On January 25, 2024, HHS Office for Civil Rights (OCR) issued guidance and responses to frequently asked questions regarding nondiscrimination regulations related to patient visitation. Hospitals, long term care facilities, and critical access hospitals that participate in Medicare and Medicaid have nondiscrimination obligations regarding patient visitation. Additionally, all entities that receive federal funding are obligated to comply with federal civil rights laws. These facilities must ensure that all patients enjoy visitation privileges in a nondiscriminatory manner. Patients do not have to be Medicare or Medicaid beneficiaries to have patient visitation rights.

For facilities subject to these federal laws and regulations, patients have the right to receive visitors without discrimination, and individuals with disabilities also have a right to be accompanied by a support person in specific situations.

There are several nondiscrimination regulations that prohibit discrimination in patient visitation policies. OCR enforces the prohibition on religious discrimination, and CMS enforces the prohibitions on discrimination on the basis of race, color, national origin, sex, gender identity sexual orientation or disability. During the COVID-19 pandemic, OCR received several complaints regarding patient visitation rights regarding religious discrimination. This new guidance set out to respond to many of these frequently asked questions.

All facilities must have written policies and procedures regarding patient visitation rights, including any clinically necessary or reasonable restrictions on visitation rights and the reasons for the clinical restriction or other limitation. Facilities may limit access as long as: (1) the restrictions are clinically necessary or otherwise reasonable; (2) the facility informs patients in advance whenever possible; (3) the policy is maintained in writing; and (4) visitation privileges are not restricted based on race, color, national origin, religion, sex, gender identity, sexual orientation, or disability. Visitation restrictions may also be based on safety reasons based on actual risks, such as limiting the number of patient visitors during the COVID-19 pandemic.

A facility may violate CMS regulations or federal civil rights laws if it subjects certain classes of visitors to additional screening or prohibits them from visitation. Facilities should ensure that religious leaders or other spiritual support persons from particular faiths are not discriminated against. Facilities must also not base a visitation policy or procedure based on stereotypes about communities and communicable diseases. Patients have the right to receive visitors of their choosing (both in-person or virtually), which can only be limited by clinically necessary or reasonable restrictions. This includes clinically necessary or reasonable restrictions on interactions with visitors, such as requiring visitors to wear protective gear during a communicable disease outbreak. There are additional protections for special access to residents of long-term care facilities.

OCR’s FAQs on patient visitation can be found here.