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 if he or she were capable of doing so. The