ARM 37.106.3236. BEHAVIOR MANAGEMENT POLICIES

(1) A facility must have written behavior management policies and procedures which include a description of the model, program, or techniques to be used with residents. The facility must have policies addressing discipline, therapeutic de-escalation in crisis situations, crisis intervention and physical restraint, and time-out. Behavior management must be based on an individual assessment of each resident’s needs, stage of development, and behavior. It must be designed with the goal of teaching the residents to manage their own behavior and be based on the concept of providing effective treatment by the least restrictive means. (2) The behavior management policies and procedures must prohibit: (a) the use of physical force, mechanical, chemical, or physical restraint as discipline; (b) pain compliance, aversive conditioning, and use of pressure point techniques; (c) placing anything in or on a resident’s mouth; (d) cruel or excessive physical exercise, prolonged positions, or work assignments that produce unreasonable discomfort; (e) verbal abuse, ridicule, humiliation, profanity, and other forms of degradation directed at a resident’s family; (f) physical discipline of any means including but not limited to hitting, shaking, biting, or pinching; (g) locked confinement or seclusion; (h) withholding of necessary food, water, clothing, shelter, bedding, rest, medications as prescribed, medical care, or toilet use; (i) denial of visits or communication with the resident’s family; (j) isolation as punishment; and (k) any other form of punishment or discipline which subjects a resident to pain, humiliation, or unnecessary isolation or restraint. (3) If facility policies and procedures allow for disciplining a group of residents for actions of one resident, the policies and procedures must clearly prescribe the circumstances and safeguards under which disciplining the group is allowed. (4) Any staff person involved in or witnessing an infraction of this rule shall complete an incident report clearly detailing the events of the infraction. The report must be completed prior to the end of the involved staff person's shift. (5) A copy of the incident report must be placed in the resident’s file and the incident must be reported to the licensure bureau and parent or legal guardian within 24 hours of its occurrence. (6) An authorized staff person must be notified of the incident immediately and: (a) begin an investigation within 24 hours of the incident; and (b) complete a written report and submit it to the licensure bureau within two days of completion of the investigation. (7) An investigation of the incident may be conducted by the department. (8) A complete report of any investigation conducted by the facility must be placed in the facility’s records and must be available for inspection by the department.