Five Star - Physically Restrained

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Home Home

Physically Restrained

Problem: Even the best-intentioned use of physical restraints— such as helping to prevent injury—can violate federal law. It also can negatively impact the number of stars your facility earns in the Centers for Medicaid & Medicare Services (CMS) Five-Star rating program. Assuring that the use of restraints is medically necessary is one of 10 CMS quality

F221 Use F221 for deficiencies concerning physical restraints. Use Guidance under F222.

F222 The resident has the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident’s medical symptoms.
Intent §483.13(a): The intent of this requirement is for each person to attain and maintain his/her highest practicable well-being in an environment that prohibits the use of restraints for discipline or convenience and limits restraint use to circumstances in which the resident has medical symptoms that warrant the use of restraints.

Solution: Improve your nursing home’s compliance with the CMS physical restraint requirement and watch your Five- Star quality rating—and your ability to attract and retain residents—improve. To help, Briggs has assembled the specific documentation, charting, education and training, and medical supplies you’ll need. Every Briggs form integrates industry best practices and has been recognized by customers as best-of-class… you know you’re getting the best solutions available.

Download the Quality Improvement Measure Guide for Physically Restrained [PDF].

Documentation
		Pack	List Price
Admissions
CFS3-4/2P	Physical Restrain Informed Consent	100/pk	32.68
CFS3-4/2TP	Physical Restrain Informed Consent	100/pk	32.68
Assessments
CFS3-3HH	Restraint Release Record	100/pad	12.28
CFS3-3HF	Restraint Release Record	100/pad	12.28
CFS3-1HH	Pre-Restraining Assessment	100/pad	10.20
CFS3-1HF	Pre-Restraining Assessment	100/pad	10.20
CFS3-2HH	Physical Restraint Elimination Assessment	100/pad	12.28
CFS3-2HF	Physical Restraint Elimination Assessment	100/pad	12.28
Physically Restrained
3646/2P	Physical Restraint Consent	100/pk	32.68
3646/2TP	Physical Restraint Consent	100/pk	32.68
3639HH	Physical Restraint Reduction Assessment	100/pad	12.28
3639HF	Physical Restraint Reduction Assessment	100/pad	12.28
Quality Improvement
3640	Physical Restraint Audit	100/pad	10.20
Charting
L-2290	Chart Needs Documentation Label	250/bx	10.85
5514	Chart Divider - Restraint Documentation - Poly - Dk Blue - Side	each	1.35
5513	Chart Divider - Restraint Documentation - Poly - Dk Blue - Bottom	each	1.35
483	Chart Divider - Assessments - Paper - Lt. Blue - Side	25/pk	11.50
414	Chart Divider - Assessments - Paper - Lt. Blue - Bottom	25/pk	11.50
448	Chart Divider - Assessments - Tyvek- Lt. Blue - Side	25/pk	28.75
440	Chart Divider - Assessments - Tyvek - Lt. Blue - Bottom	25/pk	28.75
5492	Chart Divider - Assessments - Poly- Lt. Blue - Side	each	1.35
5491	Chart Divider - Assessments - Poly - Lt. Blue - Bottom	each	1.35
5507	Chart Divider - Consents - Poly- Yellow - Side	each	1.35
5508	Chart Divider - Consents - Poly - Yellow - Bottom	each	1.35
Medical Supplies
Positioning	Bed Wedges

555-8028-1900	DMI® Foam Bed Wedge, 12" x 24" x 24", White	1 each	19.79
555-8028-0100	DMI® Foam Bed Wedge, 12" x 24" x 24", Blue	1 each	19.79
	Chair Pads
552-8004-0000	DMI® Convoluted Foam Chair Pad, 16" x 18" x 4"	1 each	6.20
552-8004-9910	DMI® Convoluted Foam Chair Pad with Cover, 16" x 18" x 4"	1 each	9.20
552-8005-0000	DMI® Convoluted Foam Chair Pad with Back, 18" x 32" x 3"	1 each	9.10
	Cervical Pillows
554-7905-1900	STRESS-EASE PILLOW 17X22 in	1 each	13.50
554-8011-4300	MEMORY FOAM PILLOW RADIAL-CUT	1 each	19.49
554-8001-1900	CERVICAL COMFORT PILLOW	1 each	18.60
554-8009-6400	CERVICAL REST PILLOW 24 IN	1 each	9.89
	Lumbar Cushions
555-7300-0200	LUMBAR CUSHION STANDARD	1 each	11.40
555-7300-2400	LUMBAR CUSHION STANDARD	1 each	11.40