We adopted a 24/7 visitor policy after much encouragement. Unfortunately, we occasionally get disruptive visitors. What can we do to restrict this without receiving complaints?

Your circumstances illustrate the intersection of multiple resident rights, all protected under federal requirements for long-term care facilities that participate in Medicare: the right to respect and dignity, the right to privacy, and the right to receive visitors of their choosing at the time of their choosing (42 C.F.R. 483.10). 

Your state also may have a law echoing and/or expanding on these rights. Illinois, for example, enshrines resident rights in its Nursing Home Care Act.

Under the LTC Medicare Requirements, the type of protected visitation varies by the type of visitor. State and Medicare representatives, a resident’s physician, and a resident’s representative must be given immediate access. Subject to the resident’s consent, the resident’s family and relatives must be given immediate access; other visitors must be given immediate access subject to reasonable clinical and safety restrictions; and individuals providing health, social or legal services must be given reasonable access. 

Facilities must publish visitation policies that clearly state (1) any clinically necessary or reasonable restrictions to visitation; (2) when such limitations apply; and (3) that the facility may need to impose restrictions on visits for clinical or safety reasons.

And yet a resident’s right to visitors does not protect visitations that impose on the rights of another resident. You may elect to curb disruptions to other residents by adopting visiting hours, but only with the understanding that certain visitors must always retain the right to immediate access, subject to the resident’s consent.