I 

117TH CONGRESS 

1ST SESSION H. R. 2114 

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

nursing facilities, nursing facilities, and intermediate care facilities for 

the intellectually disabled to permit certain essential caregiver visitors 

during a public health emergency under the Medicare and Medicaid 

programs. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 19, 2021 

Ms. TENNEY 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, and 

intermediate care facilities for the intellectually disabled 

to permit certain essential caregiver visitors during a 

public health emergency under the Medicare and Medicaid programs. 

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 2021’’. 

4 SEC. 2. REQUIRING CERTAIN FACILITIES TO PERMIT ES5 SENTIAL CAREGIVER VISITORS DURING A 

6 PUBLIC HEALTH EMERGENCY. 

7 (a) SKILLED NURSING FACILITIES; NURSING FA8 CILITIES.—Section 1819(c) and 1919(c) of the Social Se9 curity Act (42 U.S.C. 1395i–3(c), 1396r(c)) are each 

10 amended— 

11 (1) in paragraph (3)— 

12 (A) in subparagraph (D), by striking 

13 ‘‘and’’ at the end; 

14 (B) in subparagraph (E), by striking the 

15 period and inserting ‘‘; and’’; and 

16 (C) by adding at the end the following new 

17 subparagraph: 

18 ‘‘(F) establish and maintain, during the 

19 period beginning on the date of the enactment 

20 of this subparagraph and ending on the last day 

21 of the emergency period described in section 

22 1135(g)(1)(B), the essential caregiver visitor 

23 program described in paragraph (7).’’; and 

24 (2) by adding at the end the following new 

25 paragraph: 


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1 ‘‘(7) ESSENTIAL CAREGIVER VISITOR PRO2 GRAM.— 

3 ‘‘(A) IN GENERAL.—For purposes sub4 paragraph (F) of paragraph (3), the essential 

5 caregiver visitor program described in this para6 graph is a program established by a facility de7 scribed in such paragraph under which such fa8 cility— 

9 ‘‘(i) allows each resident of such facil10 ity to elect not more than 2 essential care11 givers (as defined in subparagraph (C)) to 

12 visit such resident at such facility; 

13 ‘‘(ii) permits each such caregiver so 

14 elected by such resident to provide care to 

15 such resident at such facility for up to 8 

16 hours every day; and 

17 ‘‘(iii) enforces each agreement de18 scribed in subparagraph (C)(iv) with re19 spect to an essential caregiver. 

20 ‘‘(B) PRESUMPTION OF ELECTION.—For 

21 purposes of subparagraph (A), in the case of a 

22 resident who is unable, by reason of physical or 

23 mental disability, to make an election described 

24 in such subparagraph, 2 of the following indi25 viduals who are essential caregivers (as defined 


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1 in subparagraph (C)), as selected by the legal 

2 guardian of such resident, shall be deemed to 

3 have been so elected by such resident: 

4 ‘‘(i) A relative of such resident. 

5 ‘‘(ii) The power of attorney of such 

6 resident. 

7 ‘‘(iii) The health care proxy of such 

8 resident. 

9 ‘‘(C) ESSENTIAL CAREGIVER DEFINED.— 

10 For purposes of this paragraph, the term ‘es11 sential caregiver’ means, with respect to a resi12 dent of a facility described in subparagraph 

13 (A), an individual who— 

14 ‘‘(i) furnished care to such resident 

15 prior to the first day of the emergency pe16 riod described in section 1135(g)(1)(B); 

17 ‘‘(ii) will provide activities of daily liv18 ing (as determined appropriate by the fa19 cility) or emotional support to such resi20 dent, in accordance with the care plan of 

21 such resident; 

22 ‘‘(iii) the facility approves to furnish 

23 such activities or support; 

24 ‘‘(iv) agrees to— 


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1 ‘‘(I) follow all safety protocols es2 tablished by such facility (including 

3 the use of personal protective equip4 ment and any mandatory COVID–19- 

5 related training); 

6 ‘‘(II) provide proof of a negative 

7 COVID–19 test prior to entry to such 

8 facility for the first time, and then 

9 weekly thereafter; 

10 ‘‘(III) only visit with such resi11 dent in a private room and maintain 

12 distance from other residents and 

13 staff; and 

14 ‘‘(IV) undergo screening for 

15 COVID–19 in the same manner as 

16 staff of such facility; and 

17 ‘‘(v) provides a signed waiver to such 

18 facility agreeing not to hold such facility 

19 liable for any transmission of COVID–19 

20 to the individual that may occur at such 

21 facility.’’. 

22 (b) INTERMEDIATE CARE FACILITIES FOR THE IN23 TELLECTUALLY DISABLED.—Section 1905(d) of the So24 cial Security Act (42 U.S.C. 1396d(d)) is amended— 


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

2 end; 

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

4 inserting ‘‘; and’’; and 

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

6 paragraph: 

7 ‘‘(4) the institution established and maintains, 

8 during the period beginning on the date of the en9 actment of this paragraph and ending on the last 

10 day of the emergency period described in section 

11 1135(g)(1)(B), the essential caregiver program de12 scribed in section 1919(c)(7) in the same manner as 

13 if such institution were a nursing facility.’’. 

Æ 


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