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Nursing homes exist to provide skilled care for elderly residents who are no longer able to care for themselves without assistance or whose care needs exceed the ability of their families. A nursing home provides 24-hour care, seven days per week for residents. The vast majority of nursing home residents have Medicare or Medicaid coverage to provide for their care. These government agencies guarantee residents specific rights in the Centers for Medicare and Medicaid Services (CMS), including the right to receive visitors at any time.
In September of 2016, CMS released its revised regulations for nursing home facilities. These regulations protect the residents’ rights, including the right to receive visitors without restrictions. The regulations are not specific to Arizona or any other state but apply nationwide to any facility that accepts Medicare or Medicaid reimbursement. These rights and protections include the right to be free from discrimination, the right to be treated with care, dignity, and respect, and the right to make a personalized schedule for rising and sleeping. The protections guaranteed under the revised nursing home facility regulations include the right to be free of abuse, neglect, and the unreasonable use of restraints.
Among the rights and protections guaranteed to residents of all nursing homes that accept Medicare and Medicaid is the right to have visitors with unrestricted time limits, visiting hours, and violation of privacy rights.
Nursing home residents have the right to receive visitors at any reasonable time on any day of the week under the CMS revised regulations for nursing home facilities. This includes the following rights:
Any immediate family members must also be allowed immediate access to the resident at any time unless the resident has stated a preference against receiving the visitor. Non-relative visitors should also have immediate unfettered access to the resident except where safety or clinical restrictions apply (such as during the COVID-19 pandemic) or if a visitor has been caught abusing or financially exploiting the nursing home resident.
Nursing homes must have written policies and procedures for limiting access to non-immediate family members due to reasonable safety or clinical concerns.
All nursing home facilities that accept Medicare and Medicaid must inform residents (or their representatives if the resident has cognitive impairment) of their rights, including their right to unfettered visitation. Visitation rights include spouses and domestic partners, including same-sex domestic partners and spouses. If the facility puts restrictions in place for safety or clinical reasons, they have a duty to explain the restriction to the resident and/or their family members and visitors.
Included in the CMS revised regulations, is the right to privacy, including during visitation or phone calls. If nursing home staff attempt to monitor visits or phone calls from family members, advocates, or government agency representatives, it is an unlawful restriction on the resident’s rights to privacy. The right to privacy includes privacy for phone calls, Facetime calls, Zoom meetings, and privacy while opening or reading mail.
If nursing home administrators or caregivers deny a resident’s rights to visitors or attempt to restrict visitation, there are steps to take to assert their rights under the federal guidelines. First, the resident or their advocate should ask for a copy of the facility’s policies and procedures, including their visitation guidelines. If the facility attempts to limit visitation hours, residents, their visitors, and advocates have a right to protest that practice under the terms of the CMS revised guidelines. If a facility attempts to restrict evening visits because they interfere with a resident’s roommate’s right to privacy during sleeping hours, the resident can assert their right to enjoy evening visitors in a public sitting area.
Nursing home residents have a right to dispute inappropriate restrictions that violate federal guidelines even if the facility’s stated reason for restricting visitation from a non-family member is for a “reasonable safety concern.” Because different facilities attempt to interpret the word “reasonable” differently, they might infringe on a resident’s rights. A resident or their advocate should review the portion of the facility’s policies and procedures describing their interpretation of “reasonable safety and clinical concerns” and dispute any policy that infringes on their rights.
Residents, their family members, and their advocates have a right to dispute policies and make complaints against nursing home administrators without fear of reprisals from staff.
If a nursing home facility denies a resident’s right to unrestricted visitation, despite their disputing the unlawful policy, they or their advocate may reach out to a local ombudsman. An ombudsman serves as a mediator between nursing homes and residents to protect their rights, including their rights to unrestricted visitation in addition to their right to protection of their safety and dignity. They may also reach out to their state’s Survey Agency with their complaints. Survey agencies work with CMS to provide oversight for nursing homes, hospitals, and long-term care facilities and help ensure the protection of patients’ and residents’ rights.
Finally, residents and their advocates may file a lawsuit against a nursing home that continues to violate a resident’s rights, including their rights to safety, humane treatment, respect for their dignity, and the right to unrestricted visitors guaranteed to them by CMS.
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