Behavior management intervention

1. A facility shall create a trauma informed culture that promotes respect, healing, and positive behaviors and which minimizes the use of restrictive behavior management interventions to the extent possible. 2. The facility shall provide the resident, custodian, and parents or guardians a list of facility expectations and behavior management intervention guidelines. 3. A facility shall adopt and implement written policies and procedures for behavior management consistent with the following: a. Compliance with the standards of the facility's accrediting body. b. Behavior management interventions must be constructive or educational in nature. c. Only employees of the facility may prescribe, administer, or supervise the behavior management interventions of the resident. d. A resident may not be subject to: (1) Physical abuse; (2) Excessive physical exercise or other activities causing physical discomfort; (3) Unduly strenuous physical work; (4) Verbal abuse, ridicule, or humiliation; (5) Penalizing a group for an identified group member's misbehavior; (6) Any aversive measure that is painful, discomforting, dangerous, or potentially injurious; or (7) Denial of any of the following items: (a) Shelter; (b) Emotional support; (c) Sleep; (d) A place to sleep with a pillow and bedding; (e) Meals or menu items; (f) Clean clothes; (g) Personal or telephone visits with the resident's custodian, parent or guardian, or advocate; (h) Time necessary for personal hygiene; (i) Minimum exercise; (j) Mail; (k) Access to toilet and water facilities, as needed; (l) Attendance at a religious service or religious counseling; (m) Clean and sanitary living conditions; (n) Medication; (o) Program services or treatment; or (p) Entry to the facility. 4. For the purposes of this section, "time-out" means a behavior management intervention technique that is part of an approved program that involves the voluntary option of a resident to move to an unlocked designated area for a period of time to regain self-control. 5. Application of time-out by a facility must be as follows: a. A resident in time-out must never be physically prevented from leaving the time-out area. b. Time-out may take place away from the area of activity or from other residents, such as in the resident's room, or in the area of activity or other residents. c. An employee continuously shall observe the resident while the resident is in time-out and provide calming assistance as prescribed in the resident's treatment plan.