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Medicare Finalizes New Rules to Require Equal Visitation Rights for All Hospital Patients

Posted Nov 17 2010 6:34pm

New requirements empower patients to designate their own visitors, 
including a same-sex domestic partner

The Centers for Medicare & Medicaid Services (CMS) today issued new rules for Medicare- and Medicaid-participating hospitals that protect patients’ right to choose their own visitors during a hospital stay, including a visitor who is a same-sex domestic partner.

“Basic human rights—such as your ability to choose your own support system in a time of need—must not be checked at the door of America’s hospitals,” said HHS Secretary Kathleen Sebelius.  “Today’s rules help give ‘full and equal’ rights to all of us to choose whom we want by our bedside when we are sick, and override any objection by a hospital or staffer who may disagree with us for any non-clinical reason.”

The new rules follow from an April 15, 2010 Presidential Memorandum, in which President Obama tasked HHS with developing standards for Medicare- and Medicaid-participating hospitals (including critical access hospitals) that would require them to respect the right of all patients to choose who may visit them when they are an inpatient of a hospital.  The President’s memorandum instructed HHS to develop rules that would prohibit hospitals from denying visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability.  It also directed that the rules take into account the need for a hospital to restrict visitation in medically appropriate circumstances.

The rules require hospitals to have written policies and procedures detailing patients’ visitation rights, as well as the circumstances under which the hospitals may restrict patient access to visitors based on reasonable clinical needs.

A key provision of the rules specifies that all visitors chosen by the patient (or his or her representative) must be able to enjoy “full and equal” visitation privileges consistent with the wishes of the patient (or his or her representative). 

The rules update the Conditions of Participation (CoPs), which are the health and safety standards all Medicare- and Medicaid-participating hospitals and critical access hospitals must meet, and are applicable to all patients of those hospitals regardless of payer source.

Among other things, the rules impose new requirements on hospitals to explain to all patients their right to choose who may visit them during their inpatient stay, regardless of whether the visitor is a family member, a spouse, a domestic partner (including a same-sex domestic partner), or other type of visitor, as well as their right to withdraw such consent to visitation at any time. 

“These rules put non-clinical decisions about who can visit a patient out of the hands of those who deliver care and into the hands of those who receive it,” said CMS Administrator Donald Berwick, MD, MPP.  “While we still have miles to go in making care more patient-centered, these rules make it easier for hospitals to deliver on some of the fundamental tenets of patient-centered care—care that recognizes and respects the patient as an individual with unique needs, who treated with dignity and granted the power of informed choice.”

CMS finalized the rules based on thousands of comments from patient advocates, the hospital community, and other stakeholders.  The rules will be effective 60 days after publication.  More information about the rules is available on CMS’ website at http://www.cms.gov/CFCsAndCoPs/06_Hospitals.asp and http://www.cms.gov/CFCsAndCoPs/03_CAHs.asp .

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