I 

118TH CONGRESS 

2D SESSION H. R. 8331 

To amend titles XVIII and XIX of the Social Security Act to require skilled 

nursing facilities, nursing facilities, intermediate care facilities for the 

intellectually disabled, and inpatient rehabilitation facilities to permit 

essential caregivers access during any period in which regular visitation 

is restricted. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 8, 2024 

Ms. TENNEY (for herself, Mr. LARSON of Connecticut, Mr. FITZPATRICK, Mr. 

SMITH of Nebraska, Mr. RUTHERFORD, Mr. VAN ORDEN, Ms. WILD, Mr. 

CAREY, Mr. LAWLER, Mr. CLEAVER, Ms. LEE of Nevada, Mr. 

CISCOMANI, Mr. BACON, Mr. DAVIS of North Carolina, Mr. COHEN, and 

Mr. LANGWORTHY) introduced the following bill; which was referred to 

the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined 

by the Speaker, in each case for consideration of such provisions as fall 

within the jurisdiction of the committee concerned 

A BILL 

To amend titles XVIII and XIX of the Social Security Act 

to require skilled nursing facilities, nursing facilities, intermediate care facilities for the intellectually disabled, 

and inpatient rehabilitation facilities to permit essential 

caregivers access during any period in which regular 

visitation is restricted. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Essential Caregivers 

3 Act of 2024’’. 

4 SEC. 2. FINDINGS. 

5 Congress finds the following: 

6 (1) According to the National Center for Health 

7 Statistics of the Centers for Disease Control and 

8 Prevention, an estimated 1,300,000 individuals re9 sided in nursing homes in 2020 at the onset of the 

10 COVID–19 pandemic and nearly half of all nursing 

11 home residents were living with a diagnosis of Alz12 heimer’s or other related dementia. 

13 (2) Regulations issued pursuant to the Nursing 

14 Home Reform Act of 1987 established basic rights 

15 and services for residents of nursing homes, includ16 ing ‘‘the right to a dignified existence, self-deter17 mination, and communication with and access to 

18 persons and services inside and outside the facility’’. 

19 (3) In March of 2020, the Centers for Medicare 

20 & Medicaid Services instructed nursing facilities to 

21 restrict visitation for all visitors and non-essential 

22 healthcare personnel and cancel communal dining 

23 and group activities. Long-term care ombudsman 

24 program representatives and State surveyors were 

25 among those whose access to long-term care facilities 

26 was prohibited or extremely restricted despite reVerDate Sep 11 2014 00:32 Jun 08, 2024 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8331.IH H8331

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1 opening guidance released by the Centers for Medi2 care & Medicaid Services in May of 2020. 

3 (4) Many long-term care residents declined dra4 matically or died prematurely from ‘‘failure to 

5 thrive’’ in isolation. 

6 (5) According to the National Consumer Voice 

7 for Quality Long-Term Care, in the first year of the 

8 COVID–19 pandemic, 1 in 5 healthcare workers re9 signed, retired, or were fired. This exacerbated the 

10 longstanding problem of staff shortages that already 

11 existed. Lack of staff, combined with the forced ab12 sence of families, many of whom provided informal 

13 care and support to residents, resulted in a signifi14 cant decline in residents’ health and well-being. Dur15 ing the pandemic, pressure ulcers in nursing home 

16 residents rose by 31 percent, the number of resi17 dents experiencing significant weight loss rose by 49 

18 percent, the number of residents reporting feeling 

19 down, depressed, or hopeless rose by 40 percent, and 

20 the number of residents prescribed antipsychotic 

21 medications rose by 77.5 percent. 

22 (6) According to the Department of Health and 

23 Human Services, loneliness and isolation, such as 

24 that experienced by long-term care residents during 


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1 the COVID–19 pandemic, represent profound 

2 threats to an individual’s health and well-being. 

3 (7) Essential Caregivers provide supplemental 

4 care for their loved one, regardless of staff short5 ages, staff turnover, or emergencies. Essential Care6 givers support residents and advocate on their be7 half. 

8 SEC. 3. RIGHT TO ESSENTIAL CAREGIVERS; ACCESS TO ES9 SENTIAL CAREGIVERS DURING PERIODS 

10 WHEN VISITATION IS OTHERWISE RE11 STRICTED. 

12 (a) MEDICARE SKILLED NURSING FACILITIES.—Sec13 tion 1819(c)(3) of the Social Security Act (42 U.S.C. 

14 1395i–3(c)(3)) is amended— 

15 (1) by redesignating subparagraphs (A) through 

16 (E) as clauses (i) through (v), respectively; 

17 (2) by striking ‘‘A skilled nursing facility 

18 must—’’ and inserting the following: 

19 ‘‘(A) IN GENERAL.—A skilled nursing fa20 cility shall—’’; and 

21 (3) by adding at the end the following new sub22 paragraph: 

23 ‘‘(B) ACCESS TO ESSENTIAL CAREGIVERS

24 DURING EMERGENCY PERIODS WHEN VISITA25 TION IS OTHERWISE RESTRICTED.— 


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1 ‘‘(i) DESIGNATION OF ESSENTIAL

2 CAREGIVER.—Each skilled nursing facility 

3 shall recognize the right of each resident of 

4 such facility to— 

5 ‘‘(I) designate and have access to 

6 essential caregivers for such resident 

7 at all times, including during any pe8 riod of emergency in which regular 

9 visitation is restricted by order of a 

10 Federal, State, or local authority or 

11 by other operation of law; and 

12 ‘‘(II) amend such designation at 

13 any time. 

14 ‘‘(ii) PRESUMPTION OF DESIGNA15 TION.—For purposes of clause (i), in the 

16 case of a resident who is unable, by reason 

17 of cognitive or mental disability, to make 

18 an election described in such clause, the 

19 resident representative (as defined in sec20 tion 483.5 of title 42, Code of Federal 

21 Regulations) of such resident shall be per22 mitted to make such designation for such 

23 resident. 

24 ‘‘(iii) ACCESS TO ESSENTIAL CARE25 GIVERS DURING EMERGENCY PERIODS


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1 WHEN VISITATION IS OTHERWISE RE2 STRICTED.—During a period of emergency 

3 in which regular visitation is restricted by 

4 order of a Federal, State, or local author5 ity or by other operation of law, including 

6 any period in which a waiver or modifica7 tion of requirements pursuant to section 

8 1135 is in effect, a skilled nursing facility 

9 shall— 

10 ‘‘(I) not deny in-person access to 

11 a resident by an essential caregiver of 

12 the resident except as provided in this 

13 subparagraph; 

14 ‘‘(II) allow at least 1 essential 

15 caregiver to have access to and pro16 vide assistance to such resident at 

17 such facility every day and at any 

18 time; and 

19 ‘‘(III) enforce the agreement de20 scribed in clause (vii)(III) with respect 

21 to an essential caregiver. 

22 ‘‘(iv) RESTRICTIONS ON ACCESS.— 

23 ‘‘(I) IN GENERAL.—During a pe24 riod of emergency in which regular 

25 visitation is restricted by order of a 


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1 Federal, State, or local authority or 

2 by other operation of law, including 

3 any period in which a waiver or modi4 fication of requirements pursuant to 

5 section 1135 is in effect, a skilled 

6 nursing facility may deny access to a 

7 resident by an essential caregiver of 

8 the resident for— 

9 ‘‘(aa) an initial period of not 

10 longer than 7 days; and 

11 ‘‘(bb) one additional period 

12 of not longer than 7 days (in ad13 dition to the initial period de14 scribed in item (aa)) if the de15 partment of health of the State 

16 in which the facility is located 

17 approves the denial of access for 

18 such additional period. 

19 ‘‘(II) RULE OF APPLICATION.— 

20 For purposes of subclause (I), a pe21 riod of emergency in which regular 

22 visitation is restricted by order of a 

23 Federal, State, or local authority or 

24 by other operation of law shall begin 

25 on the date that such order or other 


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1 operation of law takes effect and shall 

2 end on the date that such order or 

3 other operation of law expires or is 

4 otherwise terminated. During any 

5 such period, the maximum number of 

6 days for which a skilled nursing facil7 ity may deny access to a resident by 

8 an essential caregiver of the resident 

9 is 7 total days (or, subject to the ap10 proval of the department of health of 

11 the State in which the facility is lo12 cated, 14 total days). 

13 ‘‘(v) COMPLIANCE AND NOTIFICA14 TION.— 

15 ‘‘(I) AUTHORITY.—No essential 

16 caregiver who upholds the agreement 

17 described in clause (vii)(III) shall be 

18 denied access to the skilled nursing 

19 facility of the resident involved. 

20 ‘‘(II) NOTIFICATION.— If an es21 sential caregiver fails to comply with 

22 an agreement with a skilled nursing 

23 facility described in clause (vii)(III), 

24 the facility must first provide a warn25 ing to the essential caregiver and resiVerDate Sep 11 2014 00:32 Jun 08, 2024 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H8331.IH H8331

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1 dent in writing citing specific issues of 

2 non-compliance and providing clear 

3 guidance for corrective measures. 

4 ‘‘(III) ENFORCEMENT.—If an es5 sential caregiver or resident, after re6 ceiving a notification of noncompli7 ance described in subclause (II), fails 

8 to take corrective action, the essential 

9 caregiver may subsequently be denied 

10 access to the resident. In such cases, 

11 the facility shall provide to such care12 giver and such resident (or health 

13 care proxy of such resident), not later 

14 than 24 hours after such denial of ac15 cess occurs, a written explanation as 

16 to why such caregiver was denied ac17 cess to such resident. Such expla18 nation must include the resident’s and 

19 caregiver’s options for appeal under 

20 the processes established under clause 

21 (vi). 

22 ‘‘(vi) OPTIONS FOR RESIDENTS AND

23 CAREGIVERS TO APPEAL DENIALS OF AC24 CESS.— 


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1 ‘‘(I) IN GENERAL.—Not later 

2 than 2 years after the date of enact3 ment of this subparagraph, the Sec4 retary shall issue a final rule estab5 lishing a process for residents and 

6 caregivers to appeal denials of access. 

7 ‘‘(II) APPEALS PROCESS.—The 

8 agency responsible for overseeing the 

9 appeals process established under sub10 clause (I) shall— 

11 ‘‘(aa) receive appeals from 

12 residents and essential caregivers 

13 challenging a decision by a 

14 skilled nursing facility to deny 

15 access under clause (v); and 

16 ‘‘(bb) investigate all such 

17 appeals within 48 hours of re18 ceipt. 

19 ‘‘(III) BURDEN OF PROOF.— 

20 During an appeal received under the 

21 appeals process established under sub22 clause (I), if a skilled nursing facility 

23 defends a decision to deny access to 

24 an essential caregiver under clause (v) 

25 on the basis that the essential careVerDate Sep 11 2014 00:32 Jun 08, 2024 Jkt 049200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H8331.IH H8331

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1 giver violated the agreement described 

2 in clause (vii)(III), the skilled nursing 

3 facility shall have the burden of proof 

4 in demonstrating that the essential 

5 caregiver violated such agreement. 

6 ‘‘(IV) RESOLUTION OF AP7 PEAL.—With respect to an appeal re8 ceived under the appeals process es9 tablished under subclause (I), the 

10 agency responsible for overseeing the 

11 appeal shall make a determination as 

12 to whether a skilled nursing facility 

13 violated a requirement or prohibition 

14 of this subparagraph within 48 hours 

15 of commencing its investigation. If the 

16 agency determines that a facility has 

17 violated such a requirement or prohi18 bition the agency shall— 

19 ‘‘(aa) require the facility to 

20 allow immediate access to the es21 sential caregiver in question; 

22 ‘‘(bb) require the facility to 

23 establish a corrective action plan 

24 to prevent the recurrence of such 

25 violation within a 7-day period of 


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1 receiving notice from the agency; 

2 and 

3 ‘‘(cc) impose a civil money 

4 penalty in an amount to be deter5 mined by the agency (not to ex6 ceed $5,000) if such facility fails 

7 to implement the corrective ac8 tion plan with the 7-day period 

9 specified in item (bb). 

10 ‘‘(vii) DEFINITION OF ESSENTIAL

11 CAREGIVER.—For purposes of this sub12 paragraph, the term ‘essential caregiver’ 

13 means, with respect to a resident of a 

14 skilled nursing facility, an individual 

15 who— 

16 ‘‘(I) is designated by or on behalf 

17 of the resident pursuant to clause (i) 

18 or clause (ii); 

19 ‘‘(II) will provide assistance to 

20 such resident, which may include as21 sistance with activities of daily living 

22 or providing emotional support or 

23 companionship to such resident; and 

24 ‘‘(III) agrees to follow all safety 

25 protocols established by such facility, 


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1 which shall be clearly specified in 

2 writing and may be no more restric3 tive than the safety protocols (includ4 ing safety standards and entry re5 quirements) applicable to staff of such 

6 facility.’’. 

7 (b) MEDICAID NURSING FACILITIES.—Section 

8 1919(c)(3) of the Social Security Act (42 U.S.C. 

9 1396r(c)(3)) is amended— 

10 (1) by redesignating subparagraphs (A) through 

11 (E) as clauses (i) through (v), respectively; 

12 (2) by striking ‘‘A nursing facility must—’’ and 

13 inserting the following: 

14 ‘‘(A) IN GENERAL.—A nursing facility 

15 shall—’’; and 

16 (3) by adding at the end the following new sub17 paragraph: 

18 ‘‘(B) ACCESS TO ESSENTIAL CAREGIVERS

19 DURING EMERGENCY PERIODS WHEN VISITA20 TION IS OTHERWISE RESTRICTED.— 

21 ‘‘(i) DESIGNATION OF ESSENTIAL

22 CAREGIVER.—Each nursing facility shall 

23 recognize the right of each resident of such 

24 facility to— 


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1 ‘‘(I) designate and have access to 

2 essential caregivers for such resident 

3 at all times, including during any pe4 riod of emergency in which regular 

5 visitation is restricted by order of a 

6 Federal, State, or local authority or 

7 by other operation of law; and 

8 ‘‘(II) amend such designation at 

9 any time. 

10 ‘‘(ii) PRESUMPTION OF DESIGNA11 TION.—For purposes of clause (i), in the 

12 case of a resident who is unable, by reason 

13 of cognitive or mental disability, to make 

14 an election described in such clause, the 

15 resident representative (as defined in sec16 tion 483.5 of title 42, Code of Federal 

17 Regulations) of such resident shall be per18 mitted to make such designation for such 

19 resident. 

20 ‘‘(iii) ACCESS TO ESSENTIAL CARE21 GIVERS DURING EMERGENCY PERIODS

22 WHEN VISITATION IS OTHERWISE RE23 STRICTED.—During a period of emergency 

24 in which regular visitation is restricted by 

25 order of a Federal, State, or local authorVerDate Sep 11 2014 00:32 Jun 08, 2024 Jkt 049200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\H8331.IH H8331

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1 ity or by other operation of law, including 

2 any period in which a waiver or modifica3 tion of requirements pursuant to section 

4 1135 is in effect, a nursing facility shall— 

5 ‘‘(I) not deny in-person access to 

6 a resident by an essential caregiver of 

7 the resident except as provided in this 

8 subparagraph; 

9 ‘‘(II) allow at least 1 essential 

10 caregiver to have access to and pro11 vide assistance to such resident at 

12 such facility every day and at any 

13 time; and 

14 ‘‘(III) enforce the agreement de15 scribed in clause (vii)(III) with respect 

16 to an essential caregiver. 

17 ‘‘(iv) RESTRICTIONS ON ACCESS.— 

18 ‘‘(I) IN GENERAL.—During a pe19 riod of emergency in which regular 

20 visitation is restricted by order of a 

21 Federal, State, or local authority or 

22 by other operation of law, including 

23 any period in which a waiver or modi24 fication of requirements pursuant to 

25 section 1135 is in effect, a nursing faVerDate Sep 11 2014 00:32 Jun 08, 2024 Jkt 049200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\H8331.IH H8331

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1 cility may deny access to a resident by 

2 an essential caregiver of the resident 

3 for— 

4 ‘‘(aa) an initial period of not 

5 longer than 7 days; and 

6 ‘‘(bb) one additional period 

7 of not longer than 7 days (in ad8 dition to the initial period de9 scribed in item (aa)) if the de10 partment of health of the State 

11 in which the facility is located 

12 approves the denial of access for 

13 such additional period. 

14 ‘‘(II) RULE OF APPLICATION.— 

15 For purposes of subclause (I), a pe16 riod of emergency in which regular 

17 visitation is restricted by order of a 

18 Federal, State, or local authority or 

19 by other operation of law shall begin 

20 on the date that such order or other 

21 operation of law takes effect and shall 

22 end on the date that such order or 

23 other operation of law expires or is 

24 otherwise terminated. During any 

25 such period, the maximum number of 


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1 days for which a nursing facility may 

2 deny access to a resident by an essen3 tial caregiver of the resident is 7 total 

4 days (or, subject to the approval of 

5 the department of health of the State 

6 in which the facility is located, 14 

7 total days). 

8 ‘‘(v) COMPLIANCE AND NOTIFICA9 TION.— 

10 ‘‘(I) AUTHORITY.—No essential 

11 caregiver who upholds the agreement 

12 described in clause (vii)(III) shall be 

13 denied access to the nursing facility of 

14 the resident involved. 

15 ‘‘(II) NOTIFICATION.— If an es16 sential caregiver fails to comply with 

17 an agreement with a nursing facility 

18 described in clause (vii)(III), the facil19 ity must first provide a warning to the 

20 essential caregiver and resident in 

21 writing citing specific issues of non22 compliance and providing clear guid23 ance for corrective measures. 

24 ‘‘(III) ENFORCEMENT.—If an es25 sential caregiver or resident, after reVerDate Sep 11 2014 00:32 Jun 08, 2024 Jkt 049200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H8331.IH H8331

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1 ceiving a notification of noncompli2 ance described in subclause (II), fails 

3 to take corrective action, the essential 

4 caregiver may subsequently be denied 

5 access to the resident. In such cases, 

6 the facility shall provide to such care7 giver and such resident (or health 

8 care proxy of such resident), not later 

9 than 24 hours after such denial of ac10 cess occurs, a written explanation as 

11 to why such caregiver was denied ac12 cess to such resident. Such expla13 nation must include the resident’s and 

14 caregiver’s options for appeal under 

15 the processes established under clause 

16 (vi). 

17 ‘‘(vi) OPTIONS FOR RESIDENTS AND

18 CAREGIVERS TO APPEAL DENIALS OF AC19 CESS.— 

20 ‘‘(I) IN GENERAL.—Not later 

21 than 2 years after the date of enact22 ment of this subparagraph, the Sec23 retary shall issue a final rule estab24 lishing a process for residents and 

25 caregivers to appeal denials of access. 


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1 ‘‘(II) APPEALS PROCESS.—The 

2 agency responsible for overseeing the 

3 appeals process established under sub4 clause (I) shall— 

5 ‘‘(aa) receive appeals from 

6 residents and essential caregivers 

7 challenging a decision by a nurs8 ing facility to deny access under 

9 clause (v); and 

10 ‘‘(bb) investigate all such 

11 appeals within 48 hours of re12 ceipt. 

13 ‘‘(III) BURDEN OF PROOF.— 

14 During an appeal received under the 

15 appeals process established under sub16 clause (I), if a nursing facility defends 

17 a decision to deny access to an essen18 tial caregiver under clause (v) on the 

19 basis that the essential caregiver vio20 lated the agreement described in 

21 clause (vii)(III), the nursing facility 

22 shall have the burden of proof in dem23 onstrating that the essential caregiver 

24 violated such agreement. 


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1 ‘‘(IV) RESOLUTION OF AP2 PEAL.—With respect to an appeal re3 ceived under the appeals process es4 tablished under subclause (I), the 

5 agency responsible for overseeing the 

6 appeal shall make a determination as 

7 to whether a nursing facility violated 

8 a requirement or prohibition of this 

9 subparagraph within 48 hours of com10 mencing its investigation. If the agen11 cy determines that a facility has vio12 lated such a requirement or prohibi13 tion the agency shall— 

14 ‘‘(aa) require the facility to 

15 allow immediate access to the es16 sential caregiver in question; 

17 ‘‘(bb) require the facility to 

18 establish a corrective action plan 

19 to prevent the recurrence of such 

20 violation within a 7-day period of 

21 receiving notice from the agency; 

22 and 

23 ‘‘(cc) impose a civil money 

24 penalty in an amount to be deter25 mined by the agency (not to exVerDate Sep 11 2014 00:32 Jun 08, 2024 Jkt 049200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\H8331.IH H8331

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1 ceed $5,000) if such facility fails 

2 to implement the corrective ac3 tion plan with the 7-day period 

4 specified in item (bb). 

5 ‘‘(vii) DEFINITION OF ESSENTIAL

6 CAREGIVER.—For purposes of this sub7 paragraph, the term ‘essential caregiver’ 

8 means, with respect to a resident of a 

9 nursing facility, an individual who— 

10 ‘‘(I) is designated by or on behalf 

11 of the resident pursuant to clause (i) 

12 or clause (ii); 

13 ‘‘(II) will provide assistance to 

14 such resident, which may include as15 sistance with of activities of daily liv16 ing or providing emotional support or 

17 companionship to such resident; and 

18 ‘‘(III) agrees to follow all safety 

19 protocols established by such facility, 

20 which shall be clearly specified in 

21 writing and may be no more restric22 tive than the safety protocols (includ23 ing safety standards and entry re24 quirements) applicable to staff of such 

25 facility.’’. 


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1 (c) INTERMEDIATE CARE FACILITIES FOR THE IN2 TELLECTUALLY DISABLED.—Section 1905(d) of the So3 cial Security Act (42 U.S.C. 1396d(d)) is amended— 

4 (1) in paragraph (2), by striking ‘‘and’’ at the 

5 end; 

6 (2) in paragraph (3), by striking the period and 

7 inserting ‘‘; and’’; and 

8 (3) by adding at the end the following new 

9 paragraph: 

10 ‘‘(4) the institution complies with the require11 ments relating to the designation of, and access to 

12 residents by, essential caregivers described in section 

13 1919(c)(3)(B) in the same manner as if such insti14 tution were a nursing facility.’’. 

15 (d) INPATIENT REHABILITATION FACILITIES.—Sec16 tion 1866(a)(1) of the Social Security Act (42 U.S.C. 

17 1395cc(a)(1)) is amended— 

18 (1) in subparagraph (X), by striking ‘‘and’’ at 

19 the end; 

20 (2) in subparagraph (Y), by striking the period 

21 at the end and inserting ‘‘, and’’; and 

22 (3) by inserting after subparagraph (Y) the fol23 lowing new subparagraph: 

24 ‘‘(Z) in the case of an inpatient rehabilitation 

25 facility that is located on the same campus (as deVerDate Sep 11 2014 00:32 Jun 08, 2024 Jkt 049200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\H8331.IH H8331

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1 fined by the Secretary) as a skilled nursing facility, 

2 nursing facility (as defined in section 1919(a)), or 

3 intermediate care facility for the intellectually dis4 abled (as described in section 1905(d)), to comply 

5 with the requirements relating to the designation of, 

6 and access to residents by, essential caregivers de7 scribed in section 1819(c)(3)(B) in the same manner 

8 as if such institution were a skilled nursing facil9 ity.’’. 

10 (e) REGULATIONS.—The Secretary of Health and 

11 Human Services shall, after consultation with stakeholders 

12 (including residents, family members, long-term care om13 budsmen, other advocates of nursing home residents, and 

14 nursing home providers), promulgate regulations to carry 

15 out this Act and the amendments made by this Act. 

16 (f) RULES OF CONSTRUCTION.— 

17 (1) NO NEW AUTHORITY FOR STATE AND

18 LOCAL OFFICIALS TO RESTRICT VISITATION AT

19 NURSING FACILITIES.—Nothing in this section or 

20 the amendments made by this section shall be con21 strued as creating any new authority for State or 

22 local officials to restrict visitation at nursing facili23 ties. 

24 (2) NO NEW AUTHORITY FOR NURSING FACILI25 TIES TO UNILATERALLY RESTRICT VISITATION.— 


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1 Nothing in this section or the amendments made by 

2 this section shall be construed as creating any new 

3 authority for a skilled nursing facility or nursing fa4 cility (as such terms are defined in sections 1819 

5 and 1919 of the Social Security Act, respectively (42 

6 U.S.C. 1395i–3, 1396r)) to restrict visitation. 

7 (g) EFFECTIVE DATE.—The amendments made by 

8 this Act shall take effect on the date that is 24 months 

9 after the date of the enactment of this Act, and shall apply 

10 with respect to periods beginning on or after such date 

11 in which regular visitation at nursing facilities is restricted 

12 by order of a Federal, State, or local authority or by other 

13 operation of law. 

Æ 


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