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Nursing Home
Visitation Rights
By: Dan Frith
Federal
Law Regarding Visitation
The federal law governing nursing home regulation is called
the Nursing Home Reform Act of 1987. The Act says
that the resident has the right and the facility must
provide for immediate access to any resident by immediate
family or other relatives of the resident, subject to the
resident’s consent. Under the Act, visits by others are
subject to “reasonable restrictions” and the resident’s
consent. Consumers should note that the “reasonable
restrictions” provision does not apply to immediate family
and other relatives of the resident. The Act also says
that the facility must provide “reasonable access” to
individuals providing health, social, or legal services to
the resident. These provisions of the law clearly support a
resident’s right to have access to individuals of their
choosing.
Why Visits Are Important
Building
Relationships – Family members and friends can be important sources of information for facility staff about a resident’s past work,
habits, hobbies, likes and dislikes. By visiting frequently
and talking with staff, you can help build a relationship
between your loved one and the staff and make sure his/her
preferences are respected.
Building a relationship with
staff members can make it easier to express concerns about
care, and creates opportunities for giving positive feedback
when care is provided well. Effective communication helps
promote quality care.
Regular visitors should also build and maintain
relationships with other residents and families. This
practice will be helpful to the many residents who receive
no visitors and may help you enlist some extra sets of eyes
to look in on your loved one when you are not there.
Monitoring Care and Advocating – Family members and
friends can be an important support for residents who are
unable to advocate for themselves because of frailty or
dementia. Frequent visits help family members and friends
become familiar with the care that is being provided. This
familiarity makes it easier to recognize problems with
caregiving practices and can help consumers formulate
suggestions for solutions based on first-hand knowledge.
Emotional Support – Moving to a nursing home
can be an isolating and depressing experience. Regular
visits from family and friends help keep residents connected
to their social support network and the community. This
support can help make the transition to nursing home life
easier. A resident with dementia can often be reassured by
the familiar face of a family member or friend, which may
assist with her orientation to the new environment.
Privacy
One important component for a
visit in a nursing home is privacy. Private space may be
found in the resident’s room, on an outdoor patio, or in a
vacant dining or activity room. The facility should ensure
that private space is available for visits with residents.
Limitations on Visitation
Unfortunately, sometimes a
facility may try to limit visitation with a resident in the
following ways:
Visiting Hours – Many facilities post visiting hours. Sometimes, family
members assume or the facility states that those visiting
hours apply to all visitors to the facility including
immediate family and relatives of the residents. Immediate
family or other relatives of the resident are not subject to
visiting hour limitations or other restrictions not imposed
by the resident. In fact, it may be a good idea for family
members to make some visits during off hours to monitor the
care given to their loved one. If a visit will infringe on
the rights of other residents in the facility (Ex. a noisy
visit in a resident’s room if their roommate is sleeping),
it is reasonable for a facility to require the visit to take
place in another location within the facility.
Infection Control – When several
residents have infections of some kind, many nursing homes
will restrict access to particular units to try to limit the
spread of infection. If you feel comfortable with the care
your loved one is receiving, you should try to respect these
restrictions (especially if you are susceptible to infection
yourself). The facility can recommend that family
members and friends not visit, but may not prohibit it
unless there is an official quarantine.
Supervised Visits – Sometimes
facility staff may accuse a family member or friend of
frightening, upsetting, or harming the resident. The
facility may then insist that a staff member supervise
visits by that family member. The facility may only do this
legally if they have a court order or if they have a good
faith belief that there is a real and immediate threat to
the safety, health and welfare of the resident. Visitors
who are subject to supervised visits should seek legal
counsel.
Barring visits – Very few reasons exist for a facility to completely stop
visitation. The facility may only legally bar visitors if
there is a court order or a good faith belief that there is
a real and immediate threat to the safety, health and
welfare of the resident or a serious violation of residents'
rights. The facility must then obtain a legal restraining
order as soon as possible. Those who are barred from
visiting may wish to contact the ombudsman or seek legal
counsel providing a record of who barred them, how and why.
Power of Attorney or
Guardian restricting visits – In some cases, if there is division among family members or
if a resident has been assigned a guardian, the power of
attorney or guardian may try to restrict visits by other
family members or individuals who raise concerns about care
or seem to be creating problems for the resident. Persons
who experience these restrictions should investigate the
state’s law with regard to guardianship or power of
attorney. Even if the resident has dementia, every effort
should be made to determine what the resident's wishes are,
or would have been, with regard to receiving visits from an
individual. These wishes should be respected.
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Dan Frith
is the founding partner of Frith Law Firm, P.C.,
a firm
focusing on medical malpractice, nursing home abuse, personal injury, lead paint poisoning and business torts. Copyright © 2004 by
Frith Law Firm, P.C. All rights reserved under U.S.
and international law.
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