Visitor Policy – BJC HealthCare

For the safety of our patients during the fall and winter respiratory virus season, we ask that you please do not visit the hospital if you have a cough, congestion, runny nose, fever or gastrointestinal symptoms. Our patients thank you!

Having a support system of family, friends and loved ones is an important part of the healing process – physically and mentally. At BJC HealthCare we strive to provide a positive patient experience across our 14 hospitals, multiple health service organizations and 100+ doctors’ offices. A standard visitor policy is part of that experience.

Below please find details from BJC's visitor policy.

“Some BJC hospitals have additional guidance for their facilities. Please check the hospital websites for more information.”

The purpose of this policy is to provide guidelines for BJC HealthCare facility visitation practices that take into consideration patient wishes, their clinical condition, patient privacy, and the safety of all patients, visitors, and staff; and are consistent with applicable state and federal laws and regulations.

BJC HealthCare permits patients to have visitors, seen as partners in caring for our patients, as set forth in this policy. Visitors may include, but are not limited to, family; friends; significant others; professional services such as attorneys, doulas, photographers, hairdressers; or other persons requested by a patient or a patient’s legal guardian or legal representative. A member of clergy is allowed at the bedside and is not included in the total number of visitors.

Visitors are expected to abide by established visiting hours and conditions as set forth in this policy. Visitors are expected to support the quiet healing environment and comply with safety measures to protect patients and staff throughout the duration of the visit.

Patient’s Right of Visitation

All patients have the right to receive visitors during their inpatient admission or while receiving care in outpatient service areas (e.g., Emergency Department, outpatient surgery or procedure areas, clinic visits, or other outpatient services), with limited exceptions as set forth in this policy. Patients, or their legal guardian or legal representative, may also designate visitors on behalf of a patient.
A patient has the right to limit all visitors and/or limit a particular visitor or visitors.
A patient has a right to change his/her mind at any time about accepting visits from anyone, including family members or friends.
The facility will ensure that visitors have access to a patient in a manner consistent with the patient’s preferences.
The facility will not restrict, limit, or otherwise deny a patient’s visitation rights, or limit who a patient may have as a visitor, based on race, color, national origin, religion, gender, sexual orientation, or disability.
The facility will provide patients and/or their legal guardian or legal representative with a notice of their visitation rights as well as with information that describes the visitation hours and any restrictions on visitation which may apply.

Notice of Patient Visitation Rights/Guidelines

Patients will be provided with notice and/or information of visitor rights/guidelines upon admission to the facility, including certain outpatient areas such as the Emergency Department or outpatient surgical or procedure areas. These guidelines address a patient’s right to designate and receive visitors, as well as provide information concerning hours of visitation, and limits or restrictions on visitors, and expected visitor behavior. See the Patient and Visitor Code of Conduct.

Visiting Hours and Conditions

Area/Dept	Total Number of Visitors Permitted	Visiting Hours (Minimum of 6 hours per day)	Limitations	Special Circumstances, Conditions, or Considerations
Emergency Department (ED)	2 visitors at bedside Must remain with patient in room or treatment area for safety and privacy of all patients unless visitor’s personal care is needed, i.e., nutrition or restroom Waiting room visitors dependent on patient surge or capacity issues, but cannot prohibit all visitors Visitors may swap in and out, not to exceed maximum number allowed	24/7	Limits on visitors in waiting room if facility experiencing patient surge or capacity issues, but cannot prohibit all visitors	If applicable, visitor badges issued must be visible to staff while visitor is with patient and in facility Compassionate exceptions considered on an as needed basis to support patients and families
Inpatient and ICU	2 visitors in semi-private or isolation rooms 4 visitors in private rooms 1 overnight visitor may be permitted in semi-private rooms based on comfort level and privacy interest of both patients Visitors may swap in and out, not to exceed maximum number allowed	Minimum 9 a.m. to 9 p.m. per day Quiet hours from 9 p.m. to 9 a.m. per day	Overnight visitor may be prohibited in semi-private rooms based on comfort level and privacy interest of both patients Visiting hours may be expanded if the department and hospital can safely care for the patients	If applicable, ICU visitors must check in with unit personnel before visiting a patient Considerations to maintain a quiet healing environment and support patient rest will be observed during the overnight hours, especially in semi-private rooms. Environmental considerations for the patient, care partner/visitor, and staff safety will be observed Compassionate exceptions considered on an as-needed basis to support patients and families
Labor and Delivery	No limit on number or age of visitors during labor, but minors must be accompanied by adult Only 3 visitors at bedside Visitors may swap in and out, not to exceed maximum number allowed	24/7 during labor and delivery, at discretion of patient	Only 3 visitors at bedside	Compassionate exceptions considered on an as-needed basis to support patients and families
Post-Partum	Only 4 visitors at bedside No restrictions on age, but minors must be accompanied by adult 1 overnight visitor Visitors may swap in and out, not to exceed maximum number allowed	Minimum 9 a.m. to 9 p.m. per day Overnight visiting hours from 9 p.m. to 9 a.m. per day	Only 4 visitors at bedside in postpartum areas 1 overnight visitor	Compassionate exceptions considered on an as-needed basis to support patients and families
Outpatient Surgery or Procedure	2 visitors, but facility may limit visitors to 1 due to space constraints and safety considerations Visitors may swap in and out, not to exceed maximum number allowed	May accompany patient to surgery or procedure and stay until patient is discharged	Facility may limit visitors to 1 due to space constraints and safety considerations Number of visitors may be expanded if the department and hospital can safely care for the patients	Compassionate exceptions considered on an as needed basis to support patients and families
Clinic Visits	2 visitors, but facility may limit visitors to 1 due to space constraints and safety considerations Visitors may swap in and out, not to exceed maximum number allowed	May accompany patient to appointments, treatments, provider visits, or care planning sessions	Facility may limit visitors to 1 due to space constraints and safety considerations Number of visitors may be expanded if the department and hospital can safely care for the patients	Compassionate exceptions considered on an as needed basis to support patients and families
Outpatient Visits	2 visitors, but facility may limit visitors to 1 due to space constraints and safety considerations Visitors may swap in and out, not to exceed maximum number allowed	May accompany patient in designated waiting areas May be asked to remain in waiting room to accommodate patient volume or privacy concerns	Facility may limit visitors to 1 due to space constraints and safety considerations	Compassionate exceptions considered on an as needed basis to support patients and families
Pediatric Patients at St. Louis Children’s Hospital	Please refer to SLCH Policy: Visitor Management No more than 6 total visitors in facility 2-4 visitors in inpatient rooms 2 visitors in ED Visitors may swap in and out, not to exceed maximum number allowed	24/7 Minimum 9 a.m. to 9 p.m. per day for visitors authorized by parent/legal guardian	No more than 2-4 at bedside in inpatient room Minors under the age of 12 must be accompanied by adult Other restrictions are noted in St. Louis Children’s Hospital SLCH Policy: Visitor Management	Visitation Conferences will be conducted with family to determine a process for large families to visit Additional considerations are noted in SLCH Policy: Visitor Management Compassionate exceptions considered on an as-needed basis to support patients and families
Evelyn’s House	Please refer to Evelyn's House Visitor Guidelines No limit on number or age of visitors	24/7 Quiet hours are designated as 9 p.m. to 9 a.m. Patio visitation will end at dusk to maintain safety	No limit on number or age of visitors Patio doors will always remain locked for patient safety Patients will choose code word upon admission that visitors must provide to gain entry	Gathering rooms are available to reserve on a first come first serve basis. Reservations can be placed by 12 noon for occupancy from 9 p.m.-9 a.m.

Overnight Visitors/Quiet Hours (typically 9 p.m. to 9 a.m.)

All visitors remaining in the facility after normal daily visiting hours are expected to check in and follow the after-hours visitor process to include signing-in and badging where badging is available/required.
Visitors remaining at the facility during quiet hours must be respectful of the quiet healing environment for our patients.
A visitor 18 or older may spend the night in a patient’s room if the patient is in a single room and the visit is consistent with the well-being of the patient.
Overnight visitors for patients in semi-private rooms must be approved by unit leadership and agreed upon by both patients in the room.
Blow-up mattresses, cots, sleeping bags and bedding that is not issued by the hospital may not be used.
Overnight visitors must be able to care for themselves.

When the safety or security of patients or the care team is at risk, departments may need to temporarily limit visitation of patients to assure safety is maintained. Patients on the unit will receive notice of any limitations to visitors during this time. In these situations, limited visitation shall be no less than six (6) hours a day.

Visitor Requirements

Where applicable, visitors must comply with all badging and sign-in/sign-out requirements.
Visitors must comply with established guidelines pertaining to isolation, infection control, and other health and safety precautions as instructed by nursing staff, including hand washing and other required safety practices when entering and leaving a patient’s room.
Visitors may be required to wear personal protective equipment (PPE) such as a gown, gloves, mask, face shield as directed by staff and infection prevention practices.
Visitors may not consume alcohol, recreational or medical cannabis, or other non-prescription controlled substances while at any BJC premises.
Staff may contact Public Safety if a visitor appears intoxicated or under the influence of alcohol or other substances, whether such substances prescribed or recreational.
Visitors may not smoke or use other tobacco or cannabis products anywhere in the facility or on facility grounds consistent with the BJC smoke-free policies.
Visitors must keep their voices to a reasonable level and televisions, radios, and other sound devices may not be loud or disturb other patients, especially during Quiet Hours, typically 9 a.m. to 9 p.m.
Visitors are expected to follow the Patient and Visitor Code of Conduct to help us maintain a safe, healing, and respectful environment for everyone at our facilities, including our staff.

Removal of Visitor

A visitor who is disruptive or who fails to follow any of the expectations for visitors as set forth in this policy will be asked to stop the disruptive behavior. They may also be asked to leave the facility temporarily if the behavior does not stop or if it presents an immediate risk to patients or staff.
If the visitor refuses to leave, Public Safety may be called, and the individual may be escorted from the facility.

Limits on Visitors/Visitation

To ensure the safety of other patients and staff, the facility may limit visitation for the following reasons:

Size and Space — Size of the building and physical space, including waiting rooms, and during times of patient surge or capacity issues.
Commonly Restricted Areas — Limit movement of visitors within the facility, including restricting access to surgical or procedure areas, isolation rooms or units, behavioral health units or pods, substance abuse treatment programs with protocols around visitation, or other commonly restricted areas.
Request of Patient — At the request of the patient or their legal guardian or legal representative.
Request of Law Enforcement — A patient who is in the custody of law enforcement or the Department of Corrections shall only be allowed to have visitors if it is authorized by the law enforcement agency or the Department of Corrections. Law enforcement officers or Department of Corrections officers are not considered visitors and must remain with the patient per law enforcement or Department of Corrections’ required practices.
Court Order — Due to a court order restricting contact.
Substantial Disruption of Care or Operation of Facility — To prevent substantial disruption to the care of a patient or the operation of the facility, including interference with the care of other patients.
During Administration of Emergency Care or Care that May Harm a Visitor — Facility may limit visitors during the administration of emergency care in critical situations or when a patient is undergoing care that has the potential to harm a visitor.
Signs and Symptoms of Transmissible Infection — If the visitor has measurable signs and symptoms of a transmissible infection, they may be restricted because of the risk of further transmission; however, telephone or video conferencing shall be offered as an alternative. If in person visitors are permitted, visitors shall be screened for symptoms and epidemiological risk factors.
Disruptive, Threatening, or Violent Behavior — If the facility has reasonable cause to suspect the visitor of being a danger or otherwise contrary to the health or welfare of the patient, other patients, or facility staff, it may restrict that visitor. Reasonable cause may include, but is not limited to, a visitor engaged in disruptive, threatening, or violent behavior of any kind.
Reasonable Safety or Security Restrictions or Other Requirements — Facility may adopt reasonable safety or security restrictions or other requirements for visitors.
Attending Physician’s Attestation in Chart if Medical or Therapeutically Contraindicated — If, in the clinical judgment of the patient's attending physician, the presence of visitors would be medically or therapeutically contraindicated to the health or life of the patient, and the attending physician attests to such in the patient's chart.
Please note — the attending physician must document the required attestation in the patient’s chart to limit visitors under this provision.
Shared Rooms — Limit or redirect visitors of a patient in a shared room to ensure the health and safety of the patients in the shared room, including if a patient’s roommate needs rest or privacy.
Minors — Children under the age of 12 must be accompanied by someone 18 years old or older. Visits from children should be coordinated by a caregiver for the minor and the patient or his/her designated representative.
Patient Designated as “Confidential”, “Protective Status”, “Victim of Violence”, or “Black Out Status” — If the patient informs the facility registration staff or nursing staff, at any time, that he or she wishes to have his or her patient stay removed from the patient directory or requests or needs to be placed on protective status, victim of violence (VOV) status, or blackout status, the following procedures will be followed:
The electronic medical record system will reflect the patient’s name and status as “confidential”, “protective status”, “victim of violence (VOV), or “black out status.”
- The patient information desk(s) or areas where visitors are likely to request patients’ room numbers will be informed of the patient’s status as “confidential”, “protective status”, “victim of violence (VOV), or “black out status”.
- Facility operators will also be informed of the patient’s status as “confidential”, “protective status”, “victim of violence (VOV), or “black out status”; and
- Staff will be advised not to provide information about the patient or allow anyone to visit the patient, except at the specific request of the patient or his/her designated support person.
State of Emergency (SOE) or Public Health Emergency (PHE) — During a state of emergency (SOE) or public health emergency (PHE), a facility may limit visitation as permitted by state and/or federal laws and regulations. See State-Declared State of Emergency or Public Health Emergency of the Procedure for Patient Visitation (below) for additional detail.

While there may be valid reasons for limiting visitation of a patient, the facility will attempt to accommodate the needs of any patient who requests that at least one (1) visitor be allowed to remain in the room to provide support and comfort at such times.

If for any reason a patient would like to have a virtual visit with their friends, family, or anyone else requested by the patient, the facility will provide means for a virtual visit through the Virtual Visitor Program.

Visitation for Patients Who Lack Decision-Making Capacity

If a patient does not have decision-making capacity, then a designated representative, which may include, but is not limited to the patient’s legal guardian, the patient’s surrogate decision maker under a valid Durable Power of Attorney for Health Care, a surrogate decision maker identified under the Illinois Health Care Surrogate Act, a family member, or other friend, may exercise the patient’s visitor rights and designate visitors on behalf of the patient consistent with the considerations and guidelines described in this policy.
If there is no identified legal representative or next of kin and multiple individuals assert the right to make decisions about visitors on the patient’s behalf, the facility may consider the following and request documentation regarding individual claims and will provide a resolution process in collaboration with the facility’s patient advocate/grievance process to resolve any dispute.
- The wishes of the patient about having visitors or a particular visitor, as expressed by the patient or his/her designated representative if the patient lacks the capacity to decide.
- The patient’s expressed desire to maintain confidentiality about his/her inpatient stay.
- The clinical needs of the patient as determined by his/her physician and other members of the healthcare team.
- Safety concerns with respect to the patient or in the patient care area, such as the ability to maintain a sterile environment and adhere to necessary infection control protocols.
- The demonstrated behavior of an individual during patient visits.
- The time of day and whether the patient is in a single room or a shared room.
- Limitations established by court orders or other legal documents that are provided to the facility’s staff.
- If the hospital denies an individual’s request to be a patient’s support person, the hospital will document the refusal in the patient’s medical record together with the reason for the denial.
- Notwithstanding the conditions for visitation as identified above, extenuating circumstances (i.e., imminent death, impending surgery) may require exceptions to the policy.
  - The patient’s physician or other members of the health care team shall use professional judgment in considering the specific reasons for such requests.
  - Each request shall be reviewed individually, and decisions will consider the patient’s clinical condition, personal desires, and unique family circumstances as well as the other factors identified above.

State-Declared State of Emergency (SOE) or Public Health Emergency (PHE)

For Missouri facilities, if a State of Emergency (SOE) related to infectious, contagious, communicable, or dangerous diseases is declared by the MO Governor, the following visitation guidelines shall apply, as required by MO law, in place of Visiting Hours and Conditions of the Procedure for Patient Visitation.
Please note - Illinois facilities may elect to follow this Section 7 of the Procedure for Patient Visitation during an SOE or PHE but should comply with IL-specific requirements if any of the MO requirements are in conflict with IL law.
- Patients, who have not been determined to be incapacitated by the court, a patient's guardian, or a patient's legally authorized representative, are allowed to designate, and receive, at least two (2) family members, friends, guardian, or other individuals selected by a facility patient or the guardian or legal representative of same as visitors at the facility. Such visitors are considered essential caregivers for the patient.
- Facility may limit in-person contact to one (1) visitor at-a-time during visiting hours.
- Visiting hours shall be for no less than four (4) hours of in-person contact per day, including evenings, weekends, and holidays.
- 24-hour visitation may occur as necessary and appropriate for the patient. v) Visitors may leave and return or swap out the same day.
The facility may:
- Require visitors to follow facility’s infection prevention safety measures.
- Limit or remove a visitor for the reasons/criteria set out in Code of Conduct or Limits on Visitors/Visitation of the Procedure for Patient Visitation.
- Place limitations on a particular essential caregiver, per facility protocol, if it determines that in-person contact by a particular essential caregiver is inconsistent with the patient's therapeutic care and treatment or is a safety risk to other patients, DMH clients, or staff at the facility.
- Restrict or revoke in-person contact by an essential caregiver who fails to follow required protocols and procedures established under this policy.
- Any limitations placed upon a particular essential caregiver shall be reviewed and documented every seven (7) days to determine if the limitations remain appropriate.
- If facility wants to restrict access for longer than seven (7) days, facility may request a suspension of in-person contact from DHSS or DMH for a period not to exceed seven (7) days.
- Facility shall not suspend in-person contact for more than fourteen (14) consecutive days in a twelve (12) month period or more than forty-five (45) days total in a twelve (12) month period.
- DHSS or DMH may deny a facility's request to suspend in-person contact with essential caregivers if the department determines that such in-person contact does not pose a serious community health risk.
- Facility shall inform patients or guardians or legal representatives of same, in writing of essential caregiver program and process for designating essential caregiver.