Enhanced Non-Lethal Security Blog

    Free Virtual Panel 4/30: Decoding The CMS Rule Book For Dealing with Violent Patients

    Posted by Tony York on Apr 15, 2015

    Understanding CMS’ "use of weapons" rule can have profound impacts when it comes to determining which risk mitigation and response strategies are right for your hospital.


    The corollary is also true: misunderstanding CMS guidelines is having a tremendous impact on administrators’ response preferences. From what we’ve seen, it’s not uncommon for a hospital to decide against arming their security officers for no better reason than they believe that CMS regulations prohibit unsworn officers from carrying stun guns, batons or pepper spray in a hospital setting.


    However, more often than not, these beliefs are misguided and can result in costly mistakes.


    What administrators may not realize is that, by choosing an unarmed response, the hospital is taking on a different risk in the form of injuries to staff and patients, disability claims and patient lawsuits -- not to mention higher levels of hospital staff turnover in higher risk environments. In fact, a study by the National Institute of Justice found that confrontations in which officers went hands-on with an aggressor in order to gain control were more far more likely to last longer and result in injuries than confrontations that were subdued in the first use of force. HSS’ experience is consistent with the study’s findings, and we’ve been equipping staff members with conducted electrical weapons (Tasers) since 2006. We’ve also had staff members carry handcuffs since our inception.


    We believe it’s essential to cut through the clutter of CMS’ lengthy and seemingly conflicting guidelines in order to get a clear understanding of when CMS considers the use of firearms or intermediate devices by security staff to be a law enforcement action versus a health care intervention. Specifically, CMS says that under no circumstances should handcuffs ever be used against a patient to render medical care. And, they say the same thing about the use of any other use of force or defensive equipment. On the other hand, a response can be considered a law enforcement action when the threat of violence or assault by a patient is deemed immediate and unavoidable.


    The challenge our industry faces is that, while CMS goes to great lengths to describe when NOT to use force, they have not provided explicit guidance for when to use which defensive devices, and for what purpose. So understanding the CMS rule book for dealing with violent patients is a complex and significant question for all of us.


    These are just some of my initial thoughts. What are your thoughts or questions about the impacts of CMS on hospital security? Please share them here.


    On April 30th at 2 pm ET, I’ll continue this conversation live as part of an all-star panel of security experts that includes Mass General Hospital’s Bonnie Michelman, Universal Protection Service’ Rick Ward and Securitas’ Paul White.


    Join us?   You can register for the free panel today.


    Guardian 8 COO Paul Hughes will moderate the discussion, which will cover impacts of CMS regulations on hospital security and how a clear understanding of CMS’ “use of weapons” rule can dramatically change the way hospitals evaluate risk mitigation and response strategies. We will also talk about newly available intermediate response options and which topics should be covered when training officers in unarmed, intermediate and armed response.

    Tony is the Chief Operating Officer and Senior Vice President of Security for HSS, Denver, one of the nation’s leading specialized services outsourcing firms. York is responsible for directing the efforts of the HSS Healthcare Security division to develop programs that help hospitals and healthcare providers prevent and mitigate aggression and violence in their facilities and ensure the security and safety of their staff, patients, and visitors.

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