42 CFR § 460.114 - Restraints.

---
identifier: "/us/cfr/t42/s460.114"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 460.114 - Restraints."
title_number: 42
title_name: "Public Health"
section_number: "460.114"
section_name: "Restraints."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "E"
subchapter_name: "PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)"
part_number: "460"
part_name: "PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302, 1395, 1395eee(f), and 1396u-4(f)."
regulatory_source: "64 FR 66279, Nov. 24, 1999, unless otherwise noted."
cfr_part: "460"
---


# 460.114 Restraints.

(a) The PACE organization must limit use of restraints to the least restrictive and most effective method available. The term restraint includes either a physical restraint or a chemical restraint.

(1) A physical restraint is any manual method or physical or mechanical device, materials, or equipment attached or adjacent to the participant's body that he or she cannot easily remove that restricts freedom of movement or normal access to one's body.

(2) A chemical restraint is a medication used to control behavior or to restrict the participant's freedom of movement and is not a standard treatment for the participant's medical or psychiatric condition.

(b) If the interdisciplinary team determines that a restraint is needed to ensure the participant's physical safety or the safety of others, the use must meet the following conditions:

(1) Be imposed for a defined, limited period of time, based upon the assessed needs of the participant.

(2) Be imposed in accordance with safe and appropriate restraining techniques.

(3) Be imposed only when other less restrictive measures have been found to be ineffective to protect the participant or others from harm.

(4) Be removed or ended at the earliest possible time.

(c) The condition of the restrained participant must be continually assessed, monitored, and reevaluated.