure that places anything in, on, or over
the individual's mouth or nose;
(B)
impairs the individual's breathing by putting pressure on the individual's
torso;
(C) interferes with the
individual's ability to communicate; or
(D) places the individual in a prone or
supine position;
(5) must
ensure that if a physical restraint is used in a behavioral emergency:
(A) it must be a restraint in which the
individual's limbs are held close to the body to limit or prevent movement and
that does not violate the provisions of paragraph (4) of this
subsection;
(B) that as soon as
possible but no later than one hour after the use of the restraint, the service
provider notifies an RN of the restraint;
(C) that after the RN is notified of the use
of the restraint, the service provider documents the RN's instructions to the
service provider;
(D) that medical
services are obtained for the individual as necessary;
(E) the program provider:
(i) with the individual's consent, makes an
appointment with a physician no later than the end of the first business day
after the use of restraint and document in the individual's record that the
appointment was made; or
(ii) if
the individual refuses to see a physician, documents the refusal in the
individual's record; and
(F) that as soon as possible but no later
than 24 hours after the use of restraint, the program provider notifies one of
the following persons, if there is such a person, that the individual has been
restrained:
(i) the individual's LAR;
or
(ii) an actively involved person
with the individual's care, unless the release of this information would
violate other law;
(6) that uses a restraint must document in an
individual's record:
(A) the use of the
restraint;
(B) time and date the
restraint was used;
(C) name of
person administering the restraint;
(D) type of restraint and duration used;
and
(E) if used in a behavioral
emergency:
(i) events preceding the use of the
restraint;
(ii) actions taken after
the use of the restraint; and
(iii)
types of intervention attempted before the use of the restraint; and
(7) in order to decrease
the frequency of the use of restraint, and to minimize the risk of harm to an
individual, must ensure that a service provider is aware of and adheres to the
findings of the nursing assessment required in §
260.61(c)(8) of
this chapter (relating to Process for Enrollment of an Individual) or in §
260.77(b)(1)(B)
of this chapter (relating to Renewal and Revision of an IPP and IPC) for each
individual.
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