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Reporting And Data

Denial of Rights (Seclusion and Restraint Order)NEW 

Latest Update: August 25, 2022
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Reporting Information

Each consumer admitted to a facility for evaluation, treatment or training has rights (pursuant to NRS 433.456 to 433.536) that can only be denied to protect the consumer’s health and safety or to protect the health and safety of others, or both. Any time this occurs, the Administrator of the Facility must be noticed and a full report must be made to the NV Commission on Behavioral Health.

Responsible Party

Who Must Report?

NRS 433.534"the administrative officer of a facility"

Deadlines

When Do I Report?

When a restraint [Physical (NRS 433.5493), Mechanical (NRS 433.5496), or Chemical (NRS 433.5503)] is used on a person with a disability, "the report must be made not later than 1 working day after the procedure is used."

 

 

Method

How Do I Report?

NRS 433.534 "A copy of the report must be sent to the Commission."

Note: An example report is attached below. Sometimes referred to as "the goldenrod form" the form is requested to be printed on yellow paper.

Contact Information

Nevada Department of Health and Human Services
Division of Public and Behavioral Health | Administration
4150 Technology Way |Carson City, NV 89706
T: (775) 684-5850 |

Benefit/Penalty

Why Should I Report?

NRS 433.534 "Failure to report denial of rights by an employee may be grounds for dismissal."

NRS 433.536  Retaliation by officer, director or employee of facility prohibited.  An officer, director or employee of a facility shall not retaliate against any person for having:

      1.  Reported any violation of law; or

      2.  Provided information regarding a violation of law,

by the facility or a staff member of the facility.

      (Added to NRS by 1997, 3491)

 

Publicly Displayed

Link to the website/ranking/grading/etc. where the data is published

    NRS 433.5342.    Except as otherwise provided in NRS 239.0115, such a report is confidential and must not be disclosed. A copy of the report must be sent to the Commission.

3.  The Commission:

      (a) Shall receive reports of and may investigate apparent violations of the rights guaranteed by this chapter;

      (b) May act to resolve disputes relating to apparent violations;

      (c) May act on behalf of consumers to obtain remedies for any apparent violations; and

      (d) Shall otherwise endeavor to safeguard the rights guaranteed by this chapter.

      4.  Pursuant to NRS 241.030, the Commission may close any portion of a meeting in which it considers the character, alleged misconduct or professional competence of a person in relation to:

      (a) The denial of the rights of a consumer; or

      (b) The care and treatment of a consumer.

The provisions of this subsection do not require a meeting of the Commission to be closed to the public.

Authority

The legal mandate requiring reporting

NRS 433.534  Denial of rights prohibited; exceptions; report; investigation and action by Commission; closure of meeting in certain circumstances.

      1.  The rights of a consumer enumerated in this chapter must not be denied except to protect the consumer’s health and safety or to protect the health and safety of others, or both. Any denial of those rights in any facility must be entered in the consumer’s record of treatment, and notice of the denial must be forwarded to the administrative officer of the facility. Failure to report denial of rights by an employee may be grounds for dismissal.

      2.  If the administrative officer of a facility receives notice of a denial of rights as provided in subsection 1, the officer shall cause a full report to be prepared which must set forth in detail the factual circumstances surrounding the denial. Except as otherwise provided in NRS 239.0115, such a report is confidential and must not be disclosed. A copy of the report must be sent to the Commission.

      3.  The Commission:

      (a) Shall receive reports of and may investigate apparent violations of the rights guaranteed by this chapter;

      (b) May act to resolve disputes relating to apparent violations;

      (c) May act on behalf of consumers to obtain remedies for any apparent violations; and

      (d) Shall otherwise endeavor to safeguard the rights guaranteed by this chapter.

      4.  Pursuant to NRS 241.030, the Commission may close any portion of a meeting in which it considers the character, alleged misconduct or professional competence of a person in relation to:

      (a) The denial of the rights of a consumer; or

      (b) The care and treatment of a consumer.

The provisions of this subsection do not require a meeting of the Commission to be closed to the public.

      (Added to NRS by 1975, 1598; A 1979, 8121985, 22681989, 17571993, 211227191995, 67617352007, 21062011, 417)

NRS 433.5493  Use of physical restraint on consumer; requirements; exceptions; report as denial of rights.

      1.  Except as otherwise provided in subsection 2, physical restraint may be used on a person with a disability who is a consumer only if:

      (a) An emergency exists that necessitates the use of physical restraint;

      (b) The physical restraint is used only for the period that is necessary to contain the behavior of the consumer so that the consumer is no longer an immediate threat of causing physical injury to himself or herself or others or causing severe property damage; and

      (c) The use of force in the application of physical restraint does not exceed the force that is reasonable and necessary under the circumstances precipitating the use of physical restraint.

      2.  Physical restraint may be used on a person with a disability who is a consumer and the provisions of subsection 1 do not apply if the physical restraint is used to:

      (a) Assist the consumer in completing a task or response if the consumer does not resist the application of physical restraint or if the consumer’s resistance is minimal in intensity and duration;

      (b) Escort or carry a consumer to safety if the consumer is in danger in his or her present location; or

      (c) Conduct medical examinations or treatments on the consumer that are necessary.

      3.  If physical restraint is used on a person with a disability who is a consumer in an emergency, the use of the procedure must be reported as a denial of rights pursuant to NRS 433.534 or 435.610, as applicable, regardless of whether the use of the procedure is authorized by statute. The report must be made not later than 1 working day after the procedure is used.

NRS 433.5496  Use of mechanical restraint on consumer other than consumer of forensic facility; requirements; exceptions; report as denial of rights.

      1.  Except as otherwise provided in subsections 2 and 4, mechanical restraint may be used on a person with a disability who is a consumer only if:

      (a) An emergency exists that necessitates the use of mechanical restraint;

      (b) A medical order authorizing the use of mechanical restraint is obtained from the consumer’s treating physician or advanced practice registered nurse before the application of the mechanical restraint or not later than 15 minutes after the application of the mechanical restraint;

      (c) The physician or advanced practice registered nurse who signed the order required pursuant to paragraph (b) or the attending physician or attending advanced practice registered nurse examines the consumer not later than 1 working day immediately after the application of the mechanical restraint;

      (d) The mechanical restraint is applied by a member of the staff of the facility who is trained and qualified to apply mechanical restraint;

      (e) The consumer is given the opportunity to move and exercise the parts of his or her body that are restrained at least 10 minutes per every 60 minutes of restraint;

      (f) A member of the staff of the facility lessens or discontinues the restraint every 15 minutes to determine whether the consumer will stop or control his or her inappropriate behavior without the use of the restraint;

      (g) The record of the consumer contains a notation that includes the time of day that the restraint was lessened or discontinued pursuant to paragraph (f), the response of the consumer and the response of the member of the staff of the facility who applied the mechanical restraint;

      (h) A member of the staff of the facility continuously monitors the consumer during the time that mechanical restraint is used on the consumer; and

      (i) The mechanical restraint is used only for the period that is necessary to contain the behavior of the consumer so that the consumer is no longer an immediate threat of causing physical injury to himself or herself or others or causing severe property damage.

      2.  Mechanical restraint may be used on a person with a disability who is a consumer and the provisions of subsection 1 do not apply if the mechanical restraint is used to:

      (a) Treat the medical needs of a consumer;

      (b) Protect a consumer who is known to be at risk of injury to himself or herself because the consumer lacks coordination or suffers from frequent loss of consciousness;

      (c) Provide proper body alignment to a consumer; or

      (d) Position a consumer who has physical disabilities in a manner prescribed in the consumer’s plan of services.

      3.  If mechanical restraint is used on a person with a disability who is a consumer in an emergency, the use of the procedure must be reported as a denial of rights pursuant to NRS 433.534 or 435.610, as applicable, regardless of whether the use of the procedure is authorized by statute. The report must be made not later than 1 working day after the procedure is used.

      4.  The provisions of this section do not apply to a forensic facility, as that term is defined in subsection 5 of NRS 433.5499.

      (Added to NRS by 1999, 3231; A 2001, 27442011, 4212013, 30112017, 1746)

NRS 433.5503  Use of chemical restraint on consumer; requirements; report as denial of rights.

      1.  Chemical restraint may only be used on a person with a disability who is a consumer if:

      (a) The consumer has been deemed to be a person in a mental health crisis, as defined in NRS 433A.0175, and is receiving mental health services from a facility;

      (b) The chemical restraint is administered to the consumer while he or she is under the care of the facility;

      (c) An emergency exists that necessitates the use of chemical restraint;

      (d) A medical order authorizing the use of chemical restraint is obtained from the consumer’s attending physician, psychiatrist or advanced practice registered nurse;

      (e) The physician, psychiatrist or advanced practice registered nurse who signed the order required pursuant to paragraph (d) examines the consumer not later than 1 working day immediately after the administration of the chemical restraint; and

      (f) The chemical restraint is administered by a person licensed to administer medication.

      2.  If chemical restraint is used on a person with a disability who is a consumer, the use of the procedure must be reported as a denial of rights pursuant to NRS 433.534 or 435.610, as applicable, regardless of whether the use of the procedure is authorized by statute. The report must be made not later than 1 working day after the procedure is used.

      (Added to NRS by 1999, 3232; A 2011, 4222013, 30132017, 17472019, 347)

Notes

Any other pertinent information

NRS 433.5456  “Chemical restraint” defined.  “Chemical restraint” means the administration of drugs for the specific and exclusive purpose of controlling an acute or episodic aggressive behavior when alternative intervention techniques have failed to limit or control the behavior. The term does not include the administration of drugs on a regular basis, as prescribed by a physician, to treat the symptoms of mental, physical, emotional or behavioral disorders and for assisting a person in gaining self-control over his or her impulses.

(Added to NRS by 1999, 3230)

NRS 433.547  “Mechanical restraint” defined.  “Mechanical restraint” means the use of devices, including, without limitation, mittens, straps, restraint chairs, handcuffs, belly chains and four-point restraints to limit a person’s movement or hold a person immobile.

      (Added to NRS by 1999, 3230; A 2001, 2744)

NRS 433.5476  “Physical restraint” defined.  “Physical restraint” means the use of physical contact to limit a person’s movement or hold a person immobile.

      (Added to NRS by 1999, 3230)

See also: Consumers' Rights - NRHP Reporting and Data

For more information on mandated reporting related to restraints:

See also: Patient Death Associated with Restraint or Seclusion - NRHP Reporting and Data

See also: Restraints - Death/Serious Injury (Sentinel Event 5D) - NRHP Reporting and Data

See also: Mistreatment, Neglect, Abuse, Injuries of Residents - NRHP Reporting and Data

See also: Minimum Data Set (MDS) - NRHP Reporting and Data

DISCLAIMER
Although many of these requirements apply to individual medical professionals and other types of hospitals and health care facilities, the information is presented solely to support Critical Access Hospitals. The reporting requirements and legal mandates on this site are not an exhaustive list and Nevada Rural Hospital Partners, Inc. bears no responsibility or liability for any hospitals' or providers' failure to comply with Federal or State laws or regulations.