{
  "legislationId": "119_HR_6766",
  "lastUpdate": "2026-03-18T12:21:11.121Z",
  "history": [
    {
      "timestamp": "2026-03-18T12:21:11.120Z",
      "source_url": "https://www.congress.gov/119/bills/hr6766/BILLS-119hr6766ih.htm",
      "model": "gemini-flash-lite-latest",
      "prompt_sent": "\nROLE: Fact Checker.\nZADANIE: Porównaj SOURCE (oryginał) i SUMMARY (streszczenie przygotowane przez inne AI).\n\nTwoim celem jest wykrycie \"ZMYŚLONYCH KONKRETÓW\" (Fabricated Entities) w SUMMARY.\n\nSOURCE:\n[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 6766 Introduced in House (IH)] <DOC> 119th CONGRESS 1st Session H. R. 6766 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 December 16, 2025 Ms. Tenney (for herself, Mr. Larson of Connecticut, Mr. Fitzpatrick, Mr. Mann, Mr. Ciscomani, and Mr. Mills) 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. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Essential Caregivers Act of 2025''. SEC. 2. FINDINGS. Congress finds the following: (1) According to the National Center for Health Statistics of the Centers for Disease Control and Prevention, an estimated 1,300,000 individuals resided in nursing homes in 2020 at the onset of the COVID-19 pandemic, and nearly half of all nursing home residents were living with a diagnosis of Alzheimer's or other related dementia. (2) Regulations issued pursuant to subtitle C of title IV of the Omnibus Budget Reconciliation Act of 1987 (commonly known as the ``Nursing Home Reform Act of 1987'') (Public Law 100-203) established basic rights and services for residents of nursing homes, including ``the right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility''. (3) In March of 2020, the Centers for Medicare & Medicaid Services instructed nursing facilities to restrict visitation for all visitors and non-essential healthcare personnel and cancel communal dining and group activities. Long-term care ombudsman program representatives and State surveyors were among those whose access to long-term care facilities was prohibited or extremely restricted despite reopening guidance released by the Centers for Medicare & Medicaid Services in May of 2020. (4) Many long-term care residents declined dramatically or died prematurely from ``failure to thrive'' in isolation. (5) According to the National Consumer Voice for Quality Long-Term Care, in the first year of the COVID-19 pandemic, 1 in 5 healthcare workers resigned, retired, or were fired. This exacerbated the longstanding problem of staff shortages that already existed. Lack of staff, combined with the forced absence of families, many of whom provided informal care and support to residents, resulted in a significant decline in residents' health and well-being. During the pandemic, pressure ulcers in nursing home residents rose by 31 percent, the number of residents experiencing significant weight loss rose by 49 percent, the number of residents reporting feeling down, depressed, or hopeless rose by 40 percent, and the number of residents prescribed antipsychotic medications rose by 77.5 percent. (6) According to the Department of Health and Human Services, loneliness and isolation, such as that experienced by long-term care residents during the COVID-19 pandemic, represent profound threats to an individual's health and well- being. (7) Essential caregivers provide supplemental care for their loved one, regardless of staff shortages, staff turnover, or emergencies. Essential caregivers support residents and advocate on their behalf. SEC. 3. RIGHT TO ESSENTIAL CAREGIVERS; ACCESS TO ESSENTIAL CAREGIVERS DURING PERIODS WHEN VISITATION IS OTHERWISE RESTRICTED. (a) Medicare Skilled Nursing Facilities.--Section 1819(c)(3) of the Social Security Act (42 U.S.C. 1395i-3(c)(3)) is amended-- (1) by redesignating subparagraphs (A) through (E) as clauses (i) through (v), respectively; (2) by striking ``A skilled nursing facility must--'' and inserting the following: ``(A) In general.--A skilled nursing facility must--''; and (3) by adding at the end the following new subparagraph: ``(B) Access to essential caregivers during emergency periods when visitation is otherwise restricted.-- ``(i) Designation of essential caregiver.-- Each skilled nursing facility must recognize the right of each resident of such facility to-- ``(I) designate and have access to essential caregivers for such resident at all times, including during any period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law; and ``(II) amend such designation at any time. ``(ii) Presumption of designation.--For purposes of clause (i), in the case of a resident who is unable, by reason of cognitive or mental disability, to make an election described in such clause, the resident representative (as defined in section 483.5 of title 42, Code of Federal Regulations) of such resident may make such designation for such resident. ``(iii) Access to essential caregivers during emergency periods when visitation is otherwise restricted.--During a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law, including any period in which a waiver or modification of requirements pursuant to section 1135 is in effect, a skilled nursing facility must-- ``(I) not deny in-person access to a resident by an essential caregiver of the resident except as provided in this subparagraph; ``(II) allow at least 1 essential caregiver to have access to and provide assistance to such resident at such facility every day and at any time; ``(III) enforce the agreement described in clause (vii)(II) with respect to an essential caregiver; and ``(IV) provide reasonable accommodations to protect the rights of a roommate co-living with a resident who has an essential caregiver. ``(iv) Restrictions on access.-- ``(I) In general.--During a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law, including any period in which a waiver or modification of requirements pursuant to section 1135 is in effect, a skilled nursing facility-- ``(aa) may, subject to item (bb), deny access to a resident by an essential caregiver of the resident for-- ``(AA) an initial period of not longer than 7 days; and ``(BB) one additional period of not longer than 7 days (in addition to the initial period described in subitem (AA)) if the department of health or other applicable agency of the State in which the facility is located approves the denial of access for such additional period; and ``(bb) must allow access to a resident who is in end-of- life care or a resident in decline or distress, as defined by the Secretary. ``(II) Rule of application.--For purposes of subclause (I), a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law shall begin on the date that such order or other operation of law takes effect and shall end on the date that such order or other operation of law expires or is otherwise terminated. During any such period, the maximum number of days for which a skilled nursing facility may deny access to a resident by an essential caregiver of the resident is 7 total days (or, subject to the approval of the department of health or other applicable agency of the State in which the facility is located, 14 total days). ``(v) Compliance and notification.-- ``(I) Authority.--No essential caregiver who upholds the agreement described in clause (vii)(II) shall be denied access to the skilled nursing facility of the resident involved. ``(II) Notification.--If an essential caregiver fails to comply with an agreement with a skilled nursing facility described in clause (vii)(II), the facility must first provide a warning to the essential caregiver and resident in writing citing specific issues of non- compliance and providing clear guidance for corrective measures. ``(III) Enforcement.--If an essential caregiver or resident, after receiving a notification of noncompliance described in subclause (II), fails to take corrective action, the essential caregiver may subsequently be denied access to the resident. In such cases, the facility shall provide to such caregiver and such resident (or health care proxy of such resident), not later than 24 hours after such denial of access occurs, a written explanation as to why such caregiver was denied access to such resident. Such explanation must include the resident's and caregiver's options for appeal under the processes established under clause (vi). ``(vi) Options for residents and caregivers to appeal denials of access.-- ``(I) In general.--Not later than 2 years after the date of enactment of this subparagraph, the Secretary shall issue a final rule establishing a process for residents and caregivers to appeal denials of access to the State survey agency. ``(II) Appeals process.--The State survey agency shall-- ``(aa) receive appeals from residents and essential caregivers challenging a decision by a skilled nursing facility to deny access under clause (v); and ``(bb) begin investigating such appeals not later than 2 business days after receiving such appeals. ``(III) Burden of proof.--During an appeal received under the appeals process established under subclause (I), if a skilled nursing facility defends a decision to deny access to an essential caregiver under clause (v) on the basis that the essential caregiver violated the agreement described in clause (vii)(II), the skilled nursing facility shall have the burden of proof in demonstrating that the essential caregiver violated such agreement. ``(IV) Resolution of appeals.-- ``(aa) Determination.--With respect to an appeal received under the appeals process established under subclause (I), the State survey agency shall make a determination as to whether a skilled nursing facility violated a requirement or prohibition of this subparagraph within 48 hours of commencing its investigation. ``(bb) Violations.--If the agency determines that a facility has violated such a requirement or prohibition, the agency shall-- ``(AA) require the facility to allow immediate access to the essential caregiver in question; ``(BB) require the facility to establish a corrective action plan to prevent the recurrence of such violation within a 7- day period of receiving notice from the agency; and ``(CC) impose a civil money penalty in an amount to be determined by the agency (not to exceed $5,000) if such facility fails to implement the corrective action plan within the 7-day period specified in subitem (BB). ``(vii) Definition of essential caregiver.--For purposes of this subparagraph, the term `essential caregiver' means, with respect to a resident of a skilled nursing facility, an individual who-- ``(I) is designated by or on behalf of the resident pursuant to clause (i) or clause (ii); and ``(II) agrees to follow all safety protocols established by such facility, which shall be clearly specified in writing and may be no more restrictive than the safety protocols (including safety standards and entry requirements) applicable to staff of such facility.''. (b) Medicaid Nursing Facilities.--Section 1919(c)(3) of the Social Security Act (42 U.S.C. 1396r(c)(3)) is amended-- (1) by redesignating subparagraphs (A) through (E) as clauses (i) through (v), respectively; (2) by striking ``A nursing facility must--'' and inserting the following: ``(A) In general.--A nursing facility must--''; and (3) by adding at the end the following new subparagraph: ``(B) Access to essential caregivers during emergency periods when visitation is otherwise restricted.-- ``(i) Designation of essential caregiver.-- Each nursing facility must recognize the right of each resident of such facility to-- ``(I) designate and have access to essential caregivers for such resident at all times, including during any period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law; and ``(II) amend such designation at any time. ``(ii) Presumption of designation.--For purposes of clause (i), in the case of a resident who is unable, by reason of cognitive or mental disability, to make an election described in such clause, the resident representative (as defined in section 483.5 of title 42, Code of Federal Regulations) of such resident may be permitted to make such designation for such resident. ``(iii) Access to essential caregivers during emergency periods when visitation is otherwise restricted.--During a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law, including any period in which a waiver or modification of requirements pursuant to section 1135 is in effect, a nursing facility must-- ``(I) not deny in-person access to a resident by an essential caregiver of the resident except as provided in this subparagraph; ``(II) allow at least 1 essential caregiver to have access to and provide assistance to such resident at such facility every day and at any time; ``(III) enforce the agreement described in clause (vii)(II) with respect to an essential caregiver; and ``(IV) provide reasonable accommodations to protect the rights of a roommate co-living with a resident who has an essential caregiver. ``(iv) Restrictions on access.-- ``(I) In general.--During a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law, including any period in which a waiver or modification of requirements pursuant to section 1135 is in effect, a nursing facility-- ``(aa) may, subject to item (bb), deny access to a resident by an essential caregiver of the resident for-- ``(AA) an initial period of not longer than 7 days; and ``(BB) one additional period of not longer than 7 days (in addition to the initial period described in subitem (AA)) if the department of health or other applicable agency of the State in which the facility is located approves the denial of access for such additional period; and ``(bb) must allow access to a resident who is in end-of- life care or a resident in decline or distress, as defined by the Secretary. ``(II) Rule of application.--For purposes of subclause (I), a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law shall begin on the date that such order or other operation of law takes effect and shall end on the date that such order or other operation of law expires or is otherwise terminated. During any such period, the maximum number of days for which a nursing facility may deny access to a resident by an essential caregiver of the resident is 7 total days (or, subject to the approval of the department of health or other applicable agency of the State in which the facility is located, 14 total days). ``(v) Compliance and notification.-- ``(I) Authority.--No essential caregiver who upholds the agreement described in clause (vii)(II) shall be denied access to the nursing facility of the resident involved. ``(II) Notification.--If an essential caregiver fails to comply with an agreement with a nursing facility described in clause (vii)(II), the facility must first provide a warning to the essential caregiver and resident in writing citing specific issues of non-compliance and providing clear guidance for corrective measures. ``(III) Enforcement.--If an essential caregiver or resident, after receiving a notification of noncompliance described in subclause (II), fails to take corrective action, the essential caregiver may subsequently be denied access to the resident. In such cases, the facility shall provide to such caregiver and such resident (or health care proxy of such resident), not later than 24 hours after such denial of access occurs, a written explanation as to why such caregiver was denied access to such resident. Such explanation must include the resident's and caregiver's options for appeal under the processes established under clause (vi). ``(vi) Options for residents and caregivers to appeal denials of access.-- ``(I) In general.--Not later than 2 years after the date of enactment of this subparagraph, the Secretary shall issue a final rule establishing a process for residents and caregivers to appeal denials of access to the State survey agency. ``(II) Appeals process.--The State survey agency shall-- ``(aa) receive appeals from residents and essential caregivers challenging a decision by a nursing facility to deny access under clause (v); and ``(bb) begin investigating such appeals not later than 2 business days after receiving such appeals. ``(III) Burden of proof.--During an appeal received under the appeals process established under subclause (I), if a nursing facility defends a decision to deny access to an essential caregiver under clause (v) on the basis that the essential caregiver violated the agreement described in clause (vii)(II), the nursing facility shall have the burden of proof in demonstrating that the essential caregiver violated such agreement. ``(IV) Resolution of appeals.-- ``(aa) Determination.--With respect to an appeal received under the appeals process established under subclause (I), the State survey agency shall make a determination as to whether a nursing facility violated a requirement or prohibition of this subparagraph within 48 hours of commencing its investigation. ``(bb) Violations.--If the agency determines that a facility has violated such a requirement or prohibition, the agency shall-- ``(AA) require the facility to allow immediate access to the essential caregiver in question; ``(BB) require the facility to establish a corrective action plan to prevent the recurrence of such violation within a 7- day period of receiving notice from the agency; and ``(CC) impose a civil money penalty in an amount to be determined by the agency (not to exceed $5,000) if such facility fails to implement the corrective action plan within the 7-day period specified in subitem (BB). ``(vii) Definition of essential caregiver.--For purposes of this subparagraph, the term `essential caregiver' means, with respect to a resident of a nursing facility, an individual who-- ``(I) is designated by or on behalf of the resident pursuant to clause (i) or clause (ii); and ``(II) agrees to follow all safety protocols established by such facility, which shall be clearly specified in writing and may be no more restrictive than the safety protocols (including safety standards and entry requirements) applicable to staff of such facility.''. (c) Intermediate Care Facilities for the Intellectually Disabled.-- 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 and inserting ``; and''; and (3) by adding at the end the following new paragraph: ``(4) the institution complies with the requirements relating to the designation of, and access to residents by, essential caregivers described in section 1919(c)(3)(B) in the same manner as if such institution were a nursing facility.''. (d) 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 that is located on the same campus (as defined by the Secretary) as a skilled nursing facility, nursing facility (as defined in section 1919(a)), or intermediate care facility for the intellectually disabled (as described in section 1905(d)), to comply with the requirements relating to the designation of, and access to residents by, essential caregivers described in section 1819(c)(3)(B) in the same manner as if such institution were a skilled nursing facility.''. (e) Regulations.--The Secretary of Health and Human Services shall, after consultation with stakeholders (including residents, family members, long-term care ombudsmen, other advocates of nursing home residents, and nursing home providers), promulgate regulations to carry out this Act and the amendments made by this Act. (f) Rules of Construction.-- (1) No new authority for state and local officials to restrict visitation at nursing facilities.--Nothing in this section or the amendments made by this section shall be construed as creating any new authority for State or local officials to restrict visitation at nursing facilities. (2) No new authority for nursing facilities to unilaterally restrict visitation.--Nothing in this section or the amendments made by this section shall be construed as creating any new authority for a skilled nursing facility or nursing facility (as such terms are defined in sections 1819 and 1919 of the Social Security Act, respectively (42 U.S.C. 1395i-3, 1396r)) to restrict visitation. (g) Effective Date.--The amendments made by this Act shall take effect on the date that is 2 years after the date of enactment of this Act, and shall apply with respect to periods beginning on or after such date in which regular visitation at nursing facilities is restricted by order of a Federal, State, or local authority or by other operation of law. <all>\n\nSUMMARY TO EVALUATE:\nTitle: Essential Caregivers Act: Ensuring Access to Loved Ones in Care Facilities\nSummary: This act ensures that residents of nursing homes and rehabilitation centers can have access to a designated caregiver even during emergencies when general visitation is restricted. It aims to prevent the negative health effects of isolation by allowing family or friends to provide essential support.\nKey Points: Residents have the right to designate an 'essential caregiver' with daily access to the facility., Facilities are prohibited from denying access except for very limited, regulated periods of up to 14 days., Caregivers must follow safety protocols that are no more restrictive than those required for facility staff., A formal appeal process and fines up to $5,000 are established for facilities that wrongfully deny access.\n\nZASADY OCENY:\n1. Sprawdź wszystkie LICZBY, DATY i KWOTY w SUMMARY. Jeśli którejś brakuje w SOURCE -> is_valid: false.\n2. Sprawdź wszystkie NAZWISKA, ORGANIZACJE i MIEJSCA w SUMMARY. Jeśli którejś brakuje w SOURCE -> is_valid: false.\n3. Sprawdź wszystkie konkretne DZIAŁANIA PRAWNE . Jeśli tego mechanizmu nie ma w SOURCE -> is_valid: false.\n\nWAŻNE: Abstrakcyjne pojęcia (np. \"transparentność\", \"zaufanie\") są dozwolone jako wnioski.\n\nOUTPUT (JSON):\n{\n  \"is_valid\": true/false,\n  \"issue\": \"fabricated_entity\" / \"contradiction\" / \"none\"\n}\n\nWYMAGANIA FORMATOWANIA:\n1. Odpowiedz WYŁĄCZNIE surowym obiektem JSON.\n2. NIE używaj bloków kodu Markdown.\n3. NIE dodawaj żadnych wstępów ani wyjaśnień przed ani po JSONie.\n4. JSON musi być poprawny i gotowy do parsowania.\n\n",
      "ai_response_raw": "{\n  \"is_valid\": true,\n  \"issue\": \"none\"\n}"
    },
    {
      "timestamp": "2026-03-18T12:15:58.634Z",
      "source_url": "https://www.congress.gov/119/bills/hr6766/BILLS-119hr6766ih.htm",
      "model": "gemini-flash-latest",
      "prompt_sent": "\nJesteś ekspertem od prawa Stanów Zjednoczonych, który ma za zadanie analizować dokumenty ustaw, uchwał oraz innych dokumentów legislacyjnych, a następnie przygotowywać z nich informacje w przystępny sposób dla obywateli. Twoim celem jest przedstawienie informacji tak, aby obywatele mogli sami ocenić wpływ legislacji na ich życie, nawet bez posiadania specjalistycznej wiedzy legislacyjnej. Skup się na faktach i obiektywnych skutkach wprowadzanych zmian, unikając wartościowania i osobistych opinii. Wszelki żargon prawny jest zabroniony. Prezentuj informacje w jasny, zwięzły i angażujący sposób, tak aby były zrozumiałe dla osoby bez wykształcenia prawniczego. Unikaj długich, złożonych zdań. Zamiast pisać \"projekt ma na celu nowelizację kodeksu podatkowego...\", napisz \"Zmiany w podatkach: nowe ulgi i obowiązki dla...\". Kontynuuj swoją pracę, dopóki nie rozwiążesz swojego zadania. Jeśli nie masz pewności co do generowanej treści, przeanalizuj dokument ponownie – nie zgaduj. Rozplanuj dobrze swoje zadanie przed przystąpieniem do niego. W podsumowaniu i kluczowych punktach, jeśli to możliwe i uzasadnione, podkreśl, jakie konkretne korzyści lub skutki (pozytywne lub negatywne) wprowadza ustawa dla życia codziennego obywateli, ich praw i obowiązków, finansów osobistych, bezpieczeństwa i innych ważnych kwestii (np. kategorycznych zakazów i nakazów czy najważniejszych konkretnych alokacji finansowych i terytorialnych).\n\nTwoja odpowiedź MUSI być w formacie JSON - i zawierać następujące klucze.\nZanim zwrócisz odpowiedź, dokładnie zweryfikuj, czy cała struktura JSON jest w 100% poprawna, włącznie ze wszystkimi przecinkami, nawiasami klamrowymi, kwadratowymi oraz cudzysłowami. Błędny JSON jest nieakceptowalny i uniemożliwi przetworzenie Twojej pracy.\n\nPrzeanalizuj dokładnie poniższy tekst dokumentu prawnego. To jest treść, na podstawie której masz wygenerować podsumowanie i kluczowe punkty:\n--- POCZĄTEK DOKUMENTU ---\n[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 6766 Introduced in House (IH)] <DOC> 119th CONGRESS 1st Session H. R. 6766 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 December 16, 2025 Ms. Tenney (for herself, Mr. Larson of Connecticut, Mr. Fitzpatrick, Mr. Mann, Mr. Ciscomani, and Mr. Mills) 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. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Essential Caregivers Act of 2025''. SEC. 2. FINDINGS. Congress finds the following: (1) According to the National Center for Health Statistics of the Centers for Disease Control and Prevention, an estimated 1,300,000 individuals resided in nursing homes in 2020 at the onset of the COVID-19 pandemic, and nearly half of all nursing home residents were living with a diagnosis of Alzheimer's or other related dementia. (2) Regulations issued pursuant to subtitle C of title IV of the Omnibus Budget Reconciliation Act of 1987 (commonly known as the ``Nursing Home Reform Act of 1987'') (Public Law 100-203) established basic rights and services for residents of nursing homes, including ``the right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility''. (3) In March of 2020, the Centers for Medicare & Medicaid Services instructed nursing facilities to restrict visitation for all visitors and non-essential healthcare personnel and cancel communal dining and group activities. Long-term care ombudsman program representatives and State surveyors were among those whose access to long-term care facilities was prohibited or extremely restricted despite reopening guidance released by the Centers for Medicare & Medicaid Services in May of 2020. (4) Many long-term care residents declined dramatically or died prematurely from ``failure to thrive'' in isolation. (5) According to the National Consumer Voice for Quality Long-Term Care, in the first year of the COVID-19 pandemic, 1 in 5 healthcare workers resigned, retired, or were fired. This exacerbated the longstanding problem of staff shortages that already existed. Lack of staff, combined with the forced absence of families, many of whom provided informal care and support to residents, resulted in a significant decline in residents' health and well-being. During the pandemic, pressure ulcers in nursing home residents rose by 31 percent, the number of residents experiencing significant weight loss rose by 49 percent, the number of residents reporting feeling down, depressed, or hopeless rose by 40 percent, and the number of residents prescribed antipsychotic medications rose by 77.5 percent. (6) According to the Department of Health and Human Services, loneliness and isolation, such as that experienced by long-term care residents during the COVID-19 pandemic, represent profound threats to an individual's health and well- being. (7) Essential caregivers provide supplemental care for their loved one, regardless of staff shortages, staff turnover, or emergencies. Essential caregivers support residents and advocate on their behalf. SEC. 3. RIGHT TO ESSENTIAL CAREGIVERS; ACCESS TO ESSENTIAL CAREGIVERS DURING PERIODS WHEN VISITATION IS OTHERWISE RESTRICTED. (a) Medicare Skilled Nursing Facilities.--Section 1819(c)(3) of the Social Security Act (42 U.S.C. 1395i-3(c)(3)) is amended-- (1) by redesignating subparagraphs (A) through (E) as clauses (i) through (v), respectively; (2) by striking ``A skilled nursing facility must--'' and inserting the following: ``(A) In general.--A skilled nursing facility must--''; and (3) by adding at the end the following new subparagraph: ``(B) Access to essential caregivers during emergency periods when visitation is otherwise restricted.-- ``(i) Designation of essential caregiver.-- Each skilled nursing facility must recognize the right of each resident of such facility to-- ``(I) designate and have access to essential caregivers for such resident at all times, including during any period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law; and ``(II) amend such designation at any time. ``(ii) Presumption of designation.--For purposes of clause (i), in the case of a resident who is unable, by reason of cognitive or mental disability, to make an election described in such clause, the resident representative (as defined in section 483.5 of title 42, Code of Federal Regulations) of such resident may make such designation for such resident. ``(iii) Access to essential caregivers during emergency periods when visitation is otherwise restricted.--During a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law, including any period in which a waiver or modification of requirements pursuant to section 1135 is in effect, a skilled nursing facility must-- ``(I) not deny in-person access to a resident by an essential caregiver of the resident except as provided in this subparagraph; ``(II) allow at least 1 essential caregiver to have access to and provide assistance to such resident at such facility every day and at any time; ``(III) enforce the agreement described in clause (vii)(II) with respect to an essential caregiver; and ``(IV) provide reasonable accommodations to protect the rights of a roommate co-living with a resident who has an essential caregiver. ``(iv) Restrictions on access.-- ``(I) In general.--During a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law, including any period in which a waiver or modification of requirements pursuant to section 1135 is in effect, a skilled nursing facility-- ``(aa) may, subject to item (bb), deny access to a resident by an essential caregiver of the resident for-- ``(AA) an initial period of not longer than 7 days; and ``(BB) one additional period of not longer than 7 days (in addition to the initial period described in subitem (AA)) if the department of health or other applicable agency of the State in which the facility is located approves the denial of access for such additional period; and ``(bb) must allow access to a resident who is in end-of- life care or a resident in decline or distress, as defined by the Secretary. ``(II) Rule of application.--For purposes of subclause (I), a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law shall begin on the date that such order or other operation of law takes effect and shall end on the date that such order or other operation of law expires or is otherwise terminated. During any such period, the maximum number of days for which a skilled nursing facility may deny access to a resident by an essential caregiver of the resident is 7 total days (or, subject to the approval of the department of health or other applicable agency of the State in which the facility is located, 14 total days). ``(v) Compliance and notification.-- ``(I) Authority.--No essential caregiver who upholds the agreement described in clause (vii)(II) shall be denied access to the skilled nursing facility of the resident involved. ``(II) Notification.--If an essential caregiver fails to comply with an agreement with a skilled nursing facility described in clause (vii)(II), the facility must first provide a warning to the essential caregiver and resident in writing citing specific issues of non- compliance and providing clear guidance for corrective measures. ``(III) Enforcement.--If an essential caregiver or resident, after receiving a notification of noncompliance described in subclause (II), fails to take corrective action, the essential caregiver may subsequently be denied access to the resident. In such cases, the facility shall provide to such caregiver and such resident (or health care proxy of such resident), not later than 24 hours after such denial of access occurs, a written explanation as to why such caregiver was denied access to such resident. Such explanation must include the resident's and caregiver's options for appeal under the processes established under clause (vi). ``(vi) Options for residents and caregivers to appeal denials of access.-- ``(I) In general.--Not later than 2 years after the date of enactment of this subparagraph, the Secretary shall issue a final rule establishing a process for residents and caregivers to appeal denials of access to the State survey agency. ``(II) Appeals process.--The State survey agency shall-- ``(aa) receive appeals from residents and essential caregivers challenging a decision by a skilled nursing facility to deny access under clause (v); and ``(bb) begin investigating such appeals not later than 2 business days after receiving such appeals. ``(III) Burden of proof.--During an appeal received under the appeals process established under subclause (I), if a skilled nursing facility defends a decision to deny access to an essential caregiver under clause (v) on the basis that the essential caregiver violated the agreement described in clause (vii)(II), the skilled nursing facility shall have the burden of proof in demonstrating that the essential caregiver violated such agreement. ``(IV) Resolution of appeals.-- ``(aa) Determination.--With respect to an appeal received under the appeals process established under subclause (I), the State survey agency shall make a determination as to whether a skilled nursing facility violated a requirement or prohibition of this subparagraph within 48 hours of commencing its investigation. ``(bb) Violations.--If the agency determines that a facility has violated such a requirement or prohibition, the agency shall-- ``(AA) require the facility to allow immediate access to the essential caregiver in question; ``(BB) require the facility to establish a corrective action plan to prevent the recurrence of such violation within a 7- day period of receiving notice from the agency; and ``(CC) impose a civil money penalty in an amount to be determined by the agency (not to exceed $5,000) if such facility fails to implement the corrective action plan within the 7-day period specified in subitem (BB). ``(vii) Definition of essential caregiver.--For purposes of this subparagraph, the term `essential caregiver' means, with respect to a resident of a skilled nursing facility, an individual who-- ``(I) is designated by or on behalf of the resident pursuant to clause (i) or clause (ii); and ``(II) agrees to follow all safety protocols established by such facility, which shall be clearly specified in writing and may be no more restrictive than the safety protocols (including safety standards and entry requirements) applicable to staff of such facility.''. (b) Medicaid Nursing Facilities.--Section 1919(c)(3) of the Social Security Act (42 U.S.C. 1396r(c)(3)) is amended-- (1) by redesignating subparagraphs (A) through (E) as clauses (i) through (v), respectively; (2) by striking ``A nursing facility must--'' and inserting the following: ``(A) In general.--A nursing facility must--''; and (3) by adding at the end the following new subparagraph: ``(B) Access to essential caregivers during emergency periods when visitation is otherwise restricted.-- ``(i) Designation of essential caregiver.-- Each nursing facility must recognize the right of each resident of such facility to-- ``(I) designate and have access to essential caregivers for such resident at all times, including during any period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law; and ``(II) amend such designation at any time. ``(ii) Presumption of designation.--For purposes of clause (i), in the case of a resident who is unable, by reason of cognitive or mental disability, to make an election described in such clause, the resident representative (as defined in section 483.5 of title 42, Code of Federal Regulations) of such resident may be permitted to make such designation for such resident. ``(iii) Access to essential caregivers during emergency periods when visitation is otherwise restricted.--During a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law, including any period in which a waiver or modification of requirements pursuant to section 1135 is in effect, a nursing facility must-- ``(I) not deny in-person access to a resident by an essential caregiver of the resident except as provided in this subparagraph; ``(II) allow at least 1 essential caregiver to have access to and provide assistance to such resident at such facility every day and at any time; ``(III) enforce the agreement described in clause (vii)(II) with respect to an essential caregiver; and ``(IV) provide reasonable accommodations to protect the rights of a roommate co-living with a resident who has an essential caregiver. ``(iv) Restrictions on access.-- ``(I) In general.--During a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law, including any period in which a waiver or modification of requirements pursuant to section 1135 is in effect, a nursing facility-- ``(aa) may, subject to item (bb), deny access to a resident by an essential caregiver of the resident for-- ``(AA) an initial period of not longer than 7 days; and ``(BB) one additional period of not longer than 7 days (in addition to the initial period described in subitem (AA)) if the department of health or other applicable agency of the State in which the facility is located approves the denial of access for such additional period; and ``(bb) must allow access to a resident who is in end-of- life care or a resident in decline or distress, as defined by the Secretary. ``(II) Rule of application.--For purposes of subclause (I), a period of emergency in which regular visitation is restricted by order of a Federal, State, or local authority or by other operation of law shall begin on the date that such order or other operation of law takes effect and shall end on the date that such order or other operation of law expires or is otherwise terminated. During any such period, the maximum number of days for which a nursing facility may deny access to a resident by an essential caregiver of the resident is 7 total days (or, subject to the approval of the department of health or other applicable agency of the State in which the facility is located, 14 total days). ``(v) Compliance and notification.-- ``(I) Authority.--No essential caregiver who upholds the agreement described in clause (vii)(II) shall be denied access to the nursing facility of the resident involved. ``(II) Notification.--If an essential caregiver fails to comply with an agreement with a nursing facility described in clause (vii)(II), the facility must first provide a warning to the essential caregiver and resident in writing citing specific issues of non-compliance and providing clear guidance for corrective measures. ``(III) Enforcement.--If an essential caregiver or resident, after receiving a notification of noncompliance described in subclause (II), fails to take corrective action, the essential caregiver may subsequently be denied access to the resident. In such cases, the facility shall provide to such caregiver and such resident (or health care proxy of such resident), not later than 24 hours after such denial of access occurs, a written explanation as to why such caregiver was denied access to such resident. Such explanation must include the resident's and caregiver's options for appeal under the processes established under clause (vi). ``(vi) Options for residents and caregivers to appeal denials of access.-- ``(I) In general.--Not later than 2 years after the date of enactment of this subparagraph, the Secretary shall issue a final rule establishing a process for residents and caregivers to appeal denials of access to the State survey agency. ``(II) Appeals process.--The State survey agency shall-- ``(aa) receive appeals from residents and essential caregivers challenging a decision by a nursing facility to deny access under clause (v); and ``(bb) begin investigating such appeals not later than 2 business days after receiving such appeals. ``(III) Burden of proof.--During an appeal received under the appeals process established under subclause (I), if a nursing facility defends a decision to deny access to an essential caregiver under clause (v) on the basis that the essential caregiver violated the agreement described in clause (vii)(II), the nursing facility shall have the burden of proof in demonstrating that the essential caregiver violated such agreement. ``(IV) Resolution of appeals.-- ``(aa) Determination.--With respect to an appeal received under the appeals process established under subclause (I), the State survey agency shall make a determination as to whether a nursing facility violated a requirement or prohibition of this subparagraph within 48 hours of commencing its investigation. ``(bb) Violations.--If the agency determines that a facility has violated such a requirement or prohibition, the agency shall-- ``(AA) require the facility to allow immediate access to the essential caregiver in question; ``(BB) require the facility to establish a corrective action plan to prevent the recurrence of such violation within a 7- day period of receiving notice from the agency; and ``(CC) impose a civil money penalty in an amount to be determined by the agency (not to exceed $5,000) if such facility fails to implement the corrective action plan within the 7-day period specified in subitem (BB). ``(vii) Definition of essential caregiver.--For purposes of this subparagraph, the term `essential caregiver' means, with respect to a resident of a nursing facility, an individual who-- ``(I) is designated by or on behalf of the resident pursuant to clause (i) or clause (ii); and ``(II) agrees to follow all safety protocols established by such facility, which shall be clearly specified in writing and may be no more restrictive than the safety protocols (including safety standards and entry requirements) applicable to staff of such facility.''. (c) Intermediate Care Facilities for the Intellectually Disabled.-- 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 and inserting ``; and''; and (3) by adding at the end the following new paragraph: ``(4) the institution complies with the requirements relating to the designation of, and access to residents by, essential caregivers described in section 1919(c)(3)(B) in the same manner as if such institution were a nursing facility.''. (d) 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 that is located on the same campus (as defined by the Secretary) as a skilled nursing facility, nursing facility (as defined in section 1919(a)), or intermediate care facility for the intellectually disabled (as described in section 1905(d)), to comply with the requirements relating to the designation of, and access to residents by, essential caregivers described in section 1819(c)(3)(B) in the same manner as if such institution were a skilled nursing facility.''. (e) Regulations.--The Secretary of Health and Human Services shall, after consultation with stakeholders (including residents, family members, long-term care ombudsmen, other advocates of nursing home residents, and nursing home providers), promulgate regulations to carry out this Act and the amendments made by this Act. (f) Rules of Construction.-- (1) No new authority for state and local officials to restrict visitation at nursing facilities.--Nothing in this section or the amendments made by this section shall be construed as creating any new authority for State or local officials to restrict visitation at nursing facilities. (2) No new authority for nursing facilities to unilaterally restrict visitation.--Nothing in this section or the amendments made by this section shall be construed as creating any new authority for a skilled nursing facility or nursing facility (as such terms are defined in sections 1819 and 1919 of the Social Security Act, respectively (42 U.S.C. 1395i-3, 1396r)) to restrict visitation. (g) Effective Date.--The amendments made by this Act shall take effect on the date that is 2 years after the date of enactment of this Act, and shall apply with respect to periods beginning on or after such date in which regular visitation at nursing facilities is restricted by order of a Federal, State, or local authority or by other operation of law. <all>\n--- KONIEC DOKUMENTU ---\n\nPAMIĘTAJ: Twoja odpowiedź MUSI być wyłącznie poprawnym obiektem JSON. Nie dodawaj żadnych dodatkowych znaków, komentarzy ani tekstu przed znacznikiem '{' ani po znaczniku '}'. Cała odpowiedź musi być parsowalna jako JSON.\nNa podstawie POWYŻSZEGO dokumentu, wypełnij poniższą strukturę JSON:\nOto struktura JSON, której oczekuję (wypełnij ją treścią):\n{\n  \"pl_ai_title\": \"Nowy, krótki tytuł dla aktu prawnego po polsku, oddający sedno wprowadzanych zmian (np. maksymalnie 10-12 słów).\",\n  \"pl_summary\": \"2-3 zdania zwięzłego podsumowania treści aktu prawnego po polsku, napisane z perspektywy wpływu na życie codzienne obywateli.\",\n  \"pl_key_points\": [\n    \"Pierwszy krótki punkt po polsku dotyczący najważniejszych wprowadzanych rozwiązań lub zmian.\",\n    \"Drugi krótki punkt po polsku...\"\n  ],\n  \"eng_ai_title\": \"A new, short title for the legal act in English, capturing the essence of the changes (e.g., max 10-12 words).\",\n  \"eng_summary\": \"2-3 sentences summarizing the legal act in English, from the perspective of its impact on citizens' daily lives.\",\n  \"eng_key_points\": [\n    \"First short bullet point in English regarding the most important solutions or changes being introduced.\",\n    \"Second short bullet point in English...\"\n  ],\n  \"de_ai_title\": \"Ein neuer, kurzer Titel für das Rechtsdokument auf Deutsch, der den Kern der Änderungen erfasst (z.B. max. 10-12 Wörter).\",\n  \"de_summary\": \"2-3 Sätze Zusammenfassung des Rechtsdokuments auf Deutsch, aus der Perspektive seiner Auswirkungen auf das tägliche Leben der Bürger.\",\n  \"de_key_points\": [\n    \"Erster kurzer Stichpunkt auf Deutsch zu den wichtigsten eingeführten Lösungen oder Änderungen.\",\n    \"Zweiter kurzer Stichpunkt auf Deutsch...\"\n  ],\n  \"fr_ai_title\": \"Un nouveau titre court pour l'acte juridique en français, saisissant l'essence des changements (par exemple, 10-12 mots maximum).\",\n  \"fr_summary\": \"Résumé de 2-3 phrases de l'acte juridique en français, du point de vue de son impact sur la vie quotidienne des citoyens.\",\n  \"fr_key_points\": [\n    \"Premier court point en français concernant les solutions ou changements les plus importants introduits.\",\n    \"Deuxième court point en français...\"\n  ],\n  \"es_ai_title\": \"Un nuevo título breve para el acto jurídico en español, que recoja la esencia de los cambios (por ejemplo, máximo 10-12 palabras).\",\n  \"es_summary\": \"Resumen de 2-3 frases del acto jurídico en español, desde la perspectiva de su impacto en la vida cotidiana de los ciudadanos.\",\n  \"es_key_points\": [\n    \"Primer punto breve en español sobre las soluciones o cambios más importantes que se introducen.\",\n    \"Segundo punto breve en español...\"\n  ],\n  \"it_ai_title\": \"Un nuovo titolo breve per l'atto giuridico in italiano, che colga l'essenza delle modifiche (ad es. massimo 10-12 parole).\",\n  \"it_summary\": \"Riepilogo di 2-3 frasi dell'atto giuridico in italiano, dal punto di vista del suo impatto sulla vita quotidiana dei cittadini.\",\n  \"it_key_points\": [\n    \"Primo breve punto in italiano riguardante le soluzioni o le modifiche più importanti introdotte.\",\n    \"Secondo breve punto in italiano...\"\n  ],\n  \"nl_ai_title\": \"Een nieuwe, korte titel voor de rechtshandeling in het Nederlands, die de essentie van de wijzigingen weergeeft (bijv. max. 10-12 woorden).\",\n  \"nl_summary\": \"Samenvatting van 2-3 zinnen van de rechtshandeling in het Nederlands, vanuit het perspectief van de impact op het dagelijks leven van burgers.\",\n  \"nl_key_points\": [\n    \"Eerste korte punt in het Nederlands betreffende de belangrijkste geïntroduceerde oplossingen of wijzigingen.\",\n    \"Tweede korte punt in het Nederlands...\"\n  ],\n  \"pt_ai_title\": \"Um novo título curto para o ato jurídico em português, capturando a essência das mudanças (por exemplo, máx. 10-12 palavras).\",\n  \"pt_summary\": \"Resumo de 2-3 frases do ato jurídico em português, na perspetiva do seu impacto na vida quotidiana dos cidadãos.\",\n  \"pt_key_points\": [\n    \"Primeiro ponto curto em português sobre as soluções ou alterações mais importantes introduzidas.\",\n    \"Segundo ponto curto em português...\"\n  ],\n  \"category\": [\"Categorize the document into one category by default, based on the field it primarily concerns. Choose up to 3 if the document also touches upon SIGNIFICANT issues from other categories. You MUST select categories ONLY from the following list: Health, Education, Family, Taxes, Labor, Security, Environment, Courts and Law, Transport, Benefits, Real Estate, Media and Culture, Local Government, Migration, Agriculture, Public Investments, Informatization, Economy. If the document does not definitively fit any of these, you MUST use \"Other\". If you use \"Other\", it should be the ONLY category selected. Do NOT invent new categories. The response must be an array of strings, e.g., [\"Taxes\", \"Family\"].\"]\n}\n\n",
      "ai_response_raw": "{\n  \"pl_ai_title\": \"Ustawa o Niezbędnych Opiekunach: Prawo do kontaktu w domach opieki\",\n  \"pl_summary\": \"Ustawa gwarantuje mieszkańcom domów opieki i ośrodków rehabilitacyjnych prawo do kontaktu z wyznaczonym opiekunem, nawet gdy ogólne odwiedziny są ograniczone. Zmiany mają zapobiegać izolacji pacjentów i zapewniać im stałe wsparcie bliskich w sytuacjach kryzysowych.\",\n  \"pl_key_points\": [\n    \"Każdy mieszkaniec może wyznaczyć „niezbędnego opiekuna”, który ma prawo do codziennych odwiedzin.\",\n    \"Placówki nie mogą całkowicie zakazać wstępu opiekunom, z wyjątkiem krótkich, ściśle określonych okresów.\",\n    \"Opiekunowie muszą przestrzegać zasad bezpieczeństwa, które nie mogą być surowsze niż te dla personelu.\",\n    \"Wprowadzono szybką ścieżkę odwoławczą oraz kary finansowe do 5000 USD dla placówek łamiących te prawa.\"\n  ],\n  \"eng_ai_title\": \"Essential Caregivers Act: Ensuring Access to Loved Ones in Care Facilities\",\n  \"eng_summary\": \"This act ensures that residents of nursing homes and rehabilitation centers can have access to a designated caregiver even during emergencies when general visitation is restricted. It aims to prevent the negative health effects of isolation by allowing family or friends to provide essential support.\",\n  \"eng_key_points\": [\n    \"Residents have the right to designate an 'essential caregiver' with daily access to the facility.\",\n    \"Facilities are prohibited from denying access except for very limited, regulated periods of up to 14 days.\",\n    \"Caregivers must follow safety protocols that are no more restrictive than those required for facility staff.\",\n    \"A formal appeal process and fines up to $5,000 are established for facilities that wrongfully deny access.\"\n  ],\n  \"de_ai_title\": \"Gesetz über unverzichtbare Pflegepersonen: Besuchsrecht in Pflegeheimen sichern\",\n  \"de_summary\": \"Dieses Gesetz garantiert Bewohnern von Pflegeeinrichtungen das Recht auf Kontakt zu einer festgelegten Pflegeperson, selbst wenn allgemeine Besuche eingeschränkt sind. Ziel ist es, soziale Isolation zu verhindern und die Unterstützung durch Angehörige dauerhaft zu ermöglichen.\",\n  \"de_key_points\": [\n    \"Bewohner können eine „unverzichtbare Pflegeperson“ benennen, die täglichen Zugang zur Einrichtung erhält.\",\n    \"Einrichtungen dürfen den Zugang nur in streng begrenzten Ausnahmefällen für maximal 14 Tage verweigern.\",\n    \"Pflegepersonen müssen Sicherheitsvorgaben befolgen, die nicht strenger als die für das Personal sind.\",\n    \"Es wird ein Beschwerdeverfahren und Bußgelder für Einrichtungen eingeführt, die das Zugangsrecht verletzen.\"\n  ],\n  \"fr_ai_title\": \"Loi sur les aidants essentiels : garantir les visites en centres de soins\",\n  \"fr_summary\": \"Cette loi garantit aux résidents des maisons de retraite le droit de recevoir un aidant désigné, même en cas de restrictions générales des visites. Elle vise à lutter contre l'isolement et à assurer un soutien continu de la part des proches.\",\n  \"fr_key_points\": [\n    \"Chaque résident peut désigner un « aidant essentiel » bénéficiant d'un accès quotidien à l'établissement.\",\n    \"Les établissements ne peuvent refuser l'accès que pour des périodes très courtes et strictement réglementées.\",\n    \"Les aidants doivent respecter des protocoles de sécurité identiques à ceux imposés au personnel.\",\n    \"Un processus de recours et des amendes allant jusqu'à 5 000 $ sont prévus pour les établissements récalcitrants.\"\n  ],\n  \"es_ai_title\": \"Ley de Cuidadores Esenciales: Garantizando el contacto en centros de cuidado\",\n  \"es_summary\": \"Esta ley asegura que los residentes de hogares de ancianos mantengan el acceso a un cuidador designado, incluso durante emergencias con restricciones de visitas. Busca evitar el deterioro de la salud causado por el aislamiento social de los pacientes.\",\n  \"es_key_points\": [\n    \"Los residentes pueden designar a un 'cuidador esencial' con derecho a visitas diarias al centro.\",\n    \"Los centros solo pueden restringir el acceso por periodos breves y bajo supervisión de las autoridades estatales.\",\n    \"Los cuidadores deben cumplir protocolos de seguridad no más estrictos que los aplicados al personal.\",\n    \"Se establece un proceso de apelación y multas de hasta 5,000 USD para los centros que incumplan la norma.\"\n  ],\n  \"it_ai_title\": \"Legge sui Caregiver Essenziali: Diritto alle visite nelle strutture di cura\",\n  \"it_summary\": \"La legge garantisce ai residenti delle case di cura il diritto di accedere a un caregiver designato, anche quando le visite regolari sono limitate. L'obiettivo è prevenire l'isolamento e garantire il supporto dei propri cari per il benessere del paziente.\",\n  \"it_key_points\": [\n    \"Ogni residente può nominare un 'caregiver essenziale' con diritto di accesso quotidiano alla struttura.\",\n    \"Le strutture possono negare l'accesso solo per periodi limitati e previa approvazione delle autorità sanitarie.\",\n    \"I caregiver devono seguire protocolli di sicurezza non più restrittivi di quelli previsti per il personale.\",\n    \"È previsto un sistema di ricorso rapido e sanzioni fino a 5.000 USD per le strutture inadempienti.\"\n  ],\n  \"nl_ai_title\": \"Wet Essentiële Mantelzorgers: Toegang tot naasten in zorginstellingen waarborgen\",\n  \"nl_summary\": \"Deze wet geeft bewoners van verpleeghuizen het recht op contact met een aangewezen mantelzorger, zelfs als algemene bezoeken beperkt zijn. Het doel is om eenzaamheid en gezondheidsachteruitgang door isolatie te voorkomen.\",\n  \"nl_key_points\": [\n    \"Bewoners mogen een 'essentiële mantelzorger' aanwijzen die elke dag toegang heeft tot de instelling.\",\n    \"Instellingen mogen de toegang alleen in zeer beperkte en gereguleerde gevallen weigeren voor maximaal 14 dagen.\",\n    \"Mantelzorgers moeten veiligheidsprotocollen volgen die niet strenger zijn dan die voor het personeel.\",\n    \"Er komt een beroepsprocedure en er kunnen boetes tot 5.000 USD worden opgelegd bij overtredingen.\"\n  ],\n  \"pt_ai_title\": \"Lei dos Cuidadores Essenciais: Garantindo visitas em centros de acolhimento\",\n  \"pt_summary\": \"Esta lei assegura aos residentes de lares de idosos o direito de receber um cuidador designado, mesmo durante períodos de restrição de visitas. O objetivo é combater o isolamento e permitir o apoio contínuo de familiares na prestação de cuidados.\",\n  \"pt_key_points\": [\n    \"Os residentes podem designar um 'cuidador essencial' com direito a acesso diário à instituição.\",\n    \"As instituições só podem negar o acesso por períodos curtos e devidamente autorizados pelo estado.\",\n    \"Os cuidadores devem seguir protocolos de segurança iguais aos exigidos aos funcionários da unidade.\",\n    \"É criado um processo de recurso e multas de até 5.000 USD para instituições que desrespeitem este direito.\"\n  ],\n  \"category\": [\"Health\", \"Family\"]\n}"
    }
  ]
}