Why restraint, seclusion citations dropped during the pandemic

Between 2010 and 2019, CMS cited 2.16% of surveyed hospitals each year for restraint or seclusion issues. In 2020, that figure dropped to 0.8%, according to CMS data. 

In a review of the 25 most frequent citations doled out by accreditation organizations, data showed the prevalence of citations for patient rights related to restraint or seclusion were stable for years, up until the COVID-19 pandemic. 

After the outlier of 2020, 1.1% and 1.4% of hospitals were cited for the problem in 2021 and 2022, respectively. The frequency seems to be inching closer to normalcy, as 2023 data shows 2.1% of providers were cited. 

A CMS spokesperson told Becker's the sudden decline in the citation's frequency is because a waiver allowed an exemption to the reporting requirements. If restraint or seclusion did not lead to a patient's death, providers did not have to report it. 

During the COVID-19 pandemic, "hospitals and other healthcare providers faced unprecedented challenges," the spokesperson said. "At the beginning of the [public health emergency], CMS used emergency waiver authorities and various regulatory authorities to enable flexibilities so providers could focus on rapidly responding to the needs of patients, residents and clients."

CMS waived requirements for dozens of other citations, including nursing services and physician services, but the frequency of those citations remained relatively stable during the pandemic. 

The waivers ended May 11, 2023, when the nation's public health emergency for COVID-19 ended. 

Read more about which citations became more and less common since 2017 here.


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