Residents are to be free from mental and physical restraint.  There are to be no chemical and physical restraints unless authorized for a specific period of time by a physician according to a clear and indicated medical need.  This covers the use of psychotropic drugs, geri-chairs, high bed rails, or any other means of restricting a resident’s personal freedom.  42 U.S.C. §1396r(c)(1)(A)(ii).

 The federal rules make the same point concerning restraints at 42 C.F.R. §483.13(a) with specific language speaking to drug therapies appearing at 42 C.F.R. §483.25(1) barring “unnecessary drugs.”  The rule preamble [56 FR 48826, 48852 (9/26/91)] makes clear that while a physician may prescribe various drugs, the facility ultimately carries the responsibility for the resident’s health and safety.  Lastly, the rules restrict the introduction of anti-psychotic drugs (Thorazine, Mellarill, Navane, Haldol) except to treat specifically diagnosed conditions.