Harmony Healthcare Blog

Siderails/Bedrails F700: State Operation Manual Appendix PP

Posted by Joni Gosser on Tue, Aug 07, 2018

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


The State Operation Manual Appendix PP specifically addresses siderails in F700. 

The SOM states: 

“After a facility has attempted alternatives to bedrails and determined that these alternatives do not meet the resident’s needs, the facility must assess the residents for the risk of entrapment and possible benefits of bedrails.” 

Read More

Topics: physical restraints

Merry Walker Ambulation Device: Restraint or Not a Restraint

Posted by Sally Fecto on Thu, May 03, 2018

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Usage of the Merry Walker Ambulation Device requires observation of a professionally trained medical person to determine if the device constitutes a restraint. 

  • The Merry Walker may not constitute a “restraint” if the patient is able to open, close and maneuver out of the front gate independently. 
  • The Merry Walker is considered a restraint if the patient is unable to open and close the front gate and caregiver assistance must be provided to release the resident form the device. These details must be documented in the medical record. It is prudent to obtain a physician’s order.  
Read More

Topics: physical restraints

Positioning Devices, Self-Releasing Devices and Restraints

Posted by Kathy Monahan on Thu, Mar 08, 2018

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


The primary goal of therapeutic intervention when utilizing any therapeutic device or modality is to increase functional independence, improve functional abilities and enhance mobility utilizing the least restrictive intervention.

Read More

Topics: physical restraints

Physical Restraints: Identify the Effect of the Device, Not the Device

Posted by Kris Mastrangelo on Tue, Feb 27, 2018

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


The Harmony Healthcare International (HHI) Team is seeing a need to review the definition of Physical Restraints.   Surveyors across the country have a heightened focus on restraint reduction so this topic is a priority. First and foremost, Harmony Healthcare International (HHI) recommends a comprehensive facility wide review to determine whether the devices (such as crisscross belts and low bed) are:

  • Properly Assessed for each resident and
  • Appropriately Identified as a restraint (per regulatory definition). 
Read More

Topics: physical restraints

We’ve got a Physical Restraint!  Now what? 7 Steps to Assess

Posted by Kathy Monahan on Thu, Sep 22, 2016

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


When the interdisciplinary team determines that the use of physical restraints is the appropriate course of action, and there is a signed physician order that gives the medical symptom supporting the use of the restraint, the least restrictive manual method or physical or mechanical device, material or equipment that will meet the resident’s needs must be selected.  Care planning must focus on preventing the adverse effects of physical restraint use.

Read More

Topics: physical restraints, Quality Measures

Quality Measure: Physical Restraints - Long Stay (Section P)

Posted by Kathy Monahan on Tue, Sep 20, 2016

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


The Physical Restraint Quality Measure is common on for error and miscoding.  This measure reports the percent of long-stay nursing facility residents who are physically restrained on a daily basis. Nursing facilities consistently strive to reduce unnecessary physical restraints and safeguard that residents are free of restraints unless deemed necessary and appropriate. Even though this is a continuous are of focus, it is beneficial for you and your staff to review the definition and intent of physical restraints.

Read More

Topics: physical restraints, Quality Measures

Physical Restraints: Proper Evaluation and Implementation (Part 2)

Posted by Elisa Bovee and Melissa Fox on Tue, Aug 16, 2016

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


What are the devices currently used by your facility for fall prevention strategies? Do you use crisscross belts or a low bed? Are these devices properly assessed for each resident and appropriately identified as a restraint when the use meets the regulatory definition?  This line of questioning will aide in narrowing down the focus areas necessary for the historic as well as the newly implemented Quality Measures. In addition, this systematic inquisition will dissect triggers that could misrepresent the care planning efforts of the clinical team. 

Read More

Topics: physical restraints

Physical Restraints: Defined and Refined (Part 1)

Posted by Kris Mastrangelo on Thu, Aug 11, 2016

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


In 2012, I was hired to evaluate the clinical and operational aspects of a nursing facility in another country.  I was excited to escape the red tape and mountains of regulations connected to care in the United States.  In fact, the best part of this engagement (I thought) was that the rules and policies in this country for operating a nursing home for the elderly to reside were comprised of a mere 18 pages

Then, within 20 minutes of touring the facility, I wished I was back in the states.  Why did I experience the blood rushing from my head to my toes with a feeling of dizziness?  Because every resident was in a restraint!  As you know, I am an Occupational Therapist.  I am an avid believer that movement cures all.  I restrained myself (no pun intended) from berating the staff for their ignorance. 

Read More

Topics: physical restraints

Subscribe to The HHI Blog

Posts by Topic

see all
harmony18
ICD-10 - Is Your Staff Ready? Download Our ICD-10 On-Demand Webinars Today

Stay connected!

Instagram