Essential Caregivers Act of 2026
- Sponsor
- Rep. Tenney, Claudia [R-NY-24]
- Committees
- Ways and Means Committee (primary)
- Last action
- Jul 15, 2026
Bottom line
The bill ensures that residents in various long-term care and rehabilitation facilities retain the right to in-person visits from designated essential caregivers, even during public health emergencies when general visitation is restricted.
What it actually does
This bill mandates that nursing facilities, skilled nursing facilities, long-term care hospitals, inpatient rehabilitation facilities, and intermediate care facilities for individuals with intellectual disabilities implement an 'essential caregivers program' during any period when regular visitation is suspended. This program requires facilities to allow residents to designate two essential caregivers who must be granted in-person access, subject to specific health and safety protocols. It also prioritizes and expedites the investigation of complaints related to essential caregiver access.
Proponents argue
Supporters argue this bill is crucial for preventing the severe isolation and negative health impacts experienced by vulnerable residents in long-term care settings during past public health crises. They contend it upholds residents' fundamental rights to maintain vital social and emotional connections, which are essential for their well-being, and empowers families to provide necessary support and advocacy for their loved ones.
Opponents contend
Opponents may express concerns about the potential for increased infection risk within highly vulnerable populations if essential caregiver protocols are not rigorously followed or if facilities struggle with consistent enforcement. They might also argue that the mandates could impose additional administrative burdens and uncompensated costs on facilities, particularly smaller ones, to manage and monitor these new programs.
The bill is relatively short and clearly structured, making it accessible for an informed reader to understand its core provisions and implications within a short timeframe.
Section 2(a)(1)(A) and (B), amending Sections 1819(c) and 1919(c) of the Social Security Act
Mandate for Essential Caregivers Program in Nursing and Skilled Nursing Facilities
This provision requires nursing facilities and skilled nursing facilities to establish and maintain an 'essential caregivers program' whenever regular visitation is suspended. Under this program, each resident can elect two essential caregivers who will have in-person access to the resident. Residents are permitted to amend their caregiver selections at any time.
Supporters argue
Supporters argue this ensures continuity of care and emotional support for vulnerable residents, preventing the severe isolation experienced during past public health crises. It upholds residents' rights to choose their support system and maintain crucial family connections.
Critics contend
Some facilities might argue that managing an essential caregiver program during a public health crisis adds significant operational complexity and potential infection control risks, especially if resources are strained and new pathogens emerge.
Tradeoffs
This provision balances residents' rights to personal connection and support against facilities' need to maintain strict infection control and operational efficiency during health emergencies.
Section 2(a)(1)(B), adding Section 1819(c)(7)(B) and 1919(c)(7)(B) to the Social Security Act
Defined Limitations on Essential Caregiver Access
This provision outlines specific circumstances under which a facility may limit essential caregiver access. These include a potential 7-day initial denial (with audiovisual access provided), reasonable accommodations for roommates, denial if the caregiver displays symptoms of a serious infectious disease (until a negative test), denial for failing to follow safety protocols, and limiting to one caregiver at a time. Crucially, no limitations are allowed for residents receiving end-of-life care.
Section 2(a)(1)(B), adding Section 1819(c)(7)(D) and 1919(c)(7)(D) to the Social Security Act
Definition of Essential Caregiver and Safety Protocol Adherence
This section defines an 'essential caregiver' as an individual who agrees to follow all physical safety and infection control protocols established by the facility. These protocols must be clearly specified in writing and cannot be more restrictive than the protocols (including safety standards and entry requirements) applicable to the facility's own staff.
Section 2(a)(2), amending Section 1128I(f)(2) of the Social Security Act
Expedited Complaint Resolution for Caregiver Access Violations
This amendment requires State survey and certification agencies to prioritize the investigation of complaints related to violations of essential caregiver access requirements. Furthermore, it sets a strict deadline of not later than 3 days after receiving such a complaint for notifying the complainant of the investigation's outcome.
Sections 2(b), 2(c), and 2(d), amending Sections 1861(ccc)(4), 1866(a)(1), and 1905(d) of the Social Security Act
Extension of Essential Caregivers Program to Other Facility Types
These subsections extend the essential caregivers program requirements, as detailed for nursing and skilled nursing facilities, to long-term care hospitals, inpatient rehabilitation facilities, and intermediate care facilities for individuals with intellectual disabilities. These facilities must implement the program in the same manner as if they were a skilled nursing or nursing facility.
This provision explicitly exempts the new essential caregiver program requirements from the Secretary of Health and Human Services' emergency waiver authority under Section 1135(b)(1) of the Social Security Act. This means that during declared public health emergencies, the Secretary cannot waive the requirement for covered facilities to maintain their essential caregiver programs.
Section 2(e), amending Section 1135(b)(1) of the Social Security Act
Why it matters:This is standard legislative practice for modifying existing statutory authorities. It ensures that the new requirements are properly integrated into the broader legal framework governing emergency powers. It is not necessarily evasive, but it does require familiarity with the Social Security Act's structure and cross-references.
Case for: Supporters argue this is a critical safeguard, ensuring that the very circumstances (public health emergencies) that led to the need for this bill do not also become the justification for suspending its protections. It guarantees that essential caregiver access cannot be suspended precisely when it is most needed.
Case against: Critics might contend that limiting the Secretary's waiver authority could hinder flexibility in responding to unprecedented or rapidly evolving public health crises, potentially tying the hands of public health officials who need broad discretion.
Estimated impact: Ensures continuous access for essential caregivers during all future public health emergencies, affecting millions of residents and their families by preventing a repeat of widespread visitation bans.