In a call with reporters on Wednesday, Health and Human Services Department officials discussed the final rules submitted today regarding hospital visitation policies for hospitals that receive Medicare or Medicaid funding.
Hospitals participating in either program are required under the rules to allow a patient "to receive the visitors whom he or she designates -- regardless of sexual orientation or gender identity." A Centers for Medicare & Medicaid Services (CMS) official told reporters, "I think it would be the rare hospital that did not participate in the Medicare program."
If a hospital fails to meet its obligations under the new rules, an HHS official said, "Hospitals must provide a plan of correction -- with a very tight timeframe. If they fail to do so, they are at some risk to have their Medicare" eligibility cut.
Among the rules are:
(1) Inform each patient (or support person, where appropriate) of his or her visitation rights, including any clinical restriction or limitation on such rights, when he or she is informed of his or her other rights under this section.
(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.
(3) Not restrict, limit, or otherwise deny visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation, or disability.
Among the comments received and responses offered was one that related to issues with an incapacitated patient:
Comment: Several commenters stated that written documentation of patient representation in the form of legally valid advance directives, such as durable powers of attorney and healthcare proxies, (as opposed to oral designation of the support person by the patient) should be required only in the very rarest of cases – such as when more than one person claims to be a patient’s spouse, domestic partner, or surrogate. In all other cases, oral confirmation of an individual acting as the support person should suffice. Commenters suggested that a hospital or CAH may not require documentation in a discriminatory manner.
Response: In the preamble, we specifically asked for comments on how to best identify those rare cases where hospitals and CAHs should be permitted to ask for written documentation to establish the support person as such in order to allow the support person the right to designate visitors if the patient is unable to do so. We appreciate the comments offered on this issue. We agree that this practice would most clearly be justified in those rare cases where the hospital or CAH faces a dispute among two or more persons claiming to be the patient’s support person, and the patient is incapacitated.
The change will take effect 60 days after publication.
Read the responses to comments and final rule: 2010-29194_PI.pdf