HR6766119th CongressWALLET

Essential Caregivers Act of 2025

Sponsored By: Representative Tenney

Introduced

Summary

Guarantee essential caregivers' uninterrupted access to Medicare and Medicaid nursing facilities, including during emergency visitation restrictions. This bill would let residents name a trusted caregiver, limit when facilities can block visits, and set a fast appeals and penalty process.

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  • Residents and families: Residents could designate or change an essential caregiver at any time, and a representative can designate one if the resident lacks capacity. At least one designated essential caregiver must be allowed daily during emergency restrictions; initial denials are capped at 7 days with a possible state-approved extension to 14 days.
  • Caregivers: Designated caregivers must sign and follow written facility safety protocols that cannot be stricter than rules for staff. Facilities must rely on those written protocols when claiming a caregiver violated terms, and the facility bears the burden if it argues a violation during an appeal.
  • Facilities and state oversight: State survey agencies must accept appeals quickly, start investigations within 2 business days, and decide within 48 hours of starting the probe. Agencies can order immediate access, require a corrective action plan within 7 days, and impose civil money penalties up to $5,000 if facilities fail to comply.

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 4 benefits, 0 costs, 1 mixed.

Caregiver Access During Emergencies

If enacted, the bill would require facilities to allow ongoing access for at least one essential caregiver even when visitation is officially restricted. A facility could not deny access for more than 7 days without State approval, and only one extra 7‑day extension is allowed (14 days total with State approval). Facilities would still be able to limit access in narrow situations like end‑of‑life or severe decline. These rules would begin two years after enactment.

Caregiver Rights for Rehab and Disability Care

If enacted, the bill would extend the same essential‑caregiver designation and access rules to certain inpatient rehabilitation facilities on the same campus as a nursing home and to intermediate care facilities for people with intellectual disabilities. Those facilities would have to follow the same rules two years after enactment.

Right to Name Essential Caregiver

If enacted, residents in Medicare or Medicaid nursing facilities would be able to designate at least one "essential caregiver." Facilities would have to publish written safety and entry protocols for those caregivers. Those caregiver protocols could not be more restrictive than the rules that apply to facility staff. Residents could change their designated caregiver anytime, and a legal representative could designate a caregiver for residents who lack capacity. These changes would take effect two years after enactment.

Fast Appeals and Penalties for Denials

If enacted, the Secretary would issue a final appeals rule within two years. In the meantime, State survey agencies must start investigating appeals within 2 business days and decide within 48 hours of starting. Facilities must give a written warning before denying access and send a written denial explanation within 24 hours. If an agency finds a violation, it must order immediate access and require a corrective plan within 7 days. If a facility fails to implement that plan, the State may fine the facility up to $5,000. When a facility defends a denial by saying a caregiver broke the agreement, the facility must prove it.

No New Visitation Authority

If enacted, the bill would clarify that it does not create new authority for States, local officials, or facilities to impose broader visitation limits. This clause is a clarification and would take effect two years after enactment.

Sponsors & CoSponsors

Sponsor

Tenney

NY • R

Cosponsors

  • Larson (CT)

    CT • D

    Sponsored 12/16/2025

  • Fitzpatrick

    PA • R

    Sponsored 12/16/2025

  • Mann

    KS • R

    Sponsored 12/16/2025

  • Ciscomani

    AZ • R

    Sponsored 12/16/2025

  • Mills

    FL • R

    Sponsored 12/16/2025

  • Dingell

    MI • D

    Sponsored 12/17/2025

  • Lee (NV)

    NV • D

    Sponsored 12/17/2025

  • Panetta

    CA • D

    Sponsored 12/17/2025

  • Mannion

    NY • D

    Sponsored 12/18/2025

  • Brownley

    CA • D

    Sponsored 12/18/2025

  • Malliotakis

    NY • R

    Sponsored 12/23/2025

  • Salazar

    FL • R

    Sponsored 12/23/2025

  • Tiffany

    WI • R

    Sponsored 12/23/2025

  • Bean (FL)

    FL • R

    Sponsored 12/23/2025

  • Frost

    FL • D

    Sponsored 1/6/2026

  • Bonamici

    OR • D

    Sponsored 1/6/2026

  • Kim

    CA • R

    Sponsored 1/6/2026

  • Neguse

    CO • D

    Sponsored 1/6/2026

  • Yakym

    IN • R

    Sponsored 1/7/2026

  • Lawler

    NY • R

    Sponsored 1/8/2026

  • Costa

    CA • D

    Sponsored 1/8/2026

  • DeLauro

    CT • D

    Sponsored 1/12/2026

  • Tlaib

    MI • D

    Sponsored 1/12/2026

  • Pocan

    WI • D

    Sponsored 1/13/2026

  • Simon

    CA • D

    Sponsored 1/13/2026

  • Langworthy

    NY • R

    Sponsored 1/13/2026

  • Rutherford

    FL • R

    Sponsored 1/13/2026

  • Grijalva

    AZ • D

    Sponsored 1/13/2026

  • McBride

    DE • D

    Sponsored 1/14/2026

  • Himes

    CT • D

    Sponsored 1/14/2026

  • Courtney

    CT • D

    Sponsored 1/14/2026

  • Hayes

    CT • D

    Sponsored 1/14/2026

  • Sewell

    AL • D

    Sponsored 1/15/2026

  • Barragan

    CA • D

    Sponsored 1/15/2026

  • Thompson (CA)

    CA • D

    Sponsored 1/16/2026

  • Fine

    FL • R

    Sponsored 1/22/2026

  • Davids (KS)

    KS • D

    Sponsored 1/22/2026

  • Trahan

    MA • D

    Sponsored 1/22/2026

  • Rogers (AL)

    AL • R

    Sponsored 1/22/2026

  • Meng

    NY • D

    Sponsored 1/22/2026

  • Luna

    FL • R

    Sponsored 1/22/2026

  • Ross

    NC • D

    Sponsored 1/22/2026

  • Bacon

    NE • R

    Sponsored 1/22/2026

  • Perez

    WA • D

    Sponsored 1/22/2026

  • Carbajal

    CA • D

    Sponsored 1/22/2026

  • Smucker

    PA • R

    Sponsored 1/30/2026

  • Meuser

    PA • R

    Sponsored 1/30/2026

  • Miller (WV)

    WV • R

    Sponsored 2/2/2026

  • Chu

    CA • D

    Sponsored 2/2/2026

  • Stansbury

    NM • D

    Sponsored 2/3/2026

  • Scholten

    MI • D

    Sponsored 2/3/2026

  • Kennedy (NY)

    NY • D

    Sponsored 2/3/2026

  • Vasquez

    NM • D

    Sponsored 2/3/2026

  • Smith (NE)

    NE • R

    Sponsored 2/5/2026

  • Figures

    AL • D

    Sponsored 2/9/2026

  • Garbarino

    NY • R

    Sponsored 2/9/2026

  • Pappas

    NH • D

    Sponsored 2/9/2026

  • Owens

    UT • R

    Sponsored 2/9/2026

  • LaLota

    NY • R

    Sponsored 2/10/2026

  • Gomez

    CA • D

    Sponsored 2/11/2026

  • Tokuda

    HI • D

    Sponsored 2/20/2026

  • Peters

    CA • D

    Sponsored 2/23/2026

  • Amo

    RI • D

    Sponsored 2/23/2026

  • Pettersen

    CO • D

    Sponsored 2/24/2026

  • Soto

    FL • D

    Sponsored 2/24/2026

  • Suozzi

    NY • D

    Sponsored 2/24/2026

  • Harder (CA)

    CA • D

    Sponsored 2/24/2026

  • Kelly (IL)

    IL • D

    Sponsored 2/24/2026

  • Hill (AR)

    AR • R

    Sponsored 2/24/2026

  • Steube

    FL • R

    Sponsored 2/24/2026

  • Deluzio

    PA • D

    Sponsored 2/24/2026

  • Stefanik

    NY • R

    Sponsored 2/24/2026

  • Hinson

    IA • R

    Sponsored 2/24/2026

  • James

    MI • R

    Sponsored 2/24/2026

  • Wilson (SC)

    SC • R

    Sponsored 3/3/2026

  • Kelly (PA)

    PA • R

    Sponsored 3/4/2026

  • Thompson (PA)

    PA • R

    Sponsored 3/5/2026

  • Latimer

    NY • D

    Sponsored 3/5/2026

  • Feenstra

    IA • R

    Sponsored 3/5/2026

  • Rogers (KY)

    KY • R

    Sponsored 3/5/2026

  • Lieu

    CA • D

    Sponsored 3/5/2026

  • Davis (NC)

    NC • D

    Sponsored 3/5/2026

  • Valadao

    CA • R

    Sponsored 3/12/2026

  • Golden (ME)

    ME • D

    Sponsored 3/18/2026

  • Wittman

    VA • R

    Sponsored 3/18/2026

  • Van Orden

    WI • R

    Sponsored 3/18/2026

  • Crow

    CO • D

    Sponsored 3/18/2026

  • Torres (NY)

    NY • D

    Sponsored 3/18/2026

Roll Call Votes

No roll call votes available for this bill.

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