This section provides definitions for key terms used in the federal regulations governing Psychiatric Residential Treatment Facilities (PRTFs) for individuals under age 21, including definitions for restraint types (drug, mechanical, personal), seclusion, emergency safety interventions, and related concepts. Facility operators must understand and apply these definitions when implementing policies on restraint and seclusion use. The definitions establish the regulatory vocabulary for the entire subpart governing PRTF operations.
View official source§ 483.352 Definitions. For purposes of this subpart, the following definitions apply: Drug used as a restraint means any drug that— (1) Is administered to manage a resident's behavior in a way that reduces the safety risk to the resident or others; (2) Has the temporary effect of restricting the resident's freedom of movement; and (3) Is not a standard treatment for the resident's medical or psychiatric condition. Emergency safety intervention means the use of restraint or seclusion as an immediate response to an emergency safety situation. Emergency safety situation means unanticipated resident behavior that places the resident or others at serious threat of violence or injury if no intervention occurs and that calls for an emergency safety intervention as defined in this section. Mechanical restraint means any device attached or adjacent to the resident's body that he or she cannot easily remove that restricts freedom of movement or normal access to his or her body. Minor means a minor as defined under State law and, for the purpose of this subpart, includes a resident who has been declared legally incompetent by the applicable State court. Personal restraint means the application of physical force without the use of any device, for the purposes of restraining the free movement of a resident's body. The term personal restraint does not include briefly holding without undue force a resident in order to calm or comfort him or her, or holding a resident's hand to safely escort a resident from one area to another. Psychiatric Residential Treatment Facility means a facility other than a hospital, that provides psychiatric services, as described in subpart D of part 441 of this chapter, to individuals under age 21, in an inpatient setting. Restraint means a “personal restraint,” “mechanical restraint,” or “drug used as a restraint” as defined in this section. Seclusion means the involuntary confinement of a resident alone in a room or an area from which the resident is physically prevented from leaving. Serious injury means any significant impairment of the physical condition of the resident as determined by qualified medical personnel. This includes, but is not limited to, burns, lacerations, bone fractures, substantial hematoma, and injuries to internal organs, whether self-inflicted or inflicted by someone else. Staff means those individuals with responsibility for managing a resident's health or participating in an emergency safety intervention and who are employed by the facility on a full-time, part-time, or contract basis. Time out means the restriction of a resident for a period of time to a designated area from which the resident is not physically prevented from leaving, for the purpose of providing the resident an opportunity to regain self-control. [66 FR 7161, Jan. 22, 2001, as amended at 66 FR 28116, May 22, 2001]