MONTANA DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES Quality Assurance Division Licensure Bureau 2401 Colonial Drive 2 nd Floor P.O. Box 202953 Helena, Montana 59620-2953 (406) 444-2676 ARM Title 37, Chapter 29 Restraints, Safety Devices, Assistive Devices & Postural Supports in Assisted Living Facilities
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MONTANA DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES Quality Assurance Division Licensure Bureau 2401 Colonial Drive 2 nd Floor P.O. Box 202953 Helena,
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MONTANA DEPARTMENT OFPUBLIC HEALTH AND HUMAN SERVICES
Quality Assurance DivisionLicensure Bureau
2401 Colonial Drive2nd Floor
P.O. Box 202953Helena, Montana 59620-2953
(406) 444-2676
ARM Title 37, Chapter 29
Restraints, Safety Devices, Assistive Devices & Postural Supports in Assisted Living Facilities
• 50-5-226 (a) MCA: The (assisted living) resident may not require physical or chemical restraint or confinement in locked quarters, but may consent to the use of safety devices pursuant to Title 50, chapter 5, part 12.
physician involvement A written order from the attending physician that
specifies the circumstances under and the duration for which the device may be used and the medical symptoms being addressed.
The above does not apply to a side rail or other device used only as an assistive device and does not restrict the residents’ movement from bed or chair.
• “Restraint” any method (chemical or physical) of restricting a person’s freedom of movement –prevents independent & purposeful functioning:
Seclusion, controlling physical activity, restricting normal access to the
resident’s body that is not part of a consented medical diagnostic or treatment procedure
ARM 37.106.2902 (5)
• “Safety device” means side rails, tray tables, seat belts, or other similar devices used to maximize independence & maintain health & safety by reducing the risk of falls and injuries associated with medical symptom/s. ARM 37.106.2902 (6)
ARM 37.106.2904 Use of Safety Devices, Assistive Devices &
Postural Supports*ARM 37.106.2904 (5) Single or two quarter
bed rails that extend the entire length of the bed are prohibited.
*A bedrail that extends from the head to half the length used for safety or assistive device is allowed. (how weak is the resident? Can they become entrapped?)
*ARM 37.106.2904 (6) orthopedic devices or postural supports are not considered Physician prescribed to be safety devices and are not subject to the requirements for safety devices.
*ARM 37.106.2904 (7) Whenever a safety device or postural device is used that restricts or prevents a resident from independent and purposeful functioning, the resident must be provided the opportunity for exercise & elimination needs at least every two hours, or more often as needed, except when sleeping.
*ARM 37.106.2904 (8) All methods of safety devices, assistive devices and postural supports must be properly fastened or applied & permits rapid removal by staff in the event of fire or emergencies.
When a safety device is used the following must be documented in the resident record:
(a)frequency of monitoring according to facility policy.
(b)assessment and provision of treatment if necessary for skin care, circulation, and range of motion.
(c) any unusual occurrences or problems
ARM 37.106.2905 (3) Documentation
During a quarterly evaluation the facility must consider:
That the least restrictive safety device is being used (what other alternatives have been tried, could be tried?).
What causes the medical symptoms? (weakness from illness, stroke, etc)
Alternative safety measures if the safety device is removed. If removed, done so with the resident or resident representative and attending physician’s consultation.