Title 7 . Health and Social Services

Chapter 75 . Assisted Living Homes

Section 295. Use of intervention and physical restraint

7 AAC 75.295. Use of intervention and physical restraint

(a) An assisted living home must have a written procedure regarding the use of physical restraint. That procedure must be approved by the department under AS 47.33.330 .

(b) As provided in AS 47.33.330 (a)(4), an assisted living home may use physical restraint if a resident's actions present an imminent danger to the resident or others, but only after other interventions, including the use of a time out, have failed. A time out or physical restraint may not be used as a punishment, as a substitute for a less restrictive form of intervention, or as a convenience for the home's staff. A time out or physical restraint must be terminated as soon as the resident no longer presents an imminent danger to that resident or others.

(c) At the time of a resident's admission to the home, the home shall

(1) explain its approved physical restraint procedures to the resident or resident's representative;

(2) perform an assessment, at the time of admission, regarding the potential need for the use of time outs or physical restraint asking for information

(A) about the resident's prior behavior that might indicate a need for the use of time outs or physical restraint; and

(B) that might help minimize use of time outs or physical restraint;

(3) address the need for using time outs or physical restraint in the resident's assisted living plan if the home has reason to believe that time outs or physical restraint may be necessary because the resident's prior behavior or medical condition indicates that the resident may occasionally present an imminent danger to the resident or others; the plan must include information regarding

(A) when time outs or physical restraint should be used;

(B) what forms of physical restraint should be used, based on recommendations from the resident's primary physician; and

(C) any prenotification procedures requested by the resident's representative in addition to the 24-hour notice required by (d)(1) of this section or the five-day written report required under (d)(2) of this section.

(d) If physical restraint is used, the assisted living home shall

(1) notify the resident's representative

(A) before physical restraint is used, if prenotification is made a part of the resident's assisted living plan under (c)(3)(C) of this section; and

(B) within 24 hours, unless the representative has agreed, as reflected in the resident's assisted living plan, that notification under (2) of this subsection is sufficient; and

(2) document any use of physical restraint in the written report required under 7 AAC 75.340(a) (4) that includes

(A) the resident's name;

(B) a description of the incident that led to the decision to use physical restraint;

(C) a brief description of any other form of intervention used or attempted before the use of physical restraint;

(D) the type of physical restraint used;

(E) the time when physical restraint began; and

(F) the time when physical restraint ended.

(e) For purposes of this section, a time out is the restriction of a resident, with that resident's consent, to a quiet area or unlocked quiet room for a period not to exceed 30 minutes. A home may not require a resident to take a time out without that resident's consent, and may not use a time out that exceeds 30 minutes, with or without that resident's consent.

(f) For purposes of this section, physical restraint is a manual method that restricts body movement, or a physical or mechanical device, material, or piece of equipment that is attached or adjacent to the resident's body, that prevents the resident from easily removing it, and that restricts movement or normal access to the body. The use of the following safety equipment will not be considered physical restraint, if authorized in writing by the resident's primary physician, and if the necessity for its use is set out in the resident's assisted living plan:

(1) self-release safety belts;

(2) lap-top trays;

(3) wedge chair cushions;

(4) concave mattresses; and

(5) bedside rails if used for a resident who

(A) lacks independent mobility but has involuntary movement, including a seizure disorder, that could cause the resident to fall from bed; or

(B) needs the rails to assist in mobility.

History: Eff. 4/6/2002, Register 162; am 6/24/2004, Register 170

Authority: AS 47.33.410

AS 47.33.920