Accreditation & Quality Compliance Center
By A. J. Plunkett
December 23, 2019
As of January 1, CMS eliminated the paper version of the form to report patient deaths associated with restraint or seclusion. Form CMS-10455 must be filed through an electronic version.
CMS announced the new electronic form and provided instructions on how to use it, including a video, in an Quality, Safety & Oversight Group memo, on December 2, 2019. Memo #QSO-20-04-Hospital-CAH DPU, “Electronic Form CMS-10455, Report of a Hospital Death Associated with Restraint or Seclusion,” can be found online here.