Essential Caregivers Act of 2025
- Bill Number
- H.R. 6766
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-12-16: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-07-10T08:06:17Z
AI-Generated Summary
Purpose
The Essential Caregivers Act of 2025 aims to protect the rights of residents in certain long-term care facilities by ensuring they can designate and access "essential caregivers" (typically family members or close supporters who provide supplemental care). This is particularly important during emergencies, like pandemics, when regular visitor access is limited by government orders or laws. The bill addresses harms from isolation experienced during the COVID-19 pandemic, such as declines in health, increased depression, and higher use of medications, by mandating facility access for these caregivers to support residents' well-being and advocacy needs.
Key Provisions
- Designation of Essential Caregivers: Residents in covered facilities have the right to choose one or more essential caregivers at any time. If a resident cannot decide due to cognitive or mental disabilities (e.g., dementia), a designated representative (like a legal guardian or healthcare proxy) can make the choice.
- Access During Restrictions: When regular visitation is restricted (e.g., due to a health emergency or waiver under federal law), facilities must:
- Allow at least one essential caregiver in-person access every day and at any time to assist the resident.
- Not deny access except in limited cases (see below).
- Enforce a written agreement where caregivers follow the facility's safety rules (e.g., masking or testing), which cannot be stricter than rules for facility staff.
- Make reasonable accommodations for roommates sharing space with a resident.
- Limited Denials of Access: Facilities can temporarily deny access for up to 7 days at the start of a restriction period, plus another 7 days with approval from the state health department. However, access must always be allowed for residents in end-of-life care or those in serious decline/distress (as defined by the Secretary of Health and Human Services).
- Compliance and Enforcement:
- If a caregiver breaks safety rules, the facility must first give a written warning with specific fixes needed.
- Repeated non-compliance can lead to denial, but the facility must explain in writing within 24 hours and inform about appeal options.
- Appeals Process: Within 2 years of enactment, the Secretary must create rules for appeals to state survey agencies (government bodies that inspect facilities). Agencies must start reviews within 2 business days and decide within 48 hours. Facilities bear the burden of proving rule violations. If a facility violates access rules, it must immediately allow entry, create a 7-day fix plan, and face fines up to $5,000 for non-compliance.
- Definition of Essential Caregiver: A person chosen by or for the resident who agrees to the facility's safety protocols.
- Covered Facilities: Applies to Medicare-funded skilled nursing facilities (SNFs), Medicaid-funded nursing facilities (NFs), intermediate care facilities for people with intellectual disabilities (ICFs/ID), and inpatient rehabilitation facilities (IRFs) on the same campus as the above.
- Implementation: The Secretary of Health and Human Services must issue regulations after consulting stakeholders (e.g., residents, families, advocates, and facility operators). The law takes effect 2 years after passage and applies only during actual visitation restrictions.
Significant Changes to Existing Law
- Amends Sections 1819 and 1919 of the Social Security Act (covering Medicare SNFs and Medicaid NFs) to add a new subparagraph explicitly requiring essential caregiver access, building on the Nursing Home Reform Act of 1987's general rights to dignity, self-determination, and external communication.
- Extends similar requirements to ICFs/ID (via Section 1905) and certain IRFs (via Section 1866), which previously lacked these specific protections.
- Introduces time-limited denial rules, appeals with quick timelines, and penalties, which were not in prior law. During COVID-19, federal guidance allowed broad visitation bans without these safeguards, leading to isolation issues.
- Clarifies that the law does not grant new powers to governments or facilities to restrict visits, preventing misuse.
Potential Impacts
- On Residents and Citizens: Reduces isolation risks (e.g., loneliness linked to health declines like weight loss or depression), improves care quality through family support amid staff shortages (noted as a 1-in-5 worker loss during the pandemic), and empowers families to advocate for loved ones, especially the 1.3 million in nursing homes (nearly half with dementia).
- On Government Agencies: Centers for Medicare & Medicaid Services (CMS) and state health departments must develop regulations, handle appeals, and enforce penalties, increasing administrative workload but enhancing oversight of facility compliance.
- On Facilities: Requires policy changes for access and safety protocols, potentially easing staffing burdens by leveraging family help, but adds operational costs for warnings, appeals, and fines; non-compliance could affect federal funding eligibility.
- Broader Effects: No direct impact on international relations, but could set a U.S. model for balancing public health emergencies with individual care rights, benefiting vulnerable populations like the elderly or disabled.
Main Stakeholders Affected
- Residents: Primarily older adults or those with disabilities in long-term care, who gain guaranteed family access to combat isolation.
- Families and Essential Caregivers: Gain legal rights to enter facilities during crises, enabling them to provide hands-on support and monitoring.
- Facility Operators and Staff: SNFs, NFs, ICFs/ID, and IRFs must adapt operations; staff shortages may be indirectly alleviated, but they face new enforcement risks.
- Government Entities: HHS/CMS for rulemaking; state survey agencies for appeals and investigations; long-term care ombudsmen (advocates for residents) for input and monitoring.
- Advocacy Groups: Organizations like the National Consumer Voice for Quality Long-Term Care, which highlighted pandemic harms, benefit from stronger resident protections.
Notable Legal, Constitutional, or Political Implications
- Legal: Reinforces resident rights under existing federal nursing home laws by making essential caregiver access enforceable with appeals and penalties, potentially leading to more lawsuits or complaints if facilities resist. The 2-year delay allows time for regulatory clarity to avoid legal challenges.
- Constitutional: Supports First Amendment freedoms (e.g., family association) and Fourteenth Amendment due process by limiting arbitrary denials during emergencies, while allowing public health measures (e.g., safety protocols) to protect communal safety without overreach.
- Political: Bipartisan support (introduced by members from both parties) reflects post-COVID consensus on isolation's dangers, as cited in findings (e.g., 31% rise in pressure ulcers). It avoids creating broad visitation bans, focusing on targeted protections, which could influence future emergency policies without partisan divides.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Tenney, Claudia [R-NY-24]
Cosponsors (159)
Rep. Larson, John B. [D-CT-1], Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Mann, Tracey [R-KS-1], Rep. Ciscomani, Juan [R-AZ-6], Rep. Mills, Cory [R-FL-7], Rep. Dingell, Debbie [D-MI-6], Rep. Lee, Susie [D-NV-3], Rep. Panetta, Jimmy [D-CA-19], Rep. Mannion, John W. [D-NY-22], Rep. Brownley, Julia [D-CA-26], Rep. Malliotakis, Nicole [R-NY-11], Rep. Salazar, Maria Elvira [R-FL-27], Rep. Tiffany, Thomas P. [R-WI-7], Rep. Bean, Aaron [R-FL-4], Rep. Frost, Maxwell [D-FL-10], Rep. Bonamici, Suzanne [D-OR-1], Rep. Kim, Young [R-CA-40], Rep. Neguse, Joe [D-CO-2], Rep. Yakym, Rudy [R-IN-2], Rep. Lawler, Michael [R-NY-17], Rep. Costa, Jim [D-CA-21], Rep. DeLauro, Rosa L. [D-CT-3], Rep. Tlaib, Rashida [D-MI-12], Rep. Pocan, Mark [D-WI-2], Rep. Simon, Lateefah [D-CA-12], Rep. Langworthy, Nicholas A. [R-NY-23], Rep. Rutherford, John H. [R-FL-5], Rep. Grijalva, Adelita S. [D-AZ-7], Rep. McBride, Sarah [D-DE-At Large], Rep. Himes, James A. [D-CT-4], Rep. Courtney, Joe [D-CT-2], Rep. Hayes, Jahana [D-CT-5], Rep. Sewell, Terri A. [D-AL-7], Rep. Barragán, Nanette Diaz [D-CA-44], Rep. Thompson, Mike [D-CA-4], Rep. Fine, Randy [R-FL-6], Rep. Davids, Sharice [D-KS-3], Rep. Trahan, Lori [D-MA-3], Rep. Rogers, Mike D. [R-AL-3], Rep. Meng, Grace [D-NY-6], Rep. Luna, Anna Paulina [R-FL-13], Rep. Ross, Deborah K. [D-NC-2], Rep. Bacon, Don [R-NE-2], Rep. Perez, Marie Gluesenkamp [D-WA-3], Rep. Carbajal, Salud O. [D-CA-24], Rep. Smucker, Lloyd [R-PA-11], Rep. Meuser, Daniel [R-PA-9], Rep. Miller, Carol D. [R-WV-1], Rep. Chu, Judy [D-CA-28], Rep. Stansbury, Melanie A. [D-NM-1] and 109 more
Recent Actions
- 2025-12-16: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-12-16: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-12-16: Introduced in House
- 2025-12-16: Introduced in House
Bill Versions
- Essential Caregivers Act of 2025 — issued 2025-12-16 — PDF (26 pages)