It is the policy of the Cleveland Clinic Florida locations to sensitively respond to patients’ individual needs and wishes regarding visitation of their family and friends while maintaining a therapeutic and restful environment, and to ensure consistency and satisfaction in all patient and guest interactions in compliance with state law.

Definitions

Compassionate Exception: As used throughout this Policy, the word “Compassionate Exception” refers to circumstances in which any existing in-person visitation limits may be waived to allow for patient support. Such instances may include, but are not limited to: End of life, patient struggling with change in environment, patient making major medical decision, patient experience emotional distress or grief, patient that needs cueing to eat or drink previously provided by family, patient who used to talk that is seldom speaking, labor and delivery, pediatric patients, or other circumstances in which the care team deems the patient’s care would be enhanced by visitor support.

Essential Caregiver: As used throughout this Policy, the word “Essential Caregiver” refers to an individual the patient designates as a visitor who must be permitted at least 2 hours daily in- person visitation, despite any other restrictions, provided “Essential Caregiver” follows any and all hospital policies and procedures. This refers to the definition provided in “No Patient Left Alone Act.”

Family: As used throughout this Policy, the word “Family” means any individual who plays a significant roles in an individual’s life such as spouses, domestic partners, children, significant others (of all genders – same and different), and other individuals not legally related to the patient. “Family” includes a minor patient’s parents, regardless of the gender of either parent.

Parent: As used throughout this Policy, the word “Parent” includes a minor patient’s parents, regardless of the gender of either parent. Solely for purposes of this policy, the word “parent,” and the concept of parenthood is to be liberally construed without limitation as encompassing biological parents, legal parents, foster parents, same-sex parents, step-parents, and those serving in loco parentis, and other persons operating in caretaker roles, consistent with state law. Parent(s)/guardian(s) always have access to visit a minor child and are responsible for approving any other visitors.

Support Person: As used throughout this Policy, the word “Support Person” means the person exercising the patient’s visitation rights on his or her behalf, should the patient be unable to do so.

Policy Implementation

  • Cleveland Clinic Florida locations grant full and equal visitation access to all individuals designated by the patient or their Essential Caregiver and Support Persons (defined above). Individual patient preferences will be honored at all times subject to any clinically necessary or reasonable restrictions or limitations, described more fully below.
  • Cleveland Clinic Florida locations welcome and encourage patients to choose their own visitation, including family, friends, and visitors who are same-sex partners. Cleveland Clinic Florida locations do not restrict, limit, or otherwise deny visitation privileges on any grounds including, but not limited to, on the basis of age (subject to reasonable restrictions applicable to minor visitation, described below), race, color, national origin, culture, ethnicity, language, socioeconomic status, religion, physical or mental disability, sex, sexual orientation, or gender identity or expression. All visitors enjoy full and equal visitation privileges consistent with patient preferences.
  • Each patient (or their Essential Caregiver/Support Person where applicable) is to be informed of their visitation rights, including the right to receive visitors whom he or she designates (whether a spouse, a domestic partner –including a same-sex partner, another family member or friend), and to withdraw or deny such consent at any time. Patients are also to be informed of any clinical restrictions or limitations on such rights. This information is to be provided before care is furnished to a patient whenever possible through online posting and the “Essential Caregiver” will be asked within admission processes. Parent(s)/guardian(s) always have access to visit a minor child and are responsible for approving visitors for the minor child.
  • Any applicable infection control and education policies for visitors, as well as visitation hours or limits including lengths of stay or number of visitors, will be made available. An Essential Caregiver shall always receive the ability to visit for at least two hours daily. No proof of vaccination shall be required for visitor privileges.
  • Any infection prevention protocols required of visitors will not be more stringent than what is required of Cleveland Clinic Florida employees and staff.
  • Upon inpatient admission, a patient should be given the ability to designate an Essential Caregiver and this will be labeled within the medical record. Should a patient decline such designation, this will also be notated in the medical record. At any time during an admission, with nursing assistance, a patient may wish to change the individual designated Essential Caregiver.
    • An Essential Caregiver conveys visitation rights and not decision making rights for medical treatment or related decisions.
    • If a patient becomes incapacitated and unable to designate an Essential Caregiver, and two or more individuals claim to be the patient’s Essential Caregiver, the following are examples of sources that may be consulted to establish Essential Caregiver:
      • Patient’s advance directive.
      • Patient’s durable power of attorney for healthcare.
      • Patient’s mental health declarations.
      • Evidence of a shared residence.
      • Evidence of shared ownership of a property or business.
      • Evidence of finance interdependence.
      • Evidence of martial/relationship status.
      • Existence of a legal relationship recognized in any jurisdiction (including parent-child, civil union, marriage, or domestic partnership).
      • Acknowledge of a committed relationship (Affidavit).
      • Any written documentation of the patient’s chosen Support Person, even if it is not a legally recognized advance directive.
      • Documents such as (but not limited to) licenses, state identification cards, bank statements, deeds, and lease agreements are examples of the other types of documentation that may be consulted to make this determination.
  • Consensual physical contact between a patient and the visitor must be allowed.
  • Any limits on the number of visitors shall be considered with Compassionate Exceptions available.
  • Notwithstanding any provision in this Policy, any reasonable restriction or limitation on visitors may be made for clinical, safety, or other reasons. This includes instances in which visitor behavior creates a disturbance that disrupts patient care. In situations in which it may be necessary for patient visitation to be limited or restricted, the reasons for the limitation or restrictions shall be clearly explained to the patient.
  • The ombudsman office will serve as the person designated to assist with ensuring adherence to the policies or procedures.
  • This Policy will be provided to the Agency for Health Care Administration (AHCA) on any initial licensure, license renewal or change of ownership, upon request, and will be on website within 24 hours of establishment.

Regulatory requirement/references

42 C.F.R. 482.13
75 Fed. Reg. 70831
The Joint Commission. RI 01.01.01 Title VI, Civil Rights Act of 1964

Florida Statute 408.823 – “No Patient Left Alone Act”

Oversight and responsibility

Patient Visitation Task Force is responsible to review, revise, update, and operationalize this policy to maintain compliance with regulatory or other requirements.

It is the responsibility of each hospital, institute, department and discipline to implement the policy and to draft and operationalize related procedures to the policy if applicable.

  1. Managers and supervisors in Patient Access Services (PAS), Nursing, Ombudsman, and Protective Services are responsible for the operational success of the Patient Visitation Policy. They are responsible for education, training and monitoring compliance.
  2. Clinical personnel are responsible for following standard operating procedures developed for their respective assigned units/departments.

Other background information

Issuing Office: Corporate Compliance

Patient Visitation Task Force:

Accreditation; Corporate Compliance; Office of Diversity; Government Relations; Law Department; Nursing; Office of Patient Experience; Ombudsman; Protective Services

Affinity Nursing Groups (Behavioral Medicine Affinity Group, Bone Marrow Affinity Group, Critical Care Affinity Group, ED Affinity Group, Obstetrics Affinity Group, Women & Children’s Affinity Group