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Based on facility document review, staff interviews and review of the facility's policy and procedure for restraints, it was determined the facility failed to ensure each patient's representative was notified when initiating restraints on 3 of 10 sampled patients (Patient # 7, 8, and 10).

The findings included:

Medical Record reviews conducted on 05/15/17 revealed restraints were initiated on Patients #7, 8, and 10. Review of the patient's records revealed the facility failed to notify the responsible party there was a change in condition of the patient and restraints were initiated.

Interview with the Quality Outcomes Liaison on 05/16/17 at approximately 10:00 AM revealed, after review of the medical records, there is no evidence the patient's responsible parties were notified when there was a change in condition of the patients and restraints were initiated.

Review of the facility's Restraint Policy revealed that prior to the application of a restraint and as needed during use, the nurse will discuss with the patient and family (as applicable) the reason for the use of a restraint, measures taken to protect patient dignity and rights, safety measures and criteria for the application and removal of restraints.

Interview with the Assistant Vice President of Patient Services on 05/16/17 at approximately 3:30 PM, revealed nursing staff is to notify family when there is a change in the patient's condition and restraints are initiated. The Assistant Vice President of Patient Services confirmed that attempting less restrictive alternatives prior to initiating a non-behavioral restraint on a patient is required and one of the first less restrictive attempts is to notify the family and ask if they would like to come and sit by the patient.