Visitation Rights

Effective April 18, 2023, Alabama Code § 22-21-437 (known as the “Harold Sachs and Anne Roberts Act”) provides that a resident, client, or patient of an Alabama general acute care hospital, long-term care facility, skilled nursing facility (nursing home), intermediate care facility, assisted living facility, or specialty care assisted living facility (a “health care facility”) has the right to be visited by anyone of his or her choosing during the health care facility's visiting hours, subject to the requirements of the facility’s policies and procedures. Health care facilities designated for psychiatric care, including psychiatric hospitals, and any unit, ward, floor, wing, or other area of any health care facility which is designated for psychiatric care, are not required to comply with these visitation requirements.

Facility Policies and Procedures

The law requires each health care facility to develop visitation policies and procedures that address each of the following:

• Infection control and education policies for visitors.
• Screening, personal protective equipment, and other infection control protocols for visitors.
• The permissible length of visits and numbers of visitors.
• Designation of an individual responsible for ensuring that facility staff adhere to the policies and procedures.

A health care facility’s safety-related policies and procedures for visitors may not be more stringent than those established for the facility's staff, and visitors cannot be required to submit proof of any vaccination or immunization. The policies and procedures must allow for consensual physical contact between a resident, client, or patient and the visitor, and permit any visitor who is 18 years of age or younger to be accompanied by an adult during visitation.

Designation of an Essential Caregiver

A resident, client, or patient may designate a visitor who is a family member, friend, guardian, or other individual as an essential caregiver. A different essential caregiver may be designated each day, and the resident, client, or patient may establish a rotation designating who his or her essential caregiver will be on a given day. The health care facility must allow in-person visitation by the essential caregiver for at least two hours daily in addition to any other visitation authorized by the facility. The law does not require an essential caregiver to provide necessary care to a resident, client, or patient of a facility, and facilities may not require an essential caregiver to provide such care. Health care facilities shall allow a resident, client, or patient to have in-person visitation with a member of the clergy in the same manner that visitation is provided to an essential caregiver.

If a patient, client, or resident is incapacitated and unable to designate an essential caregiver, the individual’s guardian (as defined by Ala. Code § 26-2A-20) shall appoint an essential caregiver on behalf of the patient, client, or resident. If the patient, client or resident does not have a guardian, the individual’s power of attorney (as provided in Ala. Code § 26-1-2) shall make the appointment. If the individual does not have a guardian or a durable power of attorney, a family member shall appoint an essential caregiver on behalf of the patient, client, or resident, in the following order of priority:

• The individual's spouse.
• The individual's child or children, provided the child or children has reached 19 years of age or older.
• The individual's parent or parents.
• The individual's sibling or siblings.

An individual appointing an essential caregiver on behalf of an incapacitated patient, client, or resident may appoint a caregiver in the same manner as a resident, client, or patient.

Circumstances Allowing for In-Person Visitation

Unless the resident, client, or patient objects, a health care facility’s policies and procedures must allow for in-person visitation in all of the following circumstances:

• End of life situations.
• A resident, client, or patient who was living with family before being admitted to the health care facility's care is struggling with the change in environment and lack of in-person family support.
• The resident, client, or patient is making one or more major medical decisions.
• A resident, client, or patient is experiencing emotional distress or grieving the loss of a friend or family member who recently died.
• A resident, client, or patient needs cueing or encouragement to eat or drink which was previously provided by a family member or caregiver.
• A resident, client, or patient who used to talk and interact with others is seldom speaking.
• For hospitals, childbirth, including labor and delivery.
• Pediatric patients.

Agreement

Health care facility policies and procedures may require a visitor to agree in writing to follow the health care facility's policies and procedures. A health care facility may suspend in-person visitation of a specific visitor if the visitor violates the facility's policies and procedures. Health care facilities must make the policies and procedures easily accessible from the homepage of their websites within 24 hours after establishing the required policies and procedures.

Complaints

To file a complaint against an Alabama health care facility for violations of the in- person visitation provisions protected under Alabama law, visit Filing Complaints.

"Under CMS regulations, hospitals, long term care facilities, and critical access hospitals, are prohibited from restricting, limiting, or otherwise denying visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation, or disability and are required to have written visitation policies, procedures, and practices regarding such prohibitions. OCR enforces the bar on religious discrimination in these regulations." --- U.S. Department of Health and Human Services Office for Civil Rights