HR-9641-119
Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 38 - 0.
Sponsored by Claudia Tenney (R-NY)
What it does
This bill would amend the Social Security Act to require Medicare- and Medicaid-certified nursing facilities, skilled nursing facilities, long-term care hospitals, inpatient rehabilitation facilities, and intermediate care facilities for individuals with intellectual disabilities to maintain an "essential caregivers program" whenever regular visitation is suspended. Each resident would be allowed to designate up to two essential caregivers who must be granted in-person access, subject to the facility's safety and infection-control protocols. The bill would also make these requirements exempt from emergency waivers the Secretary of HHS may issue, and would require complaints about violations to be investigated and resolved within three days.
Who benefits
Residents of nursing homes, skilled nursing facilities, long-term care hospitals, inpatient rehabilitation facilities, and intermediate care facilities for individuals with intellectual disabilities — estimated at roughly 1.5–2 million people at any given time. Family members and friends who serve as informal caregivers, particularly those who provide emotional support, advocacy, or supplemental care. Residents with cognitive decline or mental disabilities, whose legal representatives may designate caregivers on their behalf. Residents in end-of-life care, who receive an absolute right to caregiver access with no facility override. Disability rights advocates who have long sought enforceable visitation protections.
Who is hurt
Nursing facilities and long-term care institutions, which would bear administrative and operational costs of implementing and maintaining the program, including staff time for safety protocol training and complaint response. Roommates of residents whose privacy and safety interests may be affected by increased visitor access. Facility operators in states with stricter infection-control standards, who may face tension between state rules and the federal floor. Taxpayers who fund Medicare and Medicaid, if compliance costs are passed through to program reimbursement rates. State survey and certification agencies, which would face a mandatory three-day complaint resolution deadline that may strain existing investigative capacity.
Supporters argue
Supporters argue that COVID-19 lockdowns in long-term care facilities caused severe, documented harm — including accelerated cognitive decline, depression, and preventable deaths from isolation — demonstrating that blanket visitation bans can be as dangerous as the infections they aim to prevent. They contend that designating just two caregivers per resident, subject to the same safety protocols as staff, is a narrowly tailored approach that balances infection control with residents' fundamental need for human connection and advocacy. They further argue that the emergency waiver carve-out is essential, because prior HHS waivers effectively nullified state-level essential caregiver laws during the pandemic, leaving residents without recourse.
Opponents argue
Opponents argue that mandating in-person access during infectious disease emergencies — and explicitly blocking the Secretary's waiver authority — removes critical flexibility from public health officials at precisely the moments when rapid, facility-specific responses are most needed. They contend that a one-size-fits-all federal floor may conflict with state and local infection-control orders, creating legal confusion for facility administrators who must simultaneously comply with federal, state, and local directives. They further argue that the three-day complaint investigation deadline is operationally unrealistic for already under-resourced state survey agencies, potentially diverting staff from other patient safety investigations.