Hospital Restraint/Seclusion Deaths to be Reported Using the Centers for Medicare and Medicaid Services (CMS) Form CMS-10455, Report of a Hospital Death
Guidance for: This memorandum notifies state survey agency directors that hospital restraint/seclusion deaths should be reported using form CMS-10455, Report of a Hospital Death Associated with Restraint or Seclusion. It also provides directions for implementation and regulations pertaining to reporting of hospital restraint/seclusion deaths.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 09, 2014
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.