Despite its title, S. 3491 primarily addresses nursing home visitation rights rather than black lung benefits. The bill requires nursing facilities to allow residents to designate "essential caregivers" who can visit and provide assistance at all times, even during public health emergencies—with facilities able to restrict access for only 7 to 14 days maximum and only after written warning and failed corrective action. This legislation responds to findings that COVID-19 visitation bans isolated approximately 1.3 million nursing home residents and contributed to measurable health declines, including significant increases in pressure ulcers, weight loss, depression, and antipsychotic prescriptions. The bill establishes a state-level enforcement mechanism allowing agencies to investigate violations, require immediate access restoration, impose corrective action plans, and levy penalties up to $5,000 against non-compliant facilities, with the requirements applying to nursing homes, intermediate care facilities, and certain rehabilitation facilities beginning 2 years after enactment.
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