1. A. In this chapter, the following terms have the meanings indicated.

2. B. Terms Defined.

   1. (1) Category I Restraint.

      1. (a) “Category I restraint” means a device identified by the facility which limits a patient's mobility to the extent that the patient would not be able to independently reposition himself or herself or would otherwise be rendered helpless in an emergency.
      2. (b) “Category I restraint” includes, but is not limited to, four-point restraints.
   2. (2) “Category II restraint” means any device which is not considered by the facility as a category I restraint and includes, but is not limited to, mittens and vests.
   3. (3) “Chief executive officer (CEO)” means the individual responsible for the overall management of a facility.
   4. (4) “Child” means an individual younger than 12 years old.
   5. (5) “Clinical director” means the psychiatrist in charge of the clinical care of all psychiatric patients in the facility.
   6. (6) “Emergency situation” means a situation in which a patient's behavior poses a serious and imminent danger to the physical safety of self or others.
   7. (7) “Facility” means any public or private hospital, clinic, or other institution that provides or purports to provide treatment or other services for a mental disorder, except an acute general hospital that does not have a separately identified inpatient psychiatric service.
   8. (8) “Full view” means the unobstructed view by the assigned staff of a restrained patient.
   9. (9) “Patient” means an individual receiving services for a mental disorder in a facility and includes any student receiving care and treatment in that facility.
   10. (10) “Physician” means an individual who is authorized to practice medicine under Health Occupations Article, Title 14, Annotated Code of Maryland.
   11. (11) “Protective device” means any adaptive or assistive device or devices which restrict the movement of the whole or a portion of a patient's body for the purpose of preventing unintentional harm to self or others or which are used for promoting or maintaining normative body functions.

   12. (12) Prone Restraint.

       1. (a) “Prone restraint” means restricting the free movement of all or a portion of a patient’s body through the use of physical force or mechanical devices while the patient is in a prone position.
       2. (b) “Prone restraint” does not mean a technique for transitioning a patient to a restraint position that involves momentarily placing the individual face down.
   13. (13) “Quiet room” means an unlocked room that patients are not physically prevented from leaving, which is designated for patients' voluntary use to allow them time out of the company of other patients.
   14. (14) “Registered nurse” means an individual who is licensed to practice registered nursing under Health Occupations Article, Title 8, Annotated Code of Maryland.

   15. (15) Restraint.

       1. (a) “Restraint” means:

          1. (i) Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move their arms, legs, body, or head freely; or
          2. (ii) A drug or medication when it is used as a restriction to manage the patient’s behavior or restrict the patient’s freedom of movement and is not a standard treatment or dosage for the patient’s condition.
       2. (b) “Restraint” does not include a helmet when used as a sole form of restraint or a protective device.
   16. (16) “Seclusion” means the involuntary confinement of a patient under the direction of a physician or registered nurse alone in a room which a patient is physically prevented from leaving.

   17. (17) “Trauma-informed care” means mental health treatment that includes:

       1. (a) An appreciation for the high prevalence of trauma experienced by individuals receiving mental health services;
       2. (b) An understanding of the neurological, biological, psychological, and social effects of trauma and violence, including sexual abuse and exploitation, on an individual; and
       3. (c) An understanding of the environment, practices, and treatments that may need to be modified to address trauma issues.
   18. (18) “Treatment team” means the patient's treatment team as defined in COMAR 10.21.03.02C.

Authority: Health-General Article, §§10-101(g) and 10-701, Annotated Code of Maryland

Effective date: October 25, 1993 (20:21 Md. R. 1654)

Regulation .01 amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .02B amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .03 amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .05 amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .06D amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .08D amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .09 amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation 10D amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .12D, F amended effective February 14, 2026 (52:23 Md. R. 1139)