9-Year-Old Patient Placed in Restraint and Seclusion Without Time Limits

Old Vineyard Behavioral Health was cited by the Centers for Medicare and Medicaid Services for placing minors in physician ordered restraints or seclusion without time limitations. In one case, a 9 year old was restrained or escorted to seclusion 7 times over a 3-day period, and her records did not document a time limitation for any of the 7 instances. Facility policy dictates that restraint and seclusion interventions must be time-limited. Old Vineyard was also cited because the facility failed to ensure that registered nurses consulted with the attending physician or other licensed independent practitioner (LIP) following the completion of 1-hour face-to-face evaluations of patients placed under restraint or seclusion. The 9-year-old patient’s records indicate that she was given face-to-face evaluations after each of the 7 times she was placed in restraints or seclusion, but there was no indication that the evaluation findings were shared with her attending physician as soon as they were completed.