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 Com-
mittee 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 Med-
icaid programs. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
VerDate Sep 11 2014 
23:44 May 19, 2021
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H2114.IH
H2114
kjohnson on DSK79L0C42PROD with BILLS
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Essential Caregivers 
Act of 2021’’. 
SEC. 2. REQUIRING CERTAIN FACILITIES TO PERMIT ES-
SENTIAL CAREGIVER VISITORS DURING A 
PUBLIC HEALTH EMERGENCY. 
(a) SKILLED NURSING FACILITIES; NURSING FA-
CILITIES.—Section 1819(c) and 1919(c) of the Social Se-
curity Act (42 U.S.C. 1395i–3(c), 1396r(c)) are each 
amended— 
(1) in paragraph (3)— 
(A) in subparagraph (D), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (E), by striking the 
period and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(F) establish and maintain, during the 
period beginning on the date of the enactment 
of this subparagraph and ending on the last day 
of the emergency period described in section 
1135(g)(1)(B), the essential caregiver visitor 
program described in paragraph (7).’’; and 
(2) by adding at the end the following new 
paragraph: 
VerDate Sep 11 2014 
23:44 May 19, 2021
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H2114.IH
H2114
kjohnson on DSK79L0C42PROD with BILLS
‘‘(7) ESSENTIAL
CAREGIVER
VISITOR
PRO-
GRAM.— 
‘‘(A) IN
GENERAL.—For purposes sub-
paragraph (F) of paragraph (3), the essential 
caregiver visitor program described in this para-
graph is a program established by a facility de-
scribed in such paragraph under which such fa-
cility— 
‘‘(i) allows each resident of such facil-
ity to elect not more than 2 essential care-
givers (as defined in subparagraph (C)) to 
visit such resident at such facility; 
‘‘(ii) permits each such caregiver so 
elected by such resident to provide care to 
such resident at such facility for up to 8 
hours every day; and 
‘‘(iii) enforces each agreement de-
scribed in subparagraph (C)(iv) with re-
spect to an essential caregiver. 
‘‘(B) PRESUMPTION
OF
ELECTION.—For 
purposes of subparagraph (A), in the case of a 
resident who is unable, by reason of physical or 
mental disability, to make an election described 
in such subparagraph, 2 of the following indi-
viduals who are essential caregivers (as defined 
VerDate Sep 11 2014 
23:44 May 19, 2021
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H2114.IH
H2114
kjohnson on DSK79L0C42PROD with BILLS
in subparagraph (C)), as selected by the legal 
guardian of such resident, shall be deemed to 
have been so elected by such resident: 
‘‘(i) A relative of such resident. 
‘‘(ii) The power of attorney of such 
resident. 
‘‘(iii) The health care proxy of such 
resident. 
‘‘(C) ESSENTIAL CAREGIVER DEFINED.— 
For purposes of this paragraph, the term ‘es-
sential caregiver’ means, with respect to a resi-
dent of a facility described in subparagraph 
(A), an individual who— 
‘‘(i) furnished care to such resident 
prior to the first day of the emergency pe-
riod described in section 1135(g)(1)(B); 
‘‘(ii) will provide activities of daily liv-
ing (as determined appropriate by the fa-
cility) or emotional support to such resi-
dent, in accordance with the care plan of 
such resident; 
‘‘(iii) the facility approves to furnish 
such activities or support; 
‘‘(iv) agrees to— 
VerDate Sep 11 2014 
23:44 May 19, 2021
Jkt 019200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H2114.IH
H2114
kjohnson on DSK79L0C42PROD with BILLS
‘‘(I) follow all safety protocols es-
tablished by such facility (including 
the use of personal protective equip-
ment and any mandatory COVID–19- 
related training); 
‘‘(II) provide proof of a negative 
COVID–19 test prior to entry to such 
facility for the first time, and then 
weekly thereafter; 
‘‘(III) only visit with such resi-
dent in a private room and maintain 
distance from other residents and 
staff; and 
‘‘(IV) 
undergo 
screening 
for 
COVID–19 in the same manner as 
staff of such facility; and 
‘‘(v) provides a signed waiver to such 
facility agreeing not to hold such facility 
liable for any transmission of COVID–19 
to the individual that may occur at such 
facility.’’. 
(b) INTERMEDIATE CARE FACILITIES FOR THE IN-
TELLECTUALLY DISABLED.—Section 1905(d) of the So-
cial Security Act (42 U.S.C. 1396d(d)) is amended— 
VerDate Sep 11 2014 
23:44 May 19, 2021
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H2114.IH
H2114
kjohnson on DSK79L0C42PROD with BILLS
(1) in paragraph (2), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (3), by striking the period and 
inserting ‘‘; and’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(4) the institution established and maintains, 
during the period beginning on the date of the en-
actment of this paragraph and ending on the last 
day of the emergency period described in section 
1135(g)(1)(B), the essential caregiver program de-
scribed in section 1919(c)(7) in the same manner as 
if such institution were a nursing facility.’’. 
Æ 
VerDate Sep 11 2014 
23:44 May 19, 2021
Jkt 019200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6301
E:\BILLS\H2114.IH
H2114
kjohnson on DSK79L0C42PROD with BILLS