CMS Moves Restraint and Seclusion Death Reporting Form to New Digital Platform
(Oct. 2, 2026) – Effective Sept. 21, the Centers for Medicare & Medicaid Services transitioned Form CMS-10455 — Report of a Hospital Death Associated with the Use of Restraint or Seclusion — from Qualtrics to iQIES.
Hospitals and Critical Access Hospital distinct part units must submit the form, now available directly through iQIES.
To help facilities adjust to the new platform, CMS shared a brief instructional video on completing and submitting the electronic form.
Additional information about this change is available in this CMS memo.
--Larry Van Der Wege