Restraint Reduction Materials

The Colorado Foundation for Medical Care, in collaboration with the Colorado Department of Public Health and Environment-Health Facilities Division, participated in a Health Care Quality Improvement Project funded by CMS to reduce the inappropriate use of physical restraints in long-term care facilities. The project focused on assessment of the resident. An expert study group working on the project created an assessment tool to facilitate this process. The tool is entitled "Assessment Log/Intervention Care Plan," and was designed to:

• meet the intent of the regulations relative to the use of restraints,
• assist facilities in examining incidents that lead to restraint use,
• promote least restrictive device use and highest level of functioning for the resident,
• promote alternatives to restraints,
• identify trends and patterns in events or behaviors, and
• promote evaluations and re-evaluations of interventions implemented by facilities.

This tool provides a means of documentation for the Resident Assessment Protocols (RAP). This instrument was reviewed and accepted by both state and federal surveyors. Ideas for assessments and interventions are highlighted on four Evaluation Trees: Falls, Behavior Problems, Wandering, and Medical Necessity. If staff need further details, the Assessment and Alternative Help Guide provides additional information, as outlined on the Evaluation Trees. 

These materials are provided as quality improvement tools for long-term care facilities, and can be obtained by clicking on the link below. Acute care facilities may also find the information useful to their restraint reduction efforts. The contents presented do not necessarily reflect CMS policy.

Restraint Reduction Assessment and Alternatives Help Guide in Adobe Acrobat format

If you need Adobe Acrobat reader, click on the link to download it from Adobe's site, free of charge, and then close the new window to return to this page.

Please Release Me, Let Me Go! - Thursday, February 22, 2007
A Panel of Restraint-Free Nursing Homes from Nebraska, North Dakota, and South Dakota

• WebEx Presentation
• Handout
• Side Rail Assessment

MDS Teleconference on Coding Section P4, Physical Restraints Presented by Betty Keen, MDS & OASIS Clinical Coordinator for Colorado, 06/21/07

• Handouts
• WebEx Presentation

Questions can be addressed to Laura Palmer, Project Manager, at lpalmer@coqio.sdps.org. 

Funding for this special project was provided by the Centers for Medicare and Medicaid Services under contract "500-96-P611.