Residential and Outpatient Handbook - Plymouth - 63

designation made under this paragraph. The unrelated person may also
be identified as such by the patient or by the patient's family.
Subd. 27. Advisory councils. Residents and their families shall have the
right to organize, maintain, and participate in resident advisory and family
councils. Each facility shall provide assistance and space for meetings.
Council meetings shall be afforded privacy, with staff or visitors attending
only upon the council's invitation. A staff person shall be designated the
responsibility of providing this assistance and responding to written requests
which result from council meetings. Resident and family councils shall be
encouraged to make recommendations regarding facility policies.
Subd. 28. Married residents. Residents, if married, shall be assured privacy
for visits by their spouses and, if both spouses are residents of the facility,
they shall be permitted to share a room, unless medically contraindicated
and documented by their physicians in the medical records.
Subd. 29. Transfers and discharges. Residents shall not be arbitrarily
transferred or discharged. Residents must be notified, in writing, of the
proposed discharge or transfer and its justification no later than 30 days
before discharge from the facility and seven days before transfer to another
room within the facility. This notice shall include the resident's right to
contest the proposed action, with the address and telephone number of
the area nursing home ombudsman pursuant to the Older Americans Act,
section 307(a)(12). The resident, informed of this right, may choose to relocate
before the notice period ends. The notice period may be shortened in
situations outside the facility's control, such as a determination by utilization
review, the accommodation of newly admitted residents, a change in the
resident's medical or treatment program, the resident's own or another
resident's welfare, or nonpayment for stay unless prohibited by the public
program or programs paying for the resident's care, as documented in the
medical record. Facilities shall make a reasonable effort to accommodate new
residents without disrupting room assignments.
Subd. 30. Protection and advocacy services. Patients and residents shall
have the right of reasonable access at reasonable times to any available rights
protection services and advocacy services so that the patient may receive
assistance in understanding, exercising, and protecting the rights described
in this section and in other law. This right shall include the opportunity for
private communication between the patient and a representative of the
rights protection service or advocacy service.
Subd. 31. Isolation and restraints. A minor patient who has been admitted
to a residential program as defined in section 253C.01 has the right to be
free from physical restraint and isolation except in emergency situations
involving a likelihood that the patient will physically harm the patient's self
or others. These procedures may not be used for disciplinary purposes, to
enforce program rules, or for the convenience of staff. Isolation or restraint
may be used only upon the prior authorization of a physician, advanced
practice registered nurse, psychiatrist, or licensed psychologist, only when
less restrictive measures are ineffective or not feasible and only for the
shortest time necessary.
Subd. 32. Treatment plan. A minor patient who has been admitted to a
residential program as defined in section 253C.01 has the right to a written
treatment plan that describes in behavioral terms the case problems, the
precise goals of the plan, and the procedures that will be utilized to minimize
the length of time that the minor requires inpatient treatment. The plan
shall also state goals for release to a less restrictive facility and follow-up
treatment measures and services, if appropriate. To the degree possible, the
minor patient and the minor patient's parents or guardian shall be involved
in the development of the treatment and discharge plan.
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Subd. 33. Restraints.
(a) Competent nursing home residents, family members of residents who are
not competent, and legally appointed conservators, guardians, and health
care agents as defined under section 145C.01, have the right to request
and consent to the use of a physical restraint in order to treat the medical
symptoms of the resident.
(b) Upon receiving a request for a physical restraint, a nursing home shall
inform the resident, family member, or legal representative of alternatives
to and the risks involved with physical restraint use. The nursing home
shall provide a physical restraint to a resident only upon receipt of a
signed consent form authorizing restraint use and a written order from
the attending physician or advanced practice registered nurse that
contains statements and determinations regarding medical symptoms
and specifies the circumstances under which restraints are to be used.
(c) A nursing home providing a restraint under paragraph (b) must:
(1) document that the procedures outlined in that paragraph have been
followed;
(2) monitor the use of the restraint by the resident; and
(3) periodically, in consultation with the resident, the family, and the
attending physician or advanced practice registered nurse, reevaluate
the resident's need for the restraint.
(d) A nursing home shall not be subject to fines, civil money penalties, or
other state or federal survey enforcement remedies solely as the result of
allowing the use of a physical restraint as authorized in this subdivision.
Nothing in this subdivision shall preclude the commissioner from taking
action to protect the health and safety of a resident if:
(1) the use of the restraint has jeopardized the health and safety of the
resident; and
(2) the nursing home failed to take reasonable measures to protect the
health and safety of the resident.
(e) For purposes of this subdivision, " medical symptoms " include:
(1) a concern for the physical safety of the resident; and
(2) physical or psychological needs expressed by a resident. A resident's
fear of falling may be the basis of a medical symptom.
A written order from the attending physician or advanced practice registered
nurse that contains statements and determinations regarding medical
symptoms is sufficient evidence of the medical necessity of the physical
restraint.
(f) When determining nursing facility compliance with state and federal
standards for the use of physical restraints, the commissioner of health is
bound by the statements and determinations contained in the attending
physician's or advanced practice registered nurse's order regarding
medical symptoms. For purposes of this order, " medical symptoms "
include the request by a competent resident, family member of a resident
who is not competent, or legally appointed conservator, guardian, or
health care agent as defined under section 145C.01, that the facility
provide a physical restraint in order to enhance the physical safety of the
resident.
Residential and Outpatient Handbook - Plymouth

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