On Wednesday the Department of Health and Human Services announced new guidelines to support the enforcement of rules that protect hospital visitation rights and the right of patients to choose who is allowed to visit them during a hospital stay, with a particular focus on shoring up the rights of same-sex domestic partners.
The rules announced by the Obama administration last year and finalized by the Centers for Medicare & Medicaid Services (CMS) in November, apply to all hospitals that currently participate in Medicare and Medicade programs. The guidance released this week reinforces the right of patients to designate a person of their choice to make medical decisions on their behalf should they become incapable of communicating their wishes. This specifically includes same-sex partners.
While the rule changes effect only Medicaid and Medicare-participating hospitals, the rules apply to all hospital patients within those facilities and not just those in such assistance programs. This right to designate a decision-maker is to be enforced “whether expressed in writing, orally, or through other evidence” unless otherwise prohibited by state law. The guidance also spells out that if hospitals are found to have unlawfully ignored this right, they may have their funding cut.
“Couples take a vow to be with each other in sickness and in health and it is unacceptable that, in the past, some same-sex partners were denied the right to visit their loved ones in times of need,” said HHS Secretary Kathleen Sebelius. “We are releasing guidance for enforcing new rules that give all patients, including those with same-sex partners, the right to choose who can visit them in the hospital as well as enhancing existing guidance regarding the right to choose who will help make medical decisions on their behalf.”
The rules updated the Conditions of Participation (CoPs), which are the health and safety standards all Medicare- and Medicaid-participating hospitals and critical access hospitals must meet, and apply to all patients of those hospitals even if they are not on Medicare or Medicaid. Among other things, the CoPs require hospitals to explain to all patients their right to choose who may visit them during their inpatient stay, regardless of whether the visitor is a family member, a spouse, a domestic partner (including a same-sex domestic partner), or another type of visitor, as well as their right to withdraw such consent to visitation at any time.
CMS today sent a letter to State Survey Agencies, which conduct on-site inspections of hospitals on behalf of CMS. The letter highlights the equal visitation and representation rights requirements and directs SSAs to be aware of the guidance when evaluating hospitals’ compliance with CoPs.
“This announcement is another step toward equal rights for all Americans, and it is another step toward putting the patient at the center of our health care system,” said CMS Administrator Donald M. Berwick, M.D. “All patients should be afforded the same rights and privileges when they enter our health care system, and that includes the same opportunity to see their significant other.”
In related news the U.S. Health Resources and Services Administration (HRSA), another agency of the Department of Health and Human Services, this week announced that it will be giving a $248,000 grant to the Fenway Institute to create a National Training and Technical Assistance Center to help community health centers improve the health of lesbian, gay, bisexual and transgender (LGBT) people. Read more about that here.