This regulation establishes patients' rights to visitors in Maryland mental health facilities, defined as any public or private hospital, clinic, or institution providing treatment for mental disorders (excluding acute care general hospitals without a separately identified inpatient psychiatric service). Facility operators must post conspicuous notices of visiting hours, designate visitor areas, and ensure at least one hour of visiting time per day. Staff must follow documented procedures for restricting visitation (only for medically justified reasons, with physician orders expiring after 30 days), removing disruptive visitors, and honoring patient refusals to receive visitors.
View official sourceCode of Maryland Regulations Chapter 09 Patients' Rights to Visitors Administrative History Effective date: January 8, 1990 (16:26 Md. R. 2793) Authority Health-General Article, §§10-101(e) and 10-703, Annotated Code of Maryland .01 Scope. These regulations govern the rights of patients in all facilities as defined in Health-General Article, §§10-101(e) and 10-703, Annotated Code of Maryland. Pursuant to Health-General Article, §10-703, Annotated Code of Maryland, and for the safety and well-being of patients, their visitors and staff members, all of these facilities shall provide public notice to patients, family members, and friends of the hours allowed for visiting on facility grounds and the conditions under which visiting is permitted. .02 Definitions. A. The following terms have the meanings indicated. B. Terms Defined. (1) “Administration” means the Mental Hygiene Administration. (2) “Attorney” means a person licensed to practice law or the attorney's agent. (3) “Clergy” means an official of a recognized church, religious society, or congregation of any sect, order, or denomination. (4) “Disorderly manner” means conduct as defined by Criminal Law Article, §10-202, Annotated Code of Maryland . (5) “Drugs” means any medically unauthorized substance as defined by Criminal Law Article, §5-101(f), Annotated Code of Maryland . (6) “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 care general hospital that does not have a separately identified inpatient psychiatric service. (7) “Patient” means any individual receiving care and treatment in a facility. (8) “Physician” means an individual who is authorized to practice medicine under Health Occupations Article, Title 14, Annotated Code of Maryland . (9) “Professional staff” means any clinical staff who is either licensed or certified in a health care field or clinical staff in charge of a residential area. (10) “Visitor” means a person who is coming to see a patient and is not acting as an agent of the facility or the Maryland Department of Health. .03 Facility Visitation and Visiting Hours. A. All facilities shall provide a conspicuously posted notice to patients, family members, and friends of the hours allowed for visiting on facility grounds and the conditions under which visiting is permitted. B. Visitation procedures and visiting hours shall be reasonable and each facility shall allow for visiting hours for at least 1 hour per day for each day of the week. C. Each facility administrator shall be responsible for ensuring that these regulations are available for review and shall post notice of the facility's visiting hours in a prominent location. D. Visiting hours do not apply to the patient's clergy or attorney who may visit the patient at any reasonable hour. E. Visiting hours do not apply during those times a person visits the patient at the request of the treatment team. F. Patients who wish to visit with children under the age of 12 may request a suitable location from the staff for the visit. .04 Visitation Areas. A. Specific areas shall be designated as visitor areas and may be subject to supervision by facility staff. B. Patients shall have the right to converse in private subject to the restrictions of Health-General Article, §10-703(c), Annotated Code of Maryland. C. Visitors may not be allowed on the patient units without staff permission or supervision, or both. D. Visiting may not be allowed in seclusion rooms. .05 Procedures Pertaining to Visitors. A. Staff may not provide child care services for visitors. B. Visitors who leave children unattended and without adequate supervision shall be asked to correct the situation or shall be expected to terminate the visit immediately. .06 Visitor Behavior. A. Specific visitor behaviors that are prohibited include, but are not limited to: (1) Verbal or physical abuse or both of staff or patients; (2) Drinking of alcoholic beverages; (3) Use of drugs; (4) Distribution of alcoholic beverages or drugs; (5) Intoxication when on the premises; (6) Disregard for patient or staff safety; (7) Assaultive behavior; or (8) Acting in a disorderly manner. B. The staff may ask visitors to remove from the facility any items or to submit the items to search. Specific notice to this effect shall be posted conspicuously at all times. .07 Procedures for Removal of Visitors. A. Professional staff shall request any visitor who jeopardizes the care or treatment of patients or the safety of patients, staff, or other visitors to leave the facility immediately and explain at the time of the request the reason or reasons for making the request. B. Whenever a visitor refuses to leave, the visitor shall be informed that the facility police or law enforcement agencies shall be called immediately to escort the visitor off facility premises. C. If the visitor continues to resist, formal arrest procedures may be initiated. D. Specific notice to this effect shall be posted conspicuously at all times. .08 Documentation. A. Incidents. (1) Any visitor behavior that leads to removal of the visitor from the premises shall be documented. (2) Any incident that requires police intervention shall be reported and documented in accordance with facility procedures. (3) Whenever a visitor is removed from the facility as a result of their disorderly manner, the treatment team shall review the incident and determine what restrictions, if any, shall be placed on the individual's future visiting privileges. (4) If restrictions are placed on an individual's future visiting privileges, the restrictions shall be subject to the requirements identified in Regulation .08B of this chapter . B. Patient Restriction. (1) Visitation shall be restricted only for a medically justified reason, and may not be used as a means of punishment. (2) The physician's order restricting patient visitation rights shall: (a) Be written as an order in the patient's permanent record; (b) Be subject to ongoing review; (c) Automatically expire after 30 calendar days; and (d) Be rewritten, if necessary, subject to the provisions of this subsection. (3) The rationale for the restriction shall be noted in the patient's permanent record and signed by the physician. (4) Restrictions shall be documented in the patient's individualized treatment plan as defined in COMAR 10.21.03 . (5) A member of the treatment team shall inform the patient in a timely fashion of the restriction, its rationale, and the length of time the restriction is in effect. (6) With the consent of the patient, visitors shall be informed by the facility's Clinical Director, or the Clinical Director's designee, that a patient's visits are restricted and the length of time that the restriction is in effect. (7) Upon request and with the consent of the patient, a visitor shall receive written notification of the restriction or restrictions. .09 Patient's Refusal to Receive Visitors. A. Whenever a patient refuses visitors, the refusal shall be noted in the patient's records and may be reviewed by the treatment team. B. The patient's refusal shall be honored. C. With the consent of the patient, visitors shall be informed in a timely manner of the patient's refusal. D. When a patient refuses to receive a visitor and refuses to permit the facility to inform the visitor of the patient's refusal, the facility's communications with the visitor shall be consistent with these wishes. .10 Procedures Pertaining to Complaints. Complaints about the individual application of this chapter may be addressed through any patient grievance mechanism.