CMS Updates Process for Filing Report of a Hospital Death Associated with the Use of Restraint or Seclusion Form

Published: 12/10/2019

Sources:
  • Centers for Medicare and Medicaid Services
Relevant To:
  • Critical Access Hospitals,
  • Hospitals,
  • Long Term Care,
  • Inpatient Rehabilitation Facility,
  • Behavioral Health

The U.S. Centers for Medicare and Medicaid Services (CMS) electronic Form CMS-10455, Report of a Hospital Death Associated with the Use of Restraint or Seclusion has replaced the paper version of the Form effective December 2, 2019. Additionally, beginning January 1, 2020, the CMS Regional Offices (RO) resource mailboxes will no longer accept paper versions of Form CMS-10455.

In accordance with 42 CFR 482.13(g), Death Reporting Requirements, all patient deaths associated with restraint and/or

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