Federal RuleAug 21
62
DOL Rewrites Disability Rules for 'Merit-Based Opportunity' Push
RuleLabor DepartmentFederal Contract Compliance Programs OfficeSignificant Wallet
119-hr-6766119th CongressWALLET
Essential Caregivers Act of 2025
Sponsored By: Representative Tenney, Claudia [R-NY-24]
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.
Show full summary
- 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, Claudia [R-NY-24]
NY • R
Cosponsors
Rep. Larson, John B. [D-CT-1]
CT • D
Sponsored 12/16/2025
Rep. Fitzpatrick, Brian K. [R-PA-1]
PA • R
Sponsored 12/16/2025
Rep. Mann, Tracey [R-KS-1]
KS • R
Sponsored 12/16/2025
Rep. Ciscomani, Juan [R-AZ-6]
AZ • R
Sponsored 12/16/2025
Rep. Mills, Cory [R-FL-7]
FL • R
Sponsored 12/16/2025
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 12/17/2025
Rep. Lee, Susie [D-NV-3]
NV • D
Sponsored 12/17/2025
Rep. Panetta, Jimmy [D-CA-19]
CA • D
Sponsored 12/17/2025
Rep. Mannion, John W. [D-NY-22]
NY • D
Sponsored 12/18/2025
Rep. Brownley, Julia [D-CA-26]
CA • D
Sponsored 12/18/2025
Rep. Malliotakis, Nicole [R-NY-11]
NY • R
Sponsored 12/23/2025
Rep. Salazar, Maria Elvira [R-FL-27]
FL • R
Sponsored 12/23/2025
Rep. Tiffany, Thomas P. [R-WI-7]
WI • R
Sponsored 12/23/2025
Rep. Bean, Aaron [R-FL-4]
FL • R
Sponsored 12/23/2025
Rep. Frost, Maxwell [D-FL-10]
FL • D
Sponsored 1/6/2026
Rep. Bonamici, Suzanne [D-OR-1]
OR • D
Sponsored 1/6/2026
Rep. Kim, Young [R-CA-40]
CA • R
Sponsored 1/6/2026
Rep. Neguse, Joe [D-CO-2]
CO • D
Sponsored 1/6/2026
Rep. Yakym, Rudy [R-IN-2]
IN • R
Sponsored 1/7/2026
Rep. Lawler, Michael [R-NY-17]
NY • R
Sponsored 1/8/2026
Rep. Costa, Jim [D-CA-21]
CA • D
Sponsored 1/8/2026
Rep. DeLauro, Rosa L. [D-CT-3]
CT • D
Sponsored 1/12/2026
Rep. Tlaib, Rashida [D-MI-12]
MI • D
Sponsored 1/12/2026
Rep. Pocan, Mark [D-WI-2]
WI • D
Sponsored 1/13/2026
Rep. Simon, Lateefah [D-CA-12]
CA • D
Sponsored 1/13/2026
Rep. Langworthy, Nicholas A. [R-NY-23]
NY • R
Sponsored 1/13/2026
Rep. Rutherford, John H. [R-FL-5]
FL • R
Sponsored 1/13/2026
Rep. Grijalva, Adelita S. [D-AZ-7]
AZ • D
Sponsored 1/13/2026
Rep. McBride, Sarah [D-DE-At Large]
DE • D
Sponsored 1/14/2026
Rep. Himes, James A. [D-CT-4]
CT • D
Sponsored 1/14/2026
Rep. Courtney, Joe [D-CT-2]
CT • D
Sponsored 1/14/2026
Rep. Hayes, Jahana [D-CT-5]
CT • D
Sponsored 1/14/2026
Rep. Sewell, Terri A. [D-AL-7]
AL • D
Sponsored 1/15/2026
Rep. Barragán, Nanette Diaz [D-CA-44]
CA • D
Sponsored 1/15/2026
Rep. Thompson, Mike [D-CA-4]
CA • D
Sponsored 1/16/2026
Rep. Fine, Randy [R-FL-6]
FL • R
Sponsored 1/22/2026
Rep. Davids, Sharice [D-KS-3]
KS • D
Sponsored 1/22/2026
Rep. Trahan, Lori [D-MA-3]
MA • D
Sponsored 1/22/2026
Rep. Rogers, Mike D. [R-AL-3]
AL • R
Sponsored 1/22/2026
Rep. Meng, Grace [D-NY-6]
NY • D
Sponsored 1/22/2026
Rep. Luna, Anna Paulina [R-FL-13]
FL • R
Sponsored 1/22/2026
Rep. Ross, Deborah K. [D-NC-2]
NC • D
Sponsored 1/22/2026
Rep. Bacon, Don [R-NE-2]
NE • R
Sponsored 1/22/2026
Rep. Perez, Marie Gluesenkamp [D-WA-3]
WA • D
Sponsored 1/22/2026
Rep. Carbajal, Salud O. [D-CA-24]
CA • D
Sponsored 1/22/2026
Rep. Smucker, Lloyd [R-PA-11]
PA • R
Sponsored 1/30/2026
Rep. Meuser, Daniel [R-PA-9]
PA • R
Sponsored 1/30/2026
Rep. Miller, Carol D. [R-WV-1]
WV • R
Sponsored 2/2/2026
Rep. Chu, Judy [D-CA-28]
CA • D
Sponsored 2/2/2026
Rep. Stansbury, Melanie A. [D-NM-1]
NM • D
Sponsored 2/3/2026
Rep. Scholten, Hillary J. [D-MI-3]
MI • D
Sponsored 2/3/2026
Rep. Kennedy, Timothy M. [D-NY-26]
NY • D
Sponsored 2/3/2026
Rep. Vasquez, Gabe [D-NM-2]
NM • D
Sponsored 2/3/2026
Rep. Smith, Adrian [R-NE-3]
NE • R
Sponsored 2/5/2026
Rep. Figures, Shomari [D-AL-2]
AL • D
Sponsored 2/9/2026
Rep. Garbarino, Andrew R. [R-NY-2]
NY • R
Sponsored 2/9/2026
Rep. Pappas, Chris [D-NH-1]
NH • D
Sponsored 2/9/2026
Rep. Owens, Burgess [R-UT-4]
UT • R
Sponsored 2/9/2026
Rep. LaLota, Nick [R-NY-1]
NY • R
Sponsored 2/10/2026
Rep. Gomez, Jimmy [D-CA-34]
CA • D
Sponsored 2/11/2026
Rep. Tokuda, Jill N. [D-HI-2]
HI • D
Sponsored 2/20/2026
Rep. Peters, Scott H. [D-CA-50]
CA • D
Sponsored 2/23/2026
Rep. Amo, Gabe [D-RI-1]
RI • D
Sponsored 2/23/2026
Rep. Pettersen, Brittany [D-CO-7]
CO • D
Sponsored 2/24/2026
Rep. Soto, Darren [D-FL-9]
FL • D
Sponsored 2/24/2026
Rep. Suozzi, Thomas R. [D-NY-3]
NY • D
Sponsored 2/24/2026
Rep. Harder, Josh [D-CA-9]
CA • D
Sponsored 2/24/2026
Rep. Kelly, Robin L. [D-IL-2]
IL • D
Sponsored 2/24/2026
Rep. Hill, J. French [R-AR-2]
AR • R
Sponsored 2/24/2026
Rep. Steube, W. Gregory [R-FL-17]
FL • R
Sponsored 2/24/2026
Rep. Deluzio, Christopher R. [D-PA-17]
PA • D
Sponsored 2/24/2026
Rep. Stefanik, Elise M. [R-NY-21]
NY • R
Sponsored 2/24/2026
Rep. Hinson, Ashley [R-IA-2]
IA • R
Sponsored 2/24/2026
Rep. James, John [R-MI-10]
MI • R
Sponsored 2/24/2026
Rep. Wilson, Joe [R-SC-2]
SC • R
Sponsored 3/3/2026
Rep. Kelly, Mike [R-PA-16]
PA • R
Sponsored 3/4/2026
Rep. Thompson, Glenn [R-PA-15]
PA • R
Sponsored 3/5/2026
Rep. Latimer, George [D-NY-16]
NY • D
Sponsored 3/5/2026
Rep. Feenstra, Randy [R-IA-4]
IA • R
Sponsored 3/5/2026
Rep. Rogers, Harold [R-KY-5]
KY • R
Sponsored 3/5/2026
Rep. Lieu, Ted [D-CA-36]
CA • D
Sponsored 3/5/2026
Rep. Davis, Donald G. [D-NC-1]
NC • D
Sponsored 3/5/2026
Rep. Valadao, David G. [R-CA-22]
CA • R
Sponsored 3/12/2026
Rep. Golden, Jared F. [D-ME-2]
ME • D
Sponsored 3/18/2026
Rep. Wittman, Robert J. [R-VA-1]
VA • R
Sponsored 3/18/2026
Rep. Van Orden, Derrick [R-WI-3]
WI • R
Sponsored 3/18/2026
Rep. Crow, Jason [D-CO-6]
CO • D
Sponsored 3/18/2026
Rep. Torres, Ritchie [D-NY-15]
NY • D
Sponsored 3/18/2026
Rep. McDonald Rivet, Kristen [D-MI-8]
MI • D
Sponsored 3/24/2026
Rep. Fedorchak, Julie [R-ND-At Large]
ND • R
Sponsored 3/25/2026
Rep. Thanedar, Shri [D-MI-13]
MI • D
Sponsored 3/25/2026
Rep. Cammack, Kat [R-FL-3]
FL • R
Sponsored 3/25/2026
Rep. Westerman, Bruce [R-AR-4]
AR • R
Sponsored 3/25/2026
Rep. Finstad, Brad [R-MN-1]
MN • R
Sponsored 3/26/2026
Rep. Stevens, Haley M. [D-MI-11]
MI • D
Sponsored 4/9/2026
Rep. LaHood, Darin [R-IL-16]
IL • R
Sponsored 4/9/2026
Rep. Bergman, Jack [R-MI-1]
MI • R
Sponsored 4/9/2026
Rep. Walkinshaw, James R. [D-VA-11]
VA • D
Sponsored 4/9/2026
Rep. Gottheimer, Josh [D-NJ-5]
NJ • D
Sponsored 4/9/2026
Rep. Bost, Mike [R-IL-12]
IL • R
Sponsored 4/9/2026
Rep. Mast, Brian J. [R-FL-21]
FL • R
Sponsored 4/9/2026
Rep. Crawford, Eric A. "Rick" [R-AR-1]
AR • R
Sponsored 4/9/2026
Rep. Leger Fernandez, Teresa [D-NM-3]
NM • D
Sponsored 4/9/2026
Rep. Alford, Mark [R-MO-4]
MO • R
Sponsored 4/9/2026
Rep. Palmer, Gary J. [R-AL-6]
AL • R
Sponsored 4/9/2026
Rep. Cleaver, Emanuel [D-MO-5]
MO • D
Sponsored 4/9/2026
Rep. Balint, Becca [D-VT-At Large]
VT • D
Sponsored 4/9/2026
Rep. Magaziner, Seth [D-RI-2]
RI • D
Sponsored 4/20/2026
Rep. Harrigan, Pat [R-NC-10]
NC • R
Sponsored 4/21/2026
Rep. Gosar, Paul A. [R-AZ-9]
AZ • R
Sponsored 4/13/2026
Rep. Walberg, Tim [R-MI-5]
MI • R
Sponsored 4/16/2026
Rep. Castor, Kathy [D-FL-14]
FL • D
Sponsored 4/16/2026
Rep. Carson, André [D-IN-7]
IN • D
Sponsored 4/16/2026
Rep. Clarke, Yvette D. [D-NY-9]
NY • D
Sponsored 4/16/2026
Rep. Tonko, Paul [D-NY-20]
NY • D
Sponsored 4/16/2026
Rep. McClellan, Jennifer L. [D-VA-4]
VA • D
Sponsored 4/16/2026
Rep. Levin, Mike [D-CA-49]
CA • D
Sponsored 4/16/2026
Rep. Joyce, John [R-PA-13]
PA • R
Sponsored 4/23/2026
Rep. Budzinski, Nikki [D-IL-13]
IL • D
Sponsored 4/23/2026
Rep. Fitzgerald, Scott [R-WI-5]
WI • R
Sponsored 4/23/2026
Rep. Cisneros, Gilbert Ray [D-CA-31]
CA • D
Sponsored 4/23/2026
Rep. McGovern, James P. [D-MA-2]
MA • D
Sponsored 4/23/2026
Rep. Baumgartner, Michael [R-WA-5]
WA • R
Sponsored 4/30/2026
Rep. Aderholt, Robert B. [R-AL-4]
AL • R
Sponsored 4/30/2026
Rep. Espaillat, Adriano [D-NY-13]
NY • D
Sponsored 4/30/2026
Rep. Riley, Josh [D-NY-19]
NY • D
Sponsored 4/30/2026
Rep. Morelle, Joseph D. [D-NY-25]
NY • D
Sponsored 4/30/2026
Rep. Biggs, Sheri [R-SC-3]
SC • R
Sponsored 5/12/2026
Rep. Pingree, Chellie [D-ME-1]
ME • D
Sponsored 5/12/2026
Rep. Beatty, Joyce [D-OH-3]
OH • D
Sponsored 5/12/2026
Rep. Kiggans, Jennifer A. [R-VA-2]
VA • R
Sponsored 5/12/2026
Rep. Fry, Russell [R-SC-7]
SC • R
Sponsored 5/12/2026
Rep. Brown, Shontel M. [D-OH-11]
OH • D
Sponsored 5/12/2026
Rep. Dunn, Neal P. [R-FL-2]
FL • R
Sponsored 5/12/2026
Rep. Barrett, Tom [R-MI-7]
MI • R
Sponsored 5/12/2026
Rep. Carter, Earl L. "Buddy" [R-GA-1]
GA • R
Sponsored 5/12/2026
Rep. Vargas, Juan [D-CA-52]
CA • D
Sponsored 5/29/2026
Rep. Bera, Ami [D-CA-6]
CA • D
Sponsored 5/29/2026
Rep. Fulcher, Russ [R-ID-1]
ID • R
Sponsored 5/29/2026
Rep. Huizenga, Bill [R-MI-4]
MI • R
Sponsored 5/29/2026
Rep. Edwards, Chuck [R-NC-11]
NC • R
Sponsored 5/29/2026
Rep. Rulli, Michael A. [R-OH-6]
OH • R
Sponsored 5/29/2026
Rep. Whitesides, George [D-CA-27]
CA • D
Sponsored 5/29/2026
Rep. Moore, Blake D. [R-UT-1]
UT • R
Sponsored 6/2/2026
Rep. Donalds, Byron [R-FL-19]
FL • R
Sponsored 6/2/2026
Rep. Elfreth, Sarah [D-MD-3]
MD • D
Sponsored 6/2/2026
Rep. Fischbach, Michelle [R-MN-7]
MN • R
Sponsored 6/2/2026
Rep. Gooden, Lance [R-TX-5]
TX • R
Sponsored 6/10/2026
Rep. Fleischmann, Charles J. "Chuck" [R-TN-3]
TN • R
Sponsored 6/10/2026
Rep. Vindman, Eugene Simon [D-VA-7]
VA • D
Sponsored 6/18/2026
Rep. Stauber, Pete [R-MN-8]
MN • R
Sponsored 6/22/2026
Rep. Evans, Gabe [R-CO-8]
CO • R
Sponsored 6/22/2026
Rep. Davis, Danny K. [D-IL-7]
IL • D
Sponsored 6/22/2026
Rep. Moolenaar, John R. [R-MI-2]
MI • R
Sponsored 6/22/2026
Rep. Balderson, Troy [R-OH-12]
OH • R
Sponsored 6/25/2026
Rep. Norman, Ralph [R-SC-5]
SC • R
Sponsored 6/25/2026
Rep. Velázquez, Nydia M. [D-NY-7]
NY • D
Sponsored 7/2/2026
Rep. Landsman, Greg [D-OH-1]
OH • D
Sponsored 7/9/2026
Rep. Obernolte, Jay [R-CA-23]
CA • R
Sponsored 7/9/2026
Rep. Ruiz, Raul [D-CA-25]
CA • D
Sponsored 7/13/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov