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Requires nursing homes, skilled nursing facilities, intermediate care facilities for people with intellectual disabilities, and certain inpatient rehabilitation facilities on the same campus to allow each resident to designate an "essential caregiver" who may have in-person access even during emergency periods when general visitation is restricted. The law limits how long facilities may deny access, sets rules for warnings and appeals, assigns the burden of proof for restrictions to facilities, and directs HHS to issue implementing regulations after stakeholder consultation; the rules take effect two years after enactment.
The bill prioritizes residents' rights and consistent access to designated essential caregivers during emergencies—addressing harms from isolation and lack of oversight—while trading off increased infection risk, added burdens on strained staff and facility resources, and upfront implementation cost
About 1.3 million long‑term care residents (and their family caregivers) can designate essential caregivers who are allowed in-person visits even during emergency visitation restrictions, preserving daily contact and hands‑on support.
Residents (including those with cognitive or mental disabilities) retain and have reinforced rights to dignity, self‑determination, communication and access—plus ability for representatives to designate caregivers—helping protect autonomy and access for vulnerable residents.
Facilities must provide procedural protections (written warnings, 24‑hour explanations, and an appeals process to State survey agencies with the burden of proof on facilities), giving residents and caregivers a realistic mechanism to challenge denials.
Residents and staff face increased infection risk if in‑person essential caregiver visits occur during emergencies and caregiver safety protocols fail or are inconsistently enforced.
Workforce shortages (roughly 20% departures early in the pandemic) and ongoing staffing pressures can reduce quality of care and limit the facility capacity to safely accommodate increased in‑person visitation or manage appeals and monitoring.
The bill documents measurable declines in resident health linked to past visitation restrictions and staffing problems (pressure ulcers, weight loss, depression, higher antipsychotic use), indicating serious health harms that persist and may complicate policy tradeoffs.
Introduced December 16, 2025 by Claudia Tenney · Last progress December 16, 2025