Disabled People and Physically Restraints in Nursing Facilities
People do not enter nursing homes pursuant to a court order requiring
them to stay involuntarily in these facilities. Unlike mental institutions
and hospitals, people in nursing facilities, thus, can legally walk out and
leave a nursing facility whenever they wish, including against medical
advice.
Nevertheless, physical devices and restraints are used throughout the
nursing home industry. In 2005, 92,303 people in nursing facilities were
kept in some kind of physical restraints, presumably against their will and
without any judicial or other independent authority's approval. In fact,
6.9% of all the residents in nursing facilities were either tied down or had
equipment restraints which restricted their freedom of movement.
In 2007, it has been reported that in a seven day period, every day, 9.3%or
129,148 people with disabilities in nursing facilities were physically
restrained from leaving their beds.
The variation from state to state is quite amazing. In six states, more than
20% of the disabled residents were restrained in bed on a daily basis. On
the other hand, fourteen states had 1% or less of their residents so
restrained. We list each state below.
In addition to physical restraints in a bed, disabled residents face several
other types of physical restraints in nursing facilities. Nationally, during
the same time period of the last seven days in 2007,there were 1.8 % or
another 24,000 people with disabilities restrained in chairs who were
prevented from rising from them, and 2% or 27,000residents who had limb
restraints. We do not know if the people restrained in the chairs were also
the same people who had their limbs physically restrained.
Federal regulations clearly state that nursing facility residents have the
right to be free from physical restraints that are "not required to treat
the resident's medical symptoms." The federal Centers for Medicare and
Medicaid Services note that "restraints may not be used for staff
convenience." If they are used, they must be only "for brief periods to
permit medical treatment to proceed."
Disabled Advocates:
Have you asked your State Medicaid officials for nursing facilities by
percentages that use these physical restraints? This information is known.
When you go into nursing facilities, have you discussed these restraints
with the residents?
What "medical symptoms" justify bed restraints on a daily basis for seven
days?
Do the disabled residents know their rights? Have you and the residents
reviewed their "plan of care" to determine what possible medical
justification could conceivably warrant such restraints?
Do the residents know they can refuse the "medical treatment?"
Below are percentages, by state, of nursing home residents who were
physically restrained in their beds on a daily basis for seven day in2007:
Alabama 17.2%
Alaska 1.3%
Arizona 2.1%
Arkansas 20.7%
California 29.5%
Colorado 0.9%
Connecticut 4.0%
Delaware 1.5
D. C. 7.7
Florida 6.9
Georgia 20.2
Hawaii 6.3
Idaho 2.6
Illinois 6.0
Indiana 3.2
Iowa 10.5
Kansas 4.8
Kentucky 3.4
Louisiana 21.2
Maine 0.8
Maryland 4.9
Massachus 1.0
Michigan 1.4
Minnesota 0.2
Mississippi 8.5
Missouri 21.6
Montana 0.6
Nebraska 0.8
Nevada 4.4
New Hampshire 0.7
New Jersey 17.2
New Mexico 4.2
New York 2.4
North Carolina 13.8
North Dakota 0.4
Ohio 1.7
Oklahoma 14.9
Oregon 1.9
Pennsylvania 2.1
Rhode Island 0.3
South Carolina 15.9
South Dakota 0.9
Tennessee 18.5
Texas 20.6
Utah 4.4
Vermont 0.9
Virginia 1.6
Washington 0.4
West Virginia 1.0
Wisconsin 0.3
Wyoming 0.9
National 9.3%
Steve Gold, The Disability Odyssey continues
Back issues of other Information Bulletins are available online at
http://www.stevegoldada.com
with a searchable Archive at this site divided into different subjects.
To contact Steve Gold directly, write to stevegoldada@cs.com
or call 215-627-7100.
