Foundations Behavioral Determination Hall, a Residential Treatment Center for children, was cited by the Pennsylvania Department of Human Services (DHS, formerly known as the Dept. of Public Welfare) for deficiencies related to mechanical restraints, patient rights, and facility maintenance. Pennsylvania regulations on the use of restraints state that “the position of the manual restraint or the staff person applying a manual restraint shall be changed at least every 10-consecutive minutes of applying the manual restraint.” While inspecting Determination Hall, DHS found the following related to one patient that was admitted on 4/4/2014: • Child 2 was restrained in a supine [horizontal] position on 4/10/2014 at 7:30pm for approximately 17 minutes • Child 2 was restrained on 4/15/2014 at 7:44 pm which lasted for approximately 26 minutes • Child 2 was restrained three times on 4/18/2014 from 7:05pm-7:16pm, 8:15pm-8:45pm, and 8:50pm-9:05pm • Child 2 was restrained on 5/22/2014 at 11:50am to 12:05pm and 6/7/2014 at 1:05pm to 1:30pm In all of these instances, DHS wrote that “there was no documentation to show that there was a change in positioning every 10 minutes.” DHS also cited the facility for violations of patient rights regulations because the agency could not find a copy of the child’s rights posted publicly in the facility. DHS also cited the facility for not having trash cans with lids in the bathrooms. DHS also cited the facility for deficiencies related to required dental exams for patients, required health exams for staff who have direct contact with children, and required semi-annual reviews and revisions to patients’ Individual Service Plans (ISP). The facility submitted a plan of correction that addressed each individual deficiency found by DHS.