Essential Caregivers Act of 2026

This Act may be cited as the “Essential Caregivers Act of 2026”.

(a) Nursing facilities and skilled nursing facilities.—

(1) In general.— Sections 1819(c) and 1919(c) of the Social Security Act (42 U.S.C. 1395i–3(c); 1396r(c)) are each amended—

(A) in paragraph (3)—

(i) in subparagraph (D), by striking “and” at the end;

(ii) in subparagraph (E), by striking the period and inserting “; and”; and

(iii) by adding at the end the following new subparagraph:

“(F) implement and maintain, during any period during which regular visitation at such facility is suspended, the essential caregivers program described in paragraph (7).”; and

(B) by adding at the end the following new paragraph:

“(7) Essential caregivers program.—

(A) In general.— For purposes of subparagraph (F) of paragraph (3), the essential caregivers program described in this paragraph is a program implemented by a facility described in such paragraph under which such facility must—

(i) allow each resident of such facility the ability to elect 2 essential caregivers (as defined in subparagraph (D)) to have in-person access to such resident at such facility;

(ii) allow each such resident to amend such election at any time; and

(iii) subject to subparagraph (B), permit each such caregiver so elected by such resident in-person access to such resident.

(B) Limitations on access.—

(i) In general.— The Secretary may permit a facility described in subparagraph (A) to limit the access to an essential caregiver elected by a resident of such facility in accordance with guidance issued by the Secretary. Such guidance may—

(I) permit such a facility to deny such a caregiver in-person access to such resident for the first 7 days during the period during which regular visitation at such facility is suspended (as described in paragraph (3)(F)), but only if, during the period during which such in-person access is denied, such facility provides such caregiver access to such resident through an audio-visual telecommunications system;

(II) provide reasonable accommodations to protect the rights of a roommate of such resident; and

(III) notwithstanding subclause (I)—

(aa) allow such a facility to limit or deny such a caregiver in-person access to such resident if such caregiver displays symptoms of a serious infectious disease that poses a significant risk to the residents of such facility, but only until such time as such caregiver tests negative for such disease;

(bb) allow such a facility to deny such a caregiver access to such resident if such caregiver fails to follow the safety protocols described in subparagraph (D); and

(cc) allow only 1 such caregiver at a time in-person access to such resident.

(ii) No limitation allowed for end-of-life care.— Notwithstanding clause (i), a facility described in subparagraph (A) may not deny an essential caregiver elected by a resident of such facility under subparagraph (A) in-person access to such resident, or limit the duration of such in-person access, if such resident has in effect an election under section 1812(d).

(C) Presumption of election.— For purposes of subparagraph (A), in the case of a resident who is unable, by reason of cognitive decline or mental disability, to make an election described in such subparagraph, a resident representative (as defined in section 483.5 of title 42, Code of Federal Regulations (or a successor regulation)) of such resident shall be permitted to make such election for such resident.

(D) Essential caregiver defined.— For purposes of this paragraph, the term “essential caregiver” means, with respect to a resident of a facility described in subparagraph (A), an individual who agrees to follow all protocols for physical safety and infection control established by such facility, which shall be clearly specified in writing and be not more restrictive than such protocols (including safety standards and entry requirements) applicable to staff of such facility.”.

(2) Timeline for investigation of complaints.— Section 1128I(f)(2) of the Social Security Act (42 U.S.C. 1320a–7j(f)(2)) is amended by adding at the end the following new subparagraph:

“(C) Process for complaints relating to essential caregiver access.— The complaint resolution process established under subparagraph (B) shall provide that, in the case of a complaint relating to a violation of the requirements of section 1819(c)(3)(F) or section 1919(c)(3)(F)—

(i) the State survey and certification agency shall prioritize the investigation of such complaint; and

(ii) the deadline for notifying the complainant of the outcome of the investigation is not later than 3 days after such complaint is received.”.

(b) Long-term care hospitals.— Section 1861(ccc)(4) of the Social Security Act (42 U.S.C. 1395x(ccc)(4)) is amended—

(1) in subparagraph (B), by striking “and” at the end;

(2) in subparagraph (C), by striking the period at the end and inserting “; and”; and

(3) by adding at the end the following new subparagraph:

“(D) the institution implements and maintains, during any period during which regular visitation at such institution is suspended, the essential caregivers program described in section 1819(c)(7) in the same manner as if such institution were a skilled nursing facility.”.

(c) Inpatient rehabilitation facilities.— Section 1866(a)(1) of the Social Security Act (42 U.S.C. 1395cc(a)(1)) is amended—

(1) in subparagraph (X), by striking “and” at the end;

(2) in subparagraph (Y), by striking the period at the end and inserting “; and”; and

(3) by inserting after subparagraph (Y) the following new subparagraph:

“(Z) in the case of an inpatient rehabilitation facility, to implement and maintain, during any period during which regular visitation at such facility is suspended, the essential caregivers program described in section 1819(c)(7) in the same manner as if such facility were a skilled nursing facility.”.

(d) Intermediate care facilities for individuals with intellectual disabilities.— Section 1905(d) of the Social Security Act (42 U.S.C. 1396d(d)) is amended—

(1) in paragraph (2), by striking “and” at the end;

(2) in paragraph (3), by striking the period at the end and inserting “; and”; and

(3) by adding at the end the following new paragraph:

“(4) the institution implements and maintains, during any period during which regular visitation at such institution is suspended, the essential caregivers program described in section 1919(c)(7) in the same manner as if such institution were a nursing facility.”.

(e) Nonapplicability of waivers.— Subparagraphs (A) and (B) of section 1135(b)(1) of the Social Security Act (42 U.S.C. 1320b–5(b)(1)) are each amended by inserting “(other than the requirements of sections 1819(c)(3)(F), 1861(ccc)(4)(D), 1866(a)(1)(Z), 1905(d)(4), and 1919(c)(3)(F))” after “requirements”.

(f) Regulations.— The Secretary of Health and Human Services shall promulgate regulations to carry out the amendments made by this section not later than 18 months after the date of the enactment of this section.

(g) Effective date.— The amendments made by this section shall apply beginning 1 year after the date of the enactment of this section.