(2) Inform each patient (or support person, where appropriate) of the right,
subject to his or her consent, to receive the visitors whom he or she designates,
including, but not limited to, a spouse, a domestic partner (including a same-sex
domestic partner), another family member, or a friend, and his or her right to
withdraw or deny such consent at any time.
Interpretive Guidelines §482.13(h)(1)&(2)
Hospitals are required to inform each patient (or the patient’s support person, where
appropriate) of his/her visitation rights. A patient’s “support person” does not necessarily
have to be the same person as the patient’s representative who is legally responsible for
making medical decisions on the patient’s behalf. A support person could be a family
member, friend, or other individual who supports the patient during the course of the
hospital stay. Not only may the support person visit the patient, but he or she may also
exercise a patient’s visitation rights on behalf of the patient with respect to other visitors
when the patient is unable to do so. Hospitals must accept a patient’s designation, orally or
in writing, of an individual as the patient’s support person.
When a patient is incapacitated or otherwise unable to communicate his or her wishes and
an individual provides an advance directive designating an individual as the patient’s
support person (it is not necessary for the document to use this exact term), the hospital
must accept this designation, provide the required notice of the patient’s visitation rights,
and allow the individual to exercise the patient’s visitation rights on the patient’s behalf.
When a patient is incapacitated or otherwise unable to communicate his or her wishes, there
is no advance directive designating a representative on file, and no one has presented an
advance directive designating himself or herself as the patient’s representative, but an
individual asserts that he or she, as the patient’s spouse, domestic partner (including a
same-sex domestic partner), parent or other family member, friend, or otherwise, is the
patient’s support person, the hospital is expected to accept this assertion, without
demanding supporting documentation, provide the required notice of the patient’s
visitation rights, and allow the individual to exercise the patient’s visitation rights on the
patient’s behalf. However, if more than one individual claims to be the patient’s support
person, it would not be inappropriate for the hospital to ask each individual for
documentation supporting his/her claim to be the patient’s support person.
• Hospitals are expected to adopt policies and procedures that facilitate expeditious
and non-discriminatory resolution of disputes about whether an individual is the
patient’s support person, given the critical role of the support person in exercising
the patient’s visitation rights.
• A refusal by the hospital of an individual’s request to be treated as the patient’s
support person with respect to visitation rights must be documented in the patient’s
medical record, along with the specific basis for the refusal.
Consistent with the patients’ rights notice requirements under the regulation at
§482.13(a)(1), the required notice of the patient’s visitation rights must be provided,
whenever possible, before the hospital provides or stops care. The notice to the patient, or
to the patient’s support person, where appropriate, must be in writing. If the patient also
has a representative who is different from the support person, the representative must also
be provided information on the patient’s visitation rights, in addition to the support person,
if applicable. In the event that a patient has both a representative and a support person who
are not the same individual, and they disagree on who should be allowed to visit the patient,
the hospital must defer to the decisions of the patient’s representative. As the individual
responsible for making decisions on the patient’s behalf, the patient’s representative has the
authority to exercise a patient’s right to designate and deny visitors just as the patient would