MDS Alert

Surveyors may be looking for this key piece.

A device can be a restraint in one case--and not in another. And the care team at Oak Grove Rehab and Skilled Care recently fine-tuned its assessment to make that distinction for individual residents.

The facility in Carbondale, IL made the change after surveyors recently "really challenged" whether the facility was "restraint free" when residents use pommel cushions as positioning devices to keep them from sliding forward, reports Cheryl Dillon, RN, BSN, WCCN, LMHA, director of quality assurance.

Occupational therapy had assessed four residents to determine they were appropriate candidates for using the cushions, she says. "But the assessment in this case clearly needed to show the person could stand up when the device was in place."

Vital take-home message: "The assessment has to determine if the device limits or restricts movement or keeps one body part from another," Dillon advises. "We have now spelled that out in our assessment when deciding whether to use a positioning or other device."

Editor's note: For a survey heads up on assessing and coding restraints, see "Review The ABCs Of Defining, Assessing, Coding Physical Restraints" and "CMS Survey & Cert Memo Takes A Strict Approach To Physical Restraints" in Long-Term Care Survey Alert. If you aren't yet a subscriber, e-mail your request for these two must-read stories to editormon@aol.com. For subscription information, call 1-800-508-2582.