[Code of Federal Regulations]
[Title 38, Volume 2]
[Revised as of July 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR52.90]

[Page 851-852]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
          CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS (CONTINUED)
 
PART 52--PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES--
Table of Contents
 
                          Subpart D--Standards
 
Sec. 52.90  Participant behavior and program practices.

    (a) Restraints. (1) The participant has a right to be free from any 
chemical or physical restraints imposed for purposes of discipline or 
convenience. When a restraint is applied or used, the purpose of the 
restraint is reviewed and

[[Page 852]]

is justified as a therapeutic intervention and documented in the 
participant's clinical record.
    (i) Chemical restraint is the inappropriate use of a sedating 
psychotropic drug to manage or control behavior.
    (ii) Physical restraint is any method of physically restricting a 
person's freedom of movement, physical activity or normal access to his 
or her body.
    (2) The program management uses a system to achieve a restraint-free 
environment.
    (3) The program management collects data about the use of 
restraints.
    (4) When alternatives to the use of restraint are ineffective, 
restraint is safely and appropriately used.
    (b) Abuse. (1) The participant has the right to be free from mental, 
physical, sexual, and verbal abuse or neglect, corporal punishment, and 
involuntary seclusion.
    (i) Mental abuse includes humiliation, harassment, and threats of 
punishment or deprivation.
    (ii) Physical abuse includes hitting, slapping, pinching, kicking or 
controlling behavior through corporal punishment.
    (iii) Sexual abuse includes sexual harassment, sexual coercion, and 
sexual assault.
    (iv) Neglect is any impaired quality of life for an individual 
because of the absence of minimal services or resources to meet basic 
needs. Neglect may include withholding or inadequately providing food 
and hydration, clothing, medical care, and good hygiene. It also 
includes placing the individual in unsafe or unsupervised conditions.
    (v) Involuntary seclusion is a participant's separation from other 
participants against his or her will or the will of his or her legal 
representative.
    (2) [Reserved]
    (c) Staff treatment of participants. The program management must 
develop and implement written policies and procedures that prohibit 
mistreatment, neglect, and abuse of participants and misappropriation of 
participant property.
    (1) The program management must--
    (i) Not employ individuals who--
    (A) Have been found guilty of abusing, neglecting, or mistreating 
individuals by a court of law; or
    (B) Have had a finding entered into an applicable State registry or 
with the applicable licensing authority concerning abuse, neglect, 
mistreatment of individuals or misappropriation of their property; and
    (ii) Report any knowledge it has of actions by a court of law 
against an employee, which would indicate unfitness for service as a 
program assistant or other program staff to the State oversight agency 
director and licensing authorities.
    (2) The program management must ensure that all alleged violations 
involving mistreatment, neglect, or abuse, including injuries of unknown 
source, and misappropriation of participant property are reported 
immediately to the State oversight agency director and to other 
officials in accordance with State law through established procedures.
    (3) The program management must have evidence that all alleged 
violations are thoroughly investigated, and must prevent potential abuse 
while the investigation is in progress.
    (4) The results of all investigations must be reported to the State 
oversight agency director or the designated representative and to other 
officials in accordance with State law within five working days of the 
incident, and appropriate corrective action must be taken if the alleged 
violation is verified.

(Authority: 38 U.S.C. 101, 501, 1741-1743)

(The Office of Management and Budget has approved the information 
collection requirements in this paragraph under control number 2900-
0160.)