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<bill bill-stage="Introduced-in-House" dms-id="H2C3F6334747D410199EDA33DDE56E67C" public-private="public" key="H" bill-type="olc"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>119 HR 9641 IH: Essential Caregivers Act of 2026</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2026-07-13</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">H. R. 9641</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20260713">July 13, 2026</action-date><action-desc><sponsor name-id="T000478">Ms. Tenney</sponsor> (for herself and <cosponsor name-id="L000557">Mr. Larson of Connecticut</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name>, and in addition to the Committee on <committee-name committee-id="HWM00">Ways and Means</committee-name>, 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</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend titles XVIII and XIX of the Social Security Act to require certain facilities to permit visits from an essential caregiver during certain periods.</official-title></form><legis-body id="HC98E78659E8B41ADB21CF69B0B935352" style="OLC"> 
<section id="HFB433B9EC9F54D008D71DFA6DB576F26" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Essential Caregivers Act of 2026</short-title></quote>.</text></section> <section id="H03D1C9863DD24D7F806FFC25B11E5095"><enum>2.</enum><header>Requiring certain facilities to permit visits from an essential caregiver during certain periods</header> <subsection id="H619F7735558E430D9C1400754ABB96FB"><enum>(a)</enum><header>Nursing facilities and skilled nursing facilities</header> <paragraph id="H12724C4592F34E74B1BAFDCDC679C89C"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Sections 1819(c) and 1919(c) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i-3">42 U.S.C. 1395i–3(c)</external-xref>; 1396r(c)) are each amended—</text> 
<subparagraph id="H9C31911D7F93424D809B07CECC9FEDEB"><enum>(A)</enum><text>in paragraph (3)—</text> <clause id="H792BE1C62E7648B1891AF249B13138B2"><enum>(i)</enum><text>in subparagraph (D), by striking <quote>and</quote> at the end;</text></clause> 
<clause id="H17095612C7214EDAB91E79018B8D30B1"><enum>(ii)</enum><text>in subparagraph (E), by striking the period and inserting <quote>; and</quote>; and</text></clause> <clause id="H4DC255EBD90C4F39A3B7B7C802DA1C22"><enum>(iii)</enum><text>by adding at the end the following new subparagraph:</text> 
<quoted-block style="OLC" id="HF561BF08F1EF4E639D43595DAF6E6CB2" display-inline="no-display-inline"> 
<subparagraph id="H63A26E48E225472780604F18C3C8D0C9"><enum>(F)</enum><text display-inline="yes-display-inline">implement and maintain, during any period during which regular visitation at such facility is suspended, the essential caregivers program described in paragraph (7).</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></clause></subparagraph> <subparagraph id="H02FD361516D9472C89C6724CB465D78B"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text> 
<quoted-block style="OLC" id="HED3A6649FB1641EABCE56E1F75E7F25A" display-inline="no-display-inline"> 
<paragraph id="H6143A546467643A39C0FC3BCEE091294"><enum>(7)</enum><header>Essential caregivers program</header> 
<subparagraph id="HABEC0ED97C2C4CCA922C950CC72B9F2D"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">For purposes of subparagraph (F) of paragraph (3), the essential caregivers program described in this paragraph is a program implemented by a facility described in such paragraph under which such facility must—</text> <clause id="H852E5EDD8779485A98A396F002FD0105"><enum>(i)</enum><text>allow each resident of such facility the ability to elect 2 essential caregivers (as defined in subparagraph (D)) to have in-person access to such resident at such facility;</text> </clause> 
<clause id="HD7F9C487BBFC4F3887FAC50BBE84E6FD" commented="no"><enum>(ii)</enum><text>allow each such resident to amend such election at any time; and</text></clause> <clause id="H4EA43577693D46AF9BC1F3202149797A"><enum>(iii)</enum><text>subject to subparagraph (B), permit each such caregiver so elected by such resident in-person access to such resident.</text></clause></subparagraph> 
<subparagraph id="H7407735A6AAB4FBBAAE25AC6F53EB7E2"><enum>(B)</enum><header>Limitations on access</header> 
<clause id="H94B47B14D8A846D7928D830F584F2EE0"><enum>(i)</enum><header>In general</header><text>The Secretary may permit a facility described in subparagraph (A) to limit the access to an essential caregiver elected by a resident of such facility in accordance with guidance issued by the Secretary. Such guidance may—</text> <subclause id="H7D6CE91E514F430089BF1AF2E38ED1EB"><enum>(I)</enum><text display-inline="yes-display-inline">permit such a facility to deny such a caregiver in-person access to such resident for the first 7 days during the period during which regular visitation at such facility is suspended (as described in paragraph (3)(F)), but only if, during the period during which such in-person access is denied, such facility provides such caregiver access to such resident through an audio-visual telecommunications system;</text></subclause> 
<subclause id="H3ACF8828D28E4981AE356AB272C04F6A"><enum>(II)</enum><text>provide reasonable accommodations to protect the rights of a roommate of such resident; and</text></subclause> <subclause id="H56E5B6C935914632A1FE3FCEAF3B2C1A"><enum>(III)</enum><text>notwithstanding <internal-xref idref="H7D6CE91E514F430089BF1AF2E38ED1EB" legis-path="(7)(B)(i)(I)">subclause (I)</internal-xref>—</text> 
<item id="H91BB8E4EFF7D4E139064831E24422C23"><enum>(aa)</enum><text>allow such a facility to limit or deny such a caregiver in-person access to such resident if such caregiver displays symptoms of a serious infectious disease that poses a significant risk to the residents of such facility, but only until such time as such caregiver tests negative for such disease;</text></item> <item id="H6B6955B80B554B509F0DE3622BB42D4C"><enum>(bb)</enum><text>allow such a facility to deny such a caregiver access to such resident if such caregiver fails to follow the safety protocols described in subparagraph (D); and</text></item> 
<item id="H087843C49DED4DFEA17A695222F3548E"><enum>(cc)</enum><text>allow only 1 such caregiver at a time in-person access to such resident.</text></item></subclause></clause> <clause id="HB9BCB5C9ABC348C0AE908E1B706167E9"><enum>(ii)</enum><header>No limitation allowed for end-of-life care</header><text display-inline="yes-display-inline">Notwithstanding clause (i), a facility described in subparagraph (A) may not deny an essential caregiver elected by a resident of such facility under subparagraph (A) in-person access to such resident, or limit the duration of such in-person access, if such resident has in effect an election under section 1812(d).</text> </clause></subparagraph> 
<subparagraph id="H0D590A8ACBF6418A9DBF289D49E68B97"><enum>(C)</enum><header>Presumption of election</header><text display-inline="yes-display-inline">For purposes of subparagraph (A), in the case of a resident who is unable, by reason of cognitive decline or mental disability, to make an election described in such subparagraph, a resident representative (as defined in section 483.5 of title 42, Code of Federal Regulations (or a successor regulation)) of such resident shall be permitted to make such election for such resident.</text> </subparagraph> <subparagraph id="H790DDED4EF204291A8116DE4B453AC8B"><enum>(D)</enum><header>Essential caregiver defined</header><text>For purposes of this paragraph, the term <quote>essential caregiver</quote> means, with respect to a resident of a facility described in subparagraph (A), an individual who agrees to follow all protocols for physical safety and infection control established by such facility, which shall be clearly specified in writing and be not more restrictive than such protocols (including safety standards and entry requirements) applicable to staff of such facility.</text> </subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> 
<paragraph id="H6D01DB3F6C224829BEA85F94FF928EC0"><enum>(2)</enum><header>Timeline for investigation of complaints</header><text display-inline="yes-display-inline">Section 1128I(f)(2) of the Social Security Act (42 U.S.C. 1320a–7j(f)(2)) is amended by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" id="HEA9687E6030542DFA13C809A9F1FF248" display-inline="no-display-inline"> <subparagraph id="H928D3F1411A14E2BA34221B4432F321F"><enum>(C)</enum><header>Process for complaints relating to essential caregiver access</header><text display-inline="yes-display-inline">The complaint resolution process established under subparagraph (B) shall provide that, in the case of a complaint relating to a violation of the requirements of section 1819(c)(3)(F) or section 1919(c)(3)(F)—</text> 
<clause id="H3B77B0B1562647F6AD40CE827BDDC3B0"><enum>(i)</enum><text display-inline="yes-display-inline">the State survey and certification agency shall prioritize the investigation of such complaint; and</text></clause> <clause id="HF5B8DC2265A246A3BC74C4C60181F445"><enum>(ii)</enum><text>the deadline for notifying the complainant of the outcome of the investigation is not later than 3 days after such complaint is received.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph> </subsection> 
<subsection id="H188BD8816C2643FB9FEB5201E50BD2F8"><enum>(b)</enum><header>Long-term care hospitals</header><text>Section 1861(ccc)(4) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(ccc)(4)</external-xref>) is amended—</text> <paragraph id="H6EBB9DC8DCE2474D84756DDAD9998F08"><enum>(1)</enum><text>in subparagraph (B), by striking <quote>and</quote> at the end;</text></paragraph> 
<paragraph id="H794933FC589C4D9980376C2416FBF282"><enum>(2)</enum><text>in subparagraph (C), by striking the period at the end and inserting <quote>; and</quote>; and</text></paragraph> <paragraph id="H246E13204E3E42C9AB48C60A34AE14CC"><enum>(3)</enum><text>by adding at the end the following new subparagraph:</text> 
<quoted-block style="OLC" id="H91E59DC723B248048C76C41EE02200D7" display-inline="no-display-inline"> 
<subparagraph id="HBCA65AC0BE774A52A61241914B3B55F7"><enum>(D)</enum><text display-inline="yes-display-inline">the institution implements and maintains, during any period during which regular visitation at such institution is suspended, the essential caregivers program described in section 1819(c)(7) in the same manner as if such institution were a skilled nursing facility.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H80BB07415BE14849B8087032C7E0AF53" commented="no"><enum>(c)</enum><header>Inpatient rehabilitation facilities</header><text display-inline="yes-display-inline">Section 1866(a)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395cc">42 U.S.C. 1395cc(a)(1)</external-xref>) is amended—</text> 
<paragraph id="H549416D447044BC2BC1448047200756E" commented="no"><enum>(1)</enum><text>in subparagraph (X), by striking <quote>and</quote> at the end;</text></paragraph> <paragraph id="HC7F3AEEEAC8F4EADAC33C3D3D0D3F6B7" commented="no"><enum>(2)</enum><text>in subparagraph (Y), by striking the period at the end and inserting <quote>; and</quote>; and</text></paragraph> 
<paragraph id="H3D14039A534D4BE7902EAFAB6BEBC6DD" commented="no"><enum>(3)</enum><text>by inserting after subparagraph (Y) the following new subparagraph:</text> <quoted-block style="OLC" id="HF2AA22AB3C824B258B8AA46E7758D071" display-inline="no-display-inline"> <subparagraph id="H9E7D4E86CE13428592A67F553D9F7D2D" commented="no" indent="up1"><enum>(Z)</enum><text display-inline="yes-display-inline">in the case of an inpatient rehabilitation facility, to implement and maintain, during any period during which regular visitation at such facility is suspended, the essential caregivers program described in section 1819(c)(7) in the same manner as if such facility were a skilled nursing facility.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> 
<subsection id="H2A2BF01D352A43D9A1EA3AF358419FF8"><enum>(d)</enum><header>Intermediate care facilities for individuals with intellectual disabilities</header><text>Section 1905(d) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(d)</external-xref>) is amended—</text> <paragraph id="HE6ADACF6385946E0AEA5CC9ED677163B"><enum>(1)</enum><text>in paragraph (2), by striking <quote>and</quote> at the end;</text></paragraph> 
<paragraph id="H2441DC5587EE446A89F7FA8A3758E16E"><enum>(2)</enum><text>in paragraph (3), by striking the period at the end and inserting <quote>; and</quote>; and</text></paragraph> <paragraph id="H637B940053BF4F048A6E88FED8A2F652"><enum>(3)</enum><text>by adding at the end the following new paragraph:</text> 
<quoted-block style="OLC" id="H5D04DBBA56A64094A581256EDB25146C" display-inline="no-display-inline"> 
<paragraph id="H7C96686E7A8E466984162AE9BCCBC799"><enum>(4)</enum><text display-inline="yes-display-inline">the institution implements and maintains, during any period during which regular visitation at such institution is suspended, the essential caregivers program described in section 1919(c)(7) in the same manner as if such institution were a nursing facility.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H786AED9741D148289C1E9E05EF650DE8" commented="no"><enum>(e)</enum><header>Nonapplicability of waivers</header><text>Subparagraphs (A) and (B) of section 1135(b)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-5">42 U.S.C. 1320b–5(b)(1)</external-xref>) are each amended by inserting <quote>(other than the requirements of sections 1819(c)(3)(F), 1861(ccc)(4)(D), 1866(a)(1)(Z), 1905(d)(4), and 1919(c)(3)(F))</quote> after <quote>requirements</quote>.</text></subsection> 
<subsection id="H85333CB679774E0180B2720BEB79B1B2"><enum>(f)</enum><header>Regulations</header><text>The Secretary of Health and Human Services shall promulgate regulations to carry out the amendments made by this section not later than 18 months after the date of the enactment of this section.</text></subsection> <subsection id="H45CF550B64BD4CB19C36DD3ABC25B0E6"><enum>(g)</enum><header>Effective date</header><text>The amendments made by this section shall apply beginning 1 year after the date of the enactment of this section.</text></subsection></section> 
</legis-body></bill>


