How Hospital Visitation Policies Are Changing During COVID-19

It was May 15 when Emily Schmitz's 78-year-old father was first admitted to the hospital for small bowel obstruction surgery. Despite her father testing negative for COVID-19, Schmitz says she and her siblings were not permitted to see him due to the hospital's strict visitation policies.

Schmitz, who owns a communications agency in Austin, Texas, tells Verywell that initially, her father was doing well, but he quickly deteriorated—showing signs of confusion—which concerned her and her siblings. Soon they were making countless phone calls to the hospital to ensure their father’s needs were met, including a request for water. 

"[My sister] asked every day to see him, especially when his mental and physical state was deteriorating, and they still would not allow her to see him and advocate for better care for him," she says. Eventually, on May 21, the hospital allowed Schmitz's sister to visit their father, but only for the day.

Growing more concerned about her father's condition, Schmitz flew in from Texas, but upon arriving at the hospital, she was denied visitation. She decided to take matters into her hands. “I took it all the way to the hospital administrator and it took that to have someone listen to us,” Schmitz says. “It was pretty frustrating.”

On May 29, the hospital finally allowed Schmitz and her siblings to visit their father, who at that point, was in critical condition in the intensive care unit (ICU). They wore masks and gloves and were only allowed to visit for 10 minutes.

Their father passed away the next day—alone—not from the small bowel obstruction for which he was originally admitted, but from severe sepsis with septic shock.

“Families know their loved one and know when something is not right,” Schmitz says. “So, not being able to have somebody there for the patient is where hospital systems are falling really short.”

After months of restrictive visitation policies, patients and their families are speaking out about COVID-19's emotional toll. Now, hospitals nationwide are responding by slowly relaxing their protocols, and implementing new strategies to keep families connected. 

How Strict Are Visitation Policies Now?

At the beginning of the pandemic, most hospitals implemented strict no-visitor rules to curb the spread of COVID-19. A July study, published in The American Journal of Respiratory and Critical Care Medicine, found that out of 48 Michigan hospitals, 39% prohibited visitors without exception and 59% only allowed visitors under “certain exceptions.” These certain exceptions often meant end-of-life situations or the birth of a child. Hospital systems set their own individual policies, but federal organizations like the Centers for Disease Control and Prevention have released COVID-19 guidelines for healthcare facilities.

After several reports about the negative ways visitation policies have impacted patients and their families, some hospitals are beginning to loosen their restrictions, while still requiring visitors to take the necessary COVID-19 precautions like wearing masks. For example, for inpatient units, MedStar Health System, located in Maryland and Washington D.C., now allows patients one visitor per day, but only if that patient doesn't have COVID-19.

For Mothers and Babies

“Initially, we implemented a draconian approach, which was to almost completely shut down all visitors, except for the mother’s significant other,” Jorge E. Perez, MD, neonatologist and co-founder of Kidz Medical Services, tells Verywell.

According to Perez, who also serves as medical director of neonatal and newborn services at South Miami Hospital in Florida, the visitor would have to stay isolated in the mother’s room until the mother and baby were discharged. If the visitor left the hospital, they would be unable to return.

While the one visitor-per-patient rule remains in effect at South Miami Hospital, if that visitor leaves the hospital, they are now permitted to return. 

Similar strict policies were common in other hospitals, especially during the height of the pandemic, when COVID-19’s impact on babies was relatively unknown. According to the Centers for Disease Control and Prevention (CDC), while most newborns who contract the virus have either mild or no symptoms, there have been reports of newborns who develop severe cases of COVID-19.

“We had to be creative to continue offering family-centered care," Perez says. The Kidz Medical team at his hospital communicated daily with the parents of patients in the NICU. In addition, they provided 24/7 viewing cameras so parents and extended family members could view infants in real-time and follow their progress. 

“It’s known that women have better birth outcomes when stress levels are reduced and when they’re surrounded by support and advocacy," Talitha Phillips, a labor and postpartum doula in Los Angeles and CEO of Claris Health, tells Verywell. "This is especially critical for women of color who already face health disparities when it comes to labor and delivery.”

Phillips is no stranger to the emotional difficulties pregnant women face when forced to choose only one support person to accompany them in the hospital. She and her clients were devastated to learn about the restrictive visitation rules that went into effect this March. 

“I will never forget sitting in an Uber, crying after I had to leave a mom and her husband at the entrance of a hospital," she says. "We’d labored together for 12 hours and in her most intense moments, I had to ‘abandon’ her.”

She explains that although the ability to provide her labor and postpartum doula services in-hospital is still limited, “in the last two weeks, two hospitals in LA have started allowing women to bring a partner and one support person with them.”

For ICU Patients

ICU visitation rules vary greatly by hospital and state. For example, the University of California San Francisco Health System now allows up to two visitors at a time in the ICU. Visitors may visit at any time and one visitor may stay overnight.

Studies show that visitation is highly important to patients in intensive care units, especially those who aren’t able to speak up for themselves. Researchers found that family presence at the bedside can help reduce delirium as well as help families make better decisions regarding their loved one’s care.

Schmitz and her family wish they could've been at her father's side during his hospitalization. Strict COVID-19 visitation rules made it difficult for her and her siblings to stand up for him, and keep track of the care he needed.

“The message I want to get across most urgently is the importance of having an advocate for your family member, speaking up, and taking it to the top if you have to," Schmitz says.