CHA News

CDPH Issues AFL Announcing New Electronic Process for Reporting a Death Associated with Restraint or Seclusion

For COOs, licensing & certification staff

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The California Department of Public Health has issued an All Facilities Letter notifying hospitals that the Centers for Medicare & Medicaid Services (CMS) no longer accepts paper forms for reporting deaths associated with restraint or seclusion, and that hospitals must report those deaths electronically.

Effective Jan. 1, CMS will accept only an electronically submitted Form CMS-10455. Paper versions of the form will trigger an automatic reply requesting the hospital use the electronic form to submit their death report. The electronic form features enhanced categories to collect information, which CMS will use to determine whether authorization of an onsite survey is warranted, as well as to provide rationale for its decisions.

The AFL provides details about hospitals’ reporting requirements and resources for learning more about the E-form, including where to find an instructional video and CMS contact information.