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(1) The facility must be capable of providing restraint or seclusion and must ensure that the restraint or seclusion is performed in compliance with 53-21-146, MCA.

(2) Restraint and seclusion must be performed in a manner that is safe, proportionate and appropriate to the severity of the behavior, the patient's size, gender, physical, medical, and psychiatric condition, and personal history.

(3) Restraint or seclusion may be used in emergency situations when needed to ensure the physical safety of the individual patient or other patients or staff of the facility and when less restrictive measures have been found to be ineffective to protect the resident or others from harm.

(4) Restraint and seclusion procedures must be implemented in the least restrictive manner possible in accordance with a written modification to the patient's health care/treatment plan and discontinued when the behaviors that necessitated the restraint or seclusion are no longer in evidence.

(5) "Whenever needed" or "as needed" PRN standing orders for use of restraint or seclusion are prohibited.

(6) A physician or other authorized health care provider must authorize use of the restraint or seclusion within one hour of initiating the restraint or seclusion.

(7) Each order of restraint or seclusion is limited in length of time to four hours.

(8) A facility will have at a minimum one "comfort/safe" room per 16 beds for use for patient seclusion as prescribed by the facility's policy and procedures, and in accordance with applicable state and federal standards.

History: 53-21-194, MCA; IMP, 53-21-146, 53-21-194, MCA; NEW, 2009 MAR p. 1801, Eff. 10/16/09.

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