I 
117TH CONGRESS 
2D SESSION 
H. R. 6530 
To amend the Public Health Service Act to sustain senior congregate care 
operations in the wake of ongoing COVID–19 financial burdens, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 28, 2022 
Mrs. TRAHAN (for herself and Mr. FITZPATRICK) 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 subse-
quently 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 the Public Health Service Act to sustain senior 
congregate care operations in the wake of ongoing 
COVID–19 financial burdens, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Safeguarding Elderly 
Needs for Infrastructure and Occupational Resources Act 
of 2022’’ or the ‘‘SENIOR Act of 2022’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
(1) Long-term care facilities and senior con-
gregate care homes provide direct and personalized 
care, where social distancing is not possible, 24 
hours a day, 7 days a week. 
(2) Assisted living, memory care, independent 
living, and other senior congregate care settings are 
the homes of America’s seniors and critical options 
on the long-term care continuum; these senior resi-
dences provide safety and security for our Nation’s 
most vulnerable population. 
(3) Sixty percent of a senior’s health is based 
on social determinants of health which include the 
need for adequate nutrition, housing, and social ac-
tivities; thus supporting caregivers and home- and 
community-based care models that prioritize the so-
cial determinants of senior health should be a pri-
ority of the Congress. 
(4) Investing in senior care and the caregiving 
workforce prevents hospitalization and skilled nurs-
ing expenses, preserving Medicare and Medicaid 
budgets. 
(5) Since March of 2020, senior care facilities 
have lost over 380,000 caregivers and are experi-
encing a workforce crisis as America’s population 
rapidly ages. 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
(6) By 2030, the entire Baby Boomer Genera-
tion will be 65 years of age or older. 
(7) By 2060, nearly 95 million Americans will 
be 65 years of age or older and the portion of the 
population over 85 years of age will have tripled to 
nearly 20 million persons. 
(8) Fifty-two percent of individuals require 
long-term care by age 65. Individuals over 65 years 
of age are 70 percent more likely to need long-term 
care, with half of those seniors requiring an even 
higher level of care. 
(9) The average duration of long-term care is 
nearly 4 years, and 14 percent of individuals need 
long-term care for 5 or more years. 
(10) Twenty-seven percent of seniors over 65 
years of age will spend at least $100,000 on long- 
term care, and 15 percent will have costs for long- 
term care surpassing $250,000. 
(11) The average cost for long-term care for a 
65-year old today is $138,000. 
(12) Long-term care infrastructure must ad-
dress the availability of cost-effective care and hous-
ing options to meet the growing needs of the Na-
tion’s aging population. 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
(13) On average, assisted living costs $4,300 
per month, which equals $5.91 per hour of available 
care (based on 24/7 care). Nursing homes cost 
$8,821 per month (or $13.13 per hour based on 24/ 
7 care). In-home care costs $4,576 per month (or 
$26 per hour based on 44 hours per week care). 
(14) An individual 85 years of age or older is 
630 percent more likely to die of COVID–19. 
(15) Sixty-three percent of residents of long- 
term care facilities need assistance with bathing; 48 
percent need assistance with dressing; and 40 per-
cent need assistance with toileting. 
(16) More than 42 percent of residents of long- 
term care facilities suffer from Alzheimer’s disease 
or some other form of dementia. 
(17) The people of the United States are a 
compassionate people who are committed to pro-
tecting the most vulnerable in our society, and we 
should not jeopardize the financial underpinnings of 
the long-term care communities our Nation’s senior 
citizens depend on day-in and day-out. 
SEC. 3. SENIOR CAREGIVER RELIEF ASSISTANCE. 
Part K of title III of the Public Health Service Act 
(42 U.S.C. 280c et seq.) is amended by adding at the end 
the following new subpart: 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
‘‘Subpart IV—Senior Caregiver Relief Assistance 
‘‘SEC. 399A–1. SENIOR CAREGIVER RELIEF ASSISTANCE. 
‘‘(a) AUTHORITY.—The Secretary shall provide as-
sistance under this section to eligible entities to stabilize 
and preserve senior congregate care operations. 
‘‘(b) ELIGIBLE ENTITIES.— 
‘‘(1) IN GENERAL.—The Secretary may provide 
assistance under this section only to an entity that— 
‘‘(A) is an assisted living facility; 
‘‘(B) demonstrates, by providing such doc-
umentation as the Secretary shall require, fi-
nancial need by having— 
‘‘(i) incurred uncompensated losses 
because of the public health emergency de-
clared under section 319 with respect to 
COVID–19; and 
‘‘(ii) consistently maintained ongoing 
operations during the period from March 
13, 2020, to December 31, 2020; and 
‘‘(C) makes a good-faith certification to 
the Secretary— 
‘‘(i) that the uncertainty of existing 
economic conditions makes the application 
for assistance under this section necessary 
to support ongoing operations of the enti-
ty; and 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(ii) that all amounts of such assist-
ance will be used to promote the health 
and well-being of the facility’s population 
of seniors, to retain workers, to maintain 
the facility, and for other eligible uses 
under the relevant provisions of this sec-
tion. 
‘‘(2) BASIS
OF
DETERMINATIONS.—Any indi-
vidual determination of qualification of an entity as 
an eligible entity for purposes of this section shall be 
based on review of the entity’s existing versus recent 
historic financials, including— 
‘‘(A) profit-loss statements; 
‘‘(B) account receivables; 
‘‘(C) Federal tax filings; and 
‘‘(D) such other materials that the Sec-
retary deems relevant to meet the purposes of 
this section. 
‘‘(c) APPLICATIONS.—The Secretary shall— 
‘‘(1) provide for eligible entities to submit appli-
cations for assistance under this section; and 
‘‘(2) require such applications— 
‘‘(A) to set forth the proposed uses of such 
assistance; and 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(B) to contain such other assurances and 
information as the Secretary may require. 
‘‘(d) FORMULA GRANTS
FOR HEALTH CARE-RE-
LATED EXPENSES AND LOST REVENUE ATTRIBUTABLE 
TO COVID–19.— 
‘‘(1) IN GENERAL.—To the extent and in the 
amount of appropriations made in advance to carry 
out this section, the Secretary shall— 
‘‘(A) make grants to eligible entities for 
health care-related expenses attributable to 
COVID–19 or to supplant lost revenue attrib-
utable to COVID–19; and 
‘‘(B) distribute such amounts among eligi-
ble entities in an equitable and timely manner, 
but not later than December 31, 2022, based 
on the order in which approvable applications 
from such entities are received by the Sec-
retary. 
‘‘(2) LIMITATION
ON
ADMINISTRATIVE
EX-
PENSES.—As a condition on receipt of a grant under 
this section, an eligible entity shall agree to use not 
more than 5 percent of the amounts received 
through the grant for administrative expenses. 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(3) AMOUNT.—The amount of assistance dis-
tributed to an eligible entity pursuant to this sub-
section shall be— 
‘‘(A) based on the number of beds in the 
facility to be assisted; and 
‘‘(B) proportional to the uncompensated 
losses of the eligible entity referred to in sub-
section (b)(1)(B)(i). 
‘‘(4) RULE
OF
CONSTRUCTION.—Nothing in 
this subsection shall be construed as preventing the 
Secretary from making assistance available to eligi-
ble entities at any time before the date specified in 
paragraph (1)(B). 
‘‘(e) SENIOR CAREGIVER RELIEF GRANTS.— 
‘‘(1) IN GENERAL.—To the extent and in the 
amount of appropriations made in advance to carry 
out this section, the Secretary shall make grants to 
eligible entities for use (subject to paragraph (2)) 
only for the following purposes: 
‘‘(A) 
ENHANCED
BROADBAND 
CONNECTIVITY AND TELEHEALTH SUPPORT.— 
To ensure regular and reliable communications 
connections between seniors residing in the as-
sisted living facility of the entity and their phy-
sicians and medical support personnel. 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(B) CAREGIVER
SUSTAINABILITY.—For 
costs of operating and maintaining the assisted 
living facility of the entity, including— 
‘‘(i) for payments of principal or in-
terest on any mortgage obligation in con-
nection with the facility, but not including 
any prepayment of principal on such a 
mortgage obligation; 
‘‘(ii) for payments of rent for a facil-
ity, including rent under a lease agree-
ment, but not including any prepayment of 
rent; 
‘‘(iii) for costs of activities to prevent, 
prepare for, and mitigate the presence of 
COVID–19 on facility premises, including 
costs of purchasing and installing equip-
ment and supplies to disinfect the prem-
ises, support emergency management oper-
ations, and provide for associated staff-re-
lated expenses; 
‘‘(iv) for maintenance expenses for the 
facility for the purposes of COVID–19 
mitigation and infection control, including 
construction 
to 
accommodate 
social 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
distancing and other preventive measures, 
such as plexiglass barriers; 
‘‘(v) for costs of supplies for the facil-
ity, including protective equipment and 
cleaning materials; and 
‘‘(vi) for any other expenses that the 
Secretary determines to be essential to 
maintaining the facility. 
‘‘(2) OTHER ACTIVITIES.—Nothing in this sub-
section may be construed to prevent the Secretary 
from approving applications providing for use of 
funds for other costs, purposes, and activities not 
specifically identified in paragraph (1) that the Sec-
retary deems appropriate and consistent with the 
purposes of this section. 
‘‘(f) REPORTING.—Each recipient of a grant under 
subsection (d) or (e) shall submit reports and maintain 
documentation by such deadlines, in such form, and con-
taining such content as the Secretary determines nec-
essary to ensure compliance with the conditions of the 
grant. 
‘‘(g) TAX TREATMENT.— 
‘‘(1) EXCLUSION
FROM
GROSS
INCOME.—For 
purposes of the Internal Revenue Code of 1986, 
amounts received by an eligible entity from the Sec-
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
retary under a grant under subsection (d) or (e) 
shall not be included in the gross income of such eli-
gible entity. 
‘‘(2) EFFECT OF EXCLUSION.—An eligible enti-
ty shall not have a tax deduction denied, a tax at-
tribute reduced, or any basis increased by reason of 
the exclusion from gross income pursuant to para-
graph (1). 
‘‘(h) GAO REPORT TO CONGRESS.—Not later than 
2 years after the date of enactment of this Act, the Comp-
troller General of the United States shall submit to the 
Congress a report assessing the efficacy of assistance 
made available under this section and the activities sup-
ported with such assistance. 
‘‘(i) DEFINITIONS.—In this section: 
‘‘(1) The term ‘assisted living facility’ means a 
licensed, registered, certified, listed, or State-regu-
lated residence, managed residential community, 
building, or part of a building that provides, or con-
tracts to provide, housing with supportive services on 
a continuing basis to individuals who— 
‘‘(A) are elderly or have a mental health, 
developmental, or physical disability; and 
‘‘(B) are unrelated by blood or marriage to 
the owner or operator of the residence, commu-
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
nity, building, or part of a building if the owner 
or operator is an individual. 
‘‘(2) The term ‘eligible entity’ means an entity 
that is eligible under subsection (b) to be provided 
assistance under this section. 
‘‘(3) The term ‘health care-related expenses at-
tributable to COVID–19’ means health care-related 
expenses to prevent, prepare for, and respond to 
COVID–19, including the building or construction of 
a temporary structure, the leasing of a property, the 
purchase of medical supplies and equipment (includ-
ing personal protective equipment and testing sup-
plies), providing for an expanded workforce (includ-
ing by training staff, maintaining staff, and hiring 
additional staff), the operation of an emergency op-
eration center, retrofitting a facility, providing for 
surge capacity, and other expenses determined ap-
propriate by the Secretary. 
‘‘(4) The term ‘lost revenue attributable to 
COVID–19’ means the cost of services that were re-
ceived, building modifications made, and tangible 
property ordered for mitigation and prevention of 
COVID–19, including the difference between such 
provider’s budgeted and actual revenue if such budg-
et was established and approved before March 27, 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
2020, for the purposes of preventing, preparing for, 
and responding to COVID–19. 
‘‘(j) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $10,000,000,000 for fiscal year 2022, to remain 
available until expended.’’. 
SEC. 4. SENIOR CAREGIVING WORKFORCE DEVELOPMENT 
SUSTAINMENT GRANTS. 
Part K of title III of the Public Health Service Act 
(42 U.S.C. 280c et seq.) is amended by inserting after 
section 399A–1, as added by section 3 of this Act, the 
following: 
‘‘SEC. 399A–2. SENIOR CAREGIVING WORKFORCE DEVELOP-
MENT SUSTAINMENT GRANTS. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to eligible entities to establish or expand a senior caregiver 
workforce training and recruitment program on the cam-
pus of the respective eligible entity. 
‘‘(b) AMOUNT; DURATION.—A grant under this sec-
tion shall be for— 
‘‘(1) an amount of not more than $1,000,000; 
and 
‘‘(2) a term of not more than 4 years. 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(c) USE OF FUNDS.—Amounts provided to an eligi-
ble entity through a grant under this section shall be used 
to cover the costs of— 
‘‘(1) establishing or expanding a senior care-
giver workforce training and recruitment program 
described in subsection (a), including costs associ-
ated with recruitment, training, and retention of 
senior caregivers; and 
‘‘(2) technical assistance provided by the eligi-
ble entity in connection with such program. 
‘‘(d) APPLICATION.—An eligible entity seeking a 
grant under this section shall submit an application to the 
Secretary at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(e) REPORTS.—Each recipient of a grant under this 
section shall submit reports and maintain documentation 
by such deadlines, in such form, and containing such con-
tent as the Secretary determines necessary to ensure com-
pliance with the conditions of the grant. 
‘‘(f) TAX TREATMENT.— 
‘‘(1) EXCLUSION
FROM
GROSS
INCOME.—For 
purposes of the Internal Revenue Code of 1986, 
amounts received by an eligible entity from the Sec-
retary under a grant under this section shall not be 
included in the gross income of such eligible entity. 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(2) EFFECT OF EXCLUSION.—An eligible enti-
ty shall not have a tax deduction denied, a tax at-
tribute reduced, or any basis increased by reason of 
the exclusion from gross income pursuant to para-
graph (1). 
‘‘(g) DEFINITIONS.— 
‘‘(1) The term ‘eligible entity’— 
‘‘(A) means an assisted living facility as 
defined in section 399A–1; and 
‘‘(B) excludes any skilled nursing facility 
as defined in section 1819(a) of the Social Se-
curity Act. 
‘‘(2) The term ‘senior caregiver’ means an indi-
vidual who furnishes direct personal care, assistance 
with activities of daily living, or any other related 
service for older adults located on a campus of an 
eligible entity. 
‘‘(h) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $1,250,000,000 for fiscal year 2022, to remain 
available until expended.’’. 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS
SEC. 5. NATIONAL HEALTH CARE WORKFORCE COMMIS-
SION. 
The National Health Care Workforce Commission es-
tablished under section 5101 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 294q) shall— 
(1) not later than 180 days after the date of 
enactment of this Act, pursuant to subsection (d)(4) 
of such section 5101, designate as a ‘‘high priority 
area’’ the current and projected workforce needs of 
assisted living and other senior care settings that at-
tend to the care of the senior population; and 
(2) not later than 1 year after finalizing such 
designation, submit a report pursuant to subsection 
(d)(2)(D) of such section 5101 to the Congress and 
the Administration containing a review of, and rec-
ommendations on, such high priority area. 
Æ 
VerDate Sep 11 2014 
17:15 Feb 01, 2022
Jkt 029200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6301
E:\BILLS\H6530.IH
H6530
pamtmann on DSKBC07HB2PROD with BILLS