(a) All patients have the right to be free from restraint or seclusion, of any form, imposed as a means of coercion, discipline, convenience, or retaliation by staff. Restraint or seclusion may only be imposed to ensure the immediate physical safety of the patient, a staff member, or others and must be discontinued at the earliest possible time.     
      (b) A limited services rural hospital (LSRH) may only use restraint or seclusion when less restrictive interventions have been determined to be ineffective to protect the patient, a staff member, or others from harm.     
      (c) The type or technique of restraint or seclusion used must be the least restrictive intervention that will be effective to protect the patient, a staff member, or others from harm.     
      (d) The LSRH shall have written policies and procedures regarding the use of restraint and seclusion that are consistent with current standards of practice.     
      (e) An LSRH may only seclude a patient for the management of violent or self-destructive behavior.     
      (f) The patient has the right to safe implementation of restraint or seclusion by trained staff.      
        (1) The LSRH shall provide patient-centered competency-based training and education on the use of restraint and seclusion to LSRH personnel and staff, including medical staff and, as applicable, personnel providing contracted services in the LSRH.       
        (2) The training must include de-escalation techniques and other alternatives to the use of restraint or seclusion.       
      (g) An LSRH shall comply with the restraint and seclusion documentation and reporting requirements under Code of Federal Regulations Title 42 §485.534(g).     
     Source Note:        The provisions of this §511.78 adopted to be effective October 5, 2023, 48 TexReg 5668