Black Lung Benefits Improvement Act of 2025
Sponsored By: Senator Kaine, Tim [D-VA]
Introduced
Summary
Guarantees daily in-person access for a resident’s designated essential caregiver during emergency visitation restrictions. The bill would require skilled nursing and nursing facilities covered by Medicare and Medicaid to recognize, let residents name, and allow regular access for an essential caregiver when official visitation limits are in place.
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- Residents and families: Each resident or their representative could designate and change an essential caregiver at any time. That caregiver would be allowed in-person visits and to assist the resident every day during an emergency period.
- Facilities and staff: Facilities must use written safety rules that are no stricter for caregivers than for staff. A facility could initially deny access up to 7 days and only extend denials so the aggregate does not exceed 14 days with State survey agency approval.
- State survey agencies and enforcement: Residents and caregivers could appeal denials to the State survey agency. The agency would have to begin investigating within 2 business days and could require corrective plans and impose civil penalties up to $5,000 per violation.
The bill would also extend the same access rules to intermediate care facilities for individuals with intellectual disabilities and to inpatient rehabilitation units on the same campus as a nursing facility. The Secretary must issue the appeals rule within two years and the access protections would take effect two years after enactment.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 2 benefits, 0 costs, 2 mixed.
Fast appeals and enforcement for denials
If enacted, the Secretary would issue a final rule within two years to set up appeals to State survey agencies. Caregivers or residents could appeal a denial. State agencies would have to start investigating within 2 business days and decide within 48 hours after starting. If the agency finds a violation, facilities must restore access right away and give a corrective action plan within 7 days. If a facility fails to implement the plan, the agency may fine it up to $5,000. Facilities must give a written warning before denying access and explain the denial and appeal steps within 24 hours.
Right to name essential caregivers
If enacted, each nursing facility would have to let residents name one or more "essential caregivers." Caregivers would agree to follow the facility's written safety rules, which could not be more restrictive than rules for staff. A resident's representative could name a caregiver if the resident lacks capacity. The rule would also apply to certain inpatient rehab units and ICF/IID facilities. The bill would say it does not give states or facilities new authority to restrict visits beyond existing law.
Limits on caregiver denials in emergencies
If enacted, during emergency periods when visits are restricted, a facility could initially deny an essential caregiver for up to 7 days. A facility could impose one more 7-day denial only with State survey agency approval, so total denials would be up to 7 days or 14 days with approval. Facilities would still have to allow at least one essential caregiver every day and at any time, and residents at end of life or in decline would get immediate access. Facilities must also provide reasonable roommate accommodations.
When these protections would start
If enacted, these amendments would take effect two years after the date the law is enacted. The protections would apply only to emergency periods that begin on or after that effective date when regular visitation is restricted by a federal, state, or local order or other law.
Sponsors & CoSponsors
Sponsor
Kaine, Tim [D-VA]
VA • D
Cosponsors
Sen. Warner, Mark R. [D-VA]
VA • D
Sponsored 12/16/2025
Sen. Fetterman, John [D-PA]
PA • D
Sponsored 12/16/2025
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov