Amends SSA title XI to include abusive long-term care facility employees in the national health care fraud and abuse data collection program database. Includes SNFs, certain other nursing facilities, home health agencies, hospices, intermediate care facilities for the mentally retarded, and providers of home health or long-term care services as long-term care facilities.
Directs the Secretary of Health and Human Services to establish a demonstration program to provide grants to develop information on best practices in patient abuse prevention training for managers and staff of hospital and health care facilities.
[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3933 Introduced in House (IH)]
107th CONGRESS
2d Session
H. R. 3933
To amend titles XVIII and XIX of the Social Security Act to prevent
abuse of recipients of long-term care services under the Medicare and
Medicaid programs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 12, 2002
Mr. Carson of Oklahoma 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 prevent
abuse of recipients of long-term care services under the Medicare and
Medicaid programs.
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 ``Patient Abuse Prevention Act''.
SEC. 2. ESTABLISHMENT OF PROGRAM TO PREVENT ABUSE OF NURSING FACILITY
RESIDENTS.
(a) Nursing Facility and Skilled Nursing Facility Requirements.--
(1) Medicaid program.--Section 1919(b) of the Social
Security Act (42 U.S.C. 1396r(b)) is amended by adding at the
end the following new paragraph:
``(8) Screening of nursing facility workers.--
``(A) Background checks on applicants.--Subject to
subparagraph (B)(ii), before hiring a nursing facility
worker, a nursing facility shall--
``(i) give the worker written notice that
the facility is required to perform background
checks with respect to applicants;
``(ii) require, as a condition of
employment, that such worker--
``(I) provide a written statement
disclosing any conviction for a
relevant crime or finding of patient or
resident abuse;
``(II) provide a statement signed
by the worker authorizing the facility
to request the search and exchange of
criminal records;
``(III) provide in person a copy of
the worker's fingerprints or thumb
print, depending upon available
technology; and
``(IV) provide any other
identification information the
Secretary may specify in regulation;
``(iii) initiate a check of the data
collection system established under section
1128E in accordance with regulations
promulgated by the Secretary to determine
whether such system contains any disqualifying
information with respect to such worker; and
``(iv) if that system does not contain any
such disqualifying information--
``(I) request that the State
initiate a State and national criminal
background check on such worker in
accordance with the provisions of
subsection (e)(8); and
``(II) furnish to the State the
information described in subclauses
(II) through (IV) of clause (ii) not
more than 7 days (excluding Saturdays,
Sundays, and legal public holidays
under section 6103(a) of title 5,
United States Code) after completion of
the check against the system initiated
under clause (iii).
``(B) Prohibition on hiring of abusive workers.--
``(i) In general.--A nursing facility may
not knowingly employ any nursing facility
worker who has any conviction for a relevant
crime or with respect to whom a finding of
patient or resident abuse has been made.
``(ii) Provisional employment.--After
complying with the requirements of clauses (i),
(ii), and (iii) of subparagraph (A), a nursing
facility may provide for a provisional period
of employment for a nursing facility worker
pending completion of the check against the
data collection system described under
subparagraph (A)(iii) and the background check
described under subparagraph (A)(iv). Such
facility shall maintain direct supervision of
the worker during the worker's provisional
period of employment.
``(C) Reporting requirements.--A nursing facility
shall report to the State any instance in which the
facility determines that a nursing facility worker has
committed an act of resident neglect or abuse or
misappropriation of resident property in the course of
employment by the facility.
``(D) Use of information.--
``(i) In general.--A nursing facility that
obtains information about a nursing facility
worker pursuant to clauses (iii) and (iv) of
subparagraph (A) may use such information only
for the purpose of determining the suitability
of the worker for employment.
``(ii) Immunity from liability.--A nursing
facility that, in denying employment for an
applicant (including during the period
described in subparagraph (B)(ii)), reasonably
relies upon information about such applicant
provided by the State pursuant to subsection
(e)(8) or section 1128E shall not be liable in
any action brought by such applicant based on the employment
determination resulting from the information.
``(iii) Criminal penalty.--Whoever
knowingly violates the provisions of clause (i)
shall be fined in accordance with title 18,
United States Code, imprisoned for not more
than 2 years, or both.
``(E) Civil penalty.--
``(i) In general.--A nursing facility that
violates the provisions of this paragraph shall
be subject to a civil penalty in an amount not
to exceed--
``(I) for the first such violation,
$2,000; and
``(II) for the second and each
subsequent violation within any 5-year
period, $5,000.
``(ii) Knowing retention of worker.--In
addition to any civil penalty under clause (i),
a nursing facility that--
``(I) knowingly continues to employ
a nursing facility worker in violation
of subparagraph (A) or (B); or
``(II) knowingly fails to report a
nursing facility worker under
subparagraph (C),
shall be subject to a civil penalty in an
amount not to exceed $5,000 for the first such
violation, and $10,000 for the second and each
subsequent violation within any 5-year period.
``(F) Definitions.--In this paragraph:
``(i) Conviction for a relevant crime.--The
term `conviction for a relevant crime' means
any Federal or State criminal conviction for--
``(I) any offense described in
paragraphs (1) through (4) of section
1128(a); and
``(II) such other types of offenses
as the Secretary may specify in
regulations, taking into account the
severity and relevance of such
offenses, and after consultation with
representatives of long-term care
providers, representatives of long-term
care employees, consumer advocates, and
appropriate Federal and State
officials.
``(ii) Disqualifying information.--The term
`disqualifying information' means information
about a conviction for a relevant crime or a
finding of patient or resident abuse.
``(iii) Finding of patient or resident
abuse.--The term `finding of patient or
resident abuse' means any substantiated finding
by a State agency under subsection (g)(1)(C) or
a Federal agency that a nursing facility worker
has committed--
``(I) an act of patient or resident
abuse or neglect or a misappropriation
of patient or resident property; or
``(II) such other types of acts as
the Secretary may specify in
regulations.
``(iv) Nursing facility worker.--The term
`nursing facility worker' means any individual
(other than any volunteer) that has direct
access to a patient of a nursing facility under
an employment or other contract, or both, with
such facility. Such term includes individuals
who are licensed or certified by the State to
provide such services, and nonlicensed
individuals providing such services, as defined
by the Secretary, including nurse assistants,
nurse aides, home health aides, and personal
care workers and attendants.''.
(2) Medicare program.--Section 1819(b) of the Social
Security Act (42 U.S.C. 1395i-3(b)) is amended by adding at the
end the following:
``(8) Screening of skilled nursing facility workers.--
``(A) Background checks on applicants.--Subject to
subparagraph (B)(ii), before hiring a skilled nursing
facility worker, a skilled nursing facility shall--
``(i) give the worker written notice that
the facility is required to perform background
checks with respect to applicants;
``(ii) require, as a condition of
employment, that such worker--
``(I) provide a written statement
disclosing any conviction for a
relevant crime or finding of patient or
resident abuse;
``(II) provide a statement signed
by the worker authorizing the facility
to request the search and exchange of
criminal records;
``(III) provide in person a copy of
the worker's fingerprints or thumb
print, depending upon available
technology; and
``(IV) provide any other
identification information the
Secretary may specify in regulation;
``(iii) initiate a check of the data
collection system established under section
1128E in accordance with regulations
promulgated by the Secretary to determine
whether such system contains any disqualifying
information with respect to such worker; and
``(iv) if that system does not contain any
such disqualifying information--
``(I) request that the State
initiate a State and national criminal
background check on such worker in
accordance with the provisions of
subsection (e)(6); and
``(II) furnish to the State the
information described in subclauses
(II) through (IV) of clause (ii) not
more than 7 days (excluding Saturdays,
Sundays, and legal public holidays
under section 6103(a) of title 5,
United States Code) after completion of
the check against the system initiated
under clause (iii).
``(B) Prohibition on hiring of abusive workers.--
``(i) In general.--A skilled nursing
facility may not knowingly employ any skilled
nursing facility worker who has any conviction
for a relevant crime or with respect to whom a
finding of patient or resident abuse has been
made.
``(ii) Provisional employment.--After
complying with the requirements of clauses (i),
(ii), and (iii) of subparagraph (A), a skilled
nursing facility may provide for a provisional
period of employment for a skilled nursing
facility worker pending completion of the check
against the data collection system described
under subparagraph (A)(iii) and the background
check described under subparagraph (A)(iv).
Such facility shall maintain direct supervision
of the covered individual during the worker's
provisional period of employment.
``(C) Reporting requirements.--A skilled nursing
facility shall report to the State any instance in
which the facility determines that a skilled nursing
facility worker has committed an act of resident
neglect or abuse or misappropriation of resident
property in the course of employment by the facility.
``(D) Use of information.--
``(i) In general.--A skilled nursing
facility that obtains information about a
skilled nursing facility worker pursuant to
clauses (iii) and (iv) of subparagraph (A) may
use such information only for the purpose of
determining the suitability of the worker for
employment.
``(ii) Immunity from liability.--A skilled
nursing facility that, in denying employment
for an applicant (including during the period
described in subparagraph (B)(ii)), reasonably
relies upon information about such applicant
provided by the State pursuant to subsection
(e)(6) or section 1128E shall not be liable in
any action brought by such applicant based on
the employment determination resulting from the
information.
``(iii) Criminal penalty.--Whoever
knowingly violates the provisions of clause (i)
shall be fined in accordance with title 18,
United States Code, imprisoned for not more
than 2 years, or both.
``(E) Civil penalty.--
``(i) In general.--A skilled nursing
facility that violates the provisions of this
paragraph shall be subject to a civil penalty
in an amount not to exceed--
``(I) for the first such violation,
$2,000; and
``(II) for the second and each
subsequent violation within any 5-year
period, $5,000.
``(ii) Knowing retention of worker.--In
addition to any civil penalty under clause (i),
a skilled nursing facility that--
``(I) knowingly continues to employ
a skilled nursing facility worker in
violation of subparagraph (A) or (B);
or
``(II) knowingly fails to report a
skilled nursing facility worker under
subparagraph (C),
shall be subject to a civil penalty in an
amount not to exceed $5,000 for the first such
violation, and $10,000 for the second and each
subsequent violation within any 5-year period.
``(F) Definitions.--In this paragraph:
``(i) Conviction for a relevant crime.--The
term `conviction for a relevant crime' means
any Federal or State criminal conviction for--
``(I) any offense described in
paragraphs (1) through (4) of section
1128(a); and
``(II) such other types of offenses
as the Secretary may specify in
regulations, taking into account the
severity and relevance of such
offenses, and after consultation with
representatives of long-term care
providers, representatives of long-term
care employees, consumer advocates, and
appropriate Federal and State
officials.
``(ii) Disqualifying information.--The term
`disqualifying information' means information
about a conviction for a relevant crime or a
finding of patient or resident abuse.
``(iii) Finding of patient or resident
abuse.--The term `finding of patient or
resident abuse' means any substantiated finding
by a State agency under subsection (g)(1)(C) or
a Federal agency that a skilled nursing
facility worker has committed--
``(I) an act of patient or resident
abuse or neglect or a misappropriation
of patient or resident property; or
``(II) such other types of acts as
the Secretary may specify in
regulations.
``(iv) Skilled nursing facility worker.--
The term `skilled nursing facility worker'
means any individual (other than any volunteer)
that has direct access to a patient of a skilled nursing facility under
an employment or other contract, or both, with such facility. Such term
includes individuals who are licensed or certified by the State to
provide such services, and nonlicensed individuals providing such
services, as defined by the Secretary, including nurse assistants,
nurse aides, home health aides, and personal care workers and
attendants.''.
(3) Technical amendments.--Effective as if included in the
enactment of section 941 of the Medicare, Medicaid, and SCHIP
Benefits Improvement and Protection Act of 2000 (114 Stat.
2763A-585), as enacted into law by section 1(a)(6) of Public
Law 106-554, sections 1819(b) and 1919(b) of the Social
Security Act (42 U.S.C. 1395i-3(b), 1396r(b)), as amended by
such section 941 (as so enacted into law), are each amended by
redesignating the paragraph (8) added by such section as
paragraph (9).
(b) State Requirements.--
(1) Medicaid program.--
(A) Expansion of state registry to collect
information about nursing facility employees other than
nurse aides.--Section 1919 of the Social Security Act
(42 U.S.C. 1396r) is amended--
(i) in subsection (e)(2)--
(I) in the paragraph heading, by
striking ``Nurse aide registry'' and
inserting ``Nursing facility employee
registry'';
(II) in subparagraph (A)--
(aa) by striking ``By not
later than January 1, 1989,
the'' and inserting ``The'';
(bb) by striking ``a
registry of all individuals''
and inserting ``a registry of
(I) all individuals''; and
(cc) by inserting before
the period ``, and (II) all
other nursing facility
employees with respect to whom
the State has made a finding
described in subparagraph
(B)'';
(III) in subparagraph (B), by
striking ``involving an individual
listed in the registry'' and inserting
``involving a nursing facility
employee''; and
(IV) in subparagraph (C), by
striking ``nurse aide'' and inserting
``nursing facility employee or
applicant for employment''; and
(ii) in subsection (g)(1)--
(I) in subparagraph (C)--
(aa) in the first sentence,
by striking ``nurse aide'' and
inserting ``nursing facility
employee''; and
(bb) in the third sentence,
by striking ``nurse aide'' each
place it appears and inserting
``nursing facility employee'';
and
(II) in subparagraph (D)--
(aa) in the subparagraph
heading, by striking ``nurse
aide registry'' and inserting
``nursing facility employee
registry''; and
(bb) by striking ``nurse
aide'' each place it appears
and inserting ``nursing
facility employee''.
(B) Federal and state requirement to conduct
background checks.--Section 1919(e) of the Social
Security Act (42 U.S.C. 1396r(e)) is amended by adding
at the end the following:
``(8) Federal and state requirements concerning criminal
background checks on nursing facility employees.--
``(A) In general.--Upon receipt of a request by a
nursing facility pursuant to subsection (b)(8) that is
accompanied by the information described in subclauses
(II) through (IV) of subsection (b)(8)(A)(ii), a State,
after checking appropriate State records and finding no
disqualifying information (as defined in subsection
(b)(8)(F)(ii)), shall submit such request and
information to the Attorney General and shall request
the Attorney General to conduct a search and exchange
of records with respect to the individual as described
in subparagraph (B).
``(B) Search and exchange of records by attorney
general.--Upon receipt of a submission pursuant to
subparagraph (A), the Attorney General shall direct a
search of the records of the Federal Bureau of
Investigation for any criminal history records
corresponding to the fingerprints and other positive
identification information submitted. The Attorney
General shall provide any corresponding information
resulting from the search to the State.
``(C) State reporting of information to nursing
facility.--Upon receipt of the information provided by
the Attorney General pursuant to subparagraph (B), the
State shall--
``(i) review the information to determine
whether the individual has any conviction for a
relevant crime (as defined in subsection
(b)(8)(F)(i));
``(ii) report to the nursing facility the
results of such review; and
``(iii) in the case of an individual with a
conviction for a relevant crime, report the
existence of such conviction of such individual
to the database established under section
1128E.
``(D) Fees for performance of criminal background
checks.--
``(i) Authority to charge fees.--
``(I) Attorney general.--The
Attorney General may charge a fee to
any State requesting a search and
exchange of records pursuant to this
paragraph and subsection (b)(8) for
conducting the search and providing the
records. The amount of such fee shall
not exceed the lesser of the actual
cost of such activities or $50. Such
fees shall be available to the Attorney
General, or, in the Attorney General's
discretion, to the Federal Bureau of
Investigation, until expended.
``(II) State.--A State may charge a
nursing facility a fee for initiating
the criminal background check under
this paragraph and subsection (b)(8),
including fees charged by the Attorney
General, and for performing the review
and report required by subparagraph
(C). The amount of such fee shall not
exceed the actual cost of such
activities.
``(ii) Prohibition on charging applicants
or employees.--An entity may not impose on an
applicant for employment or an employee any
charges relating to the performance of a
background check under this paragraph.
``(E) Regulations.--
``(i) In general.--In addition to the
Secretary's authority to promulgate regulations
under this title, the Attorney General, in
consultation with the Secretary, may promulgate
such regulations as are necessary to carry out
the Attorney General's responsibilities under
this paragraph and subsection (b)(8), including
regulations regarding the security,
confidentiality, accuracy, use, destruction,
and dissemination of information, audits and
recordkeeping, and the imposition of fees.
``(ii) Appeal procedures.--The Attorney
General, in consultation with the Secretary,
shall promulgate such regulations as are
necessary to establish procedures by which an
applicant or employee may appeal or dispute the
accuracy of the information obtained in a
background check conducted under this
paragraph. Appeals shall be limited to
instances in which an applicant or employee is
incorrectly identified as the subject of the
background check, or when information about the
applicant or employee has not been updated to
reflect changes in the applicant's or
employee's criminal record.
``(F) Report.--Not later than 2 years after the
date of enactment of this paragraph, the Attorney
General shall submit a report to Congress on--
``(i) the number of requests for searches
and exchanges of records made under this
section;
``(ii) the disposition of such requests;
and
``(iii) the cost of responding to such
requests.''.
(2) Medicare program.--
(A) Expansion of state registry to collect
information about skilled nursing facility employees
other than nurse aides.--Section 1819 of the Social
Security Act (42 U.S.C. 1395i-3) is amended--
(i) in subsection (e)(2)--
(I) in the paragraph heading, by
striking ``Nurse aide registry'' and
inserting ``Skilled nursing care
employee registry'';
(II) in subparagraph (A)--
(aa) by striking ``By not
later than January 1, 1989,
the'' and inserting ``The'';
(bb) by striking ``a
registry of all individuals''
and inserting ``a registry of
(I) all individuals''; and
(cc) by inserting before
the period ``, and (II) all
other skilled nursing facility
employees with respect to whom
the State has made a finding
described in subparagraph
(B)'';
(III) in subparagraph (B), by
striking ``involving an individual
listed in the registry'' and inserting
``involving a skilled nursing facility
employee''; and
(IV) in subparagraph (C), by
striking ``nurse aide'' and inserting
``skilled nursing facility employee or
applicant for employment''; and
(ii) in subsection (g)(1)--
(I) in subparagraph (C)--
(aa) in the first sentence,
by striking ``nurse aide'' and
inserting ``skilled nursing
facility employee''; and
(bb) in the third sentence,
by striking ``nurse aide'' each
place it appears and inserting
``skilled nursing facility
employee''; and
(II) in subparagraph (D)--
(aa) in the subparagraph
heading, by striking ``nurse
aide registry'' and inserting
``nursing facility employee
registry''; and
(bb) by striking ``nurse
aide'' each place it appears
and inserting ``nursing
facility employee''.
(B) Federal and state requirement to conduct
background checks.--Section 1819(e) of the Social
Security Act (42 U.S.C. 1395i-3(e)) is amended by
adding at the end the following:
``(6) Federal and state requirements concerning criminal
background checks on skilled nursing facility employees.--
``(A) In general.--Upon receipt of a request by a
skilled nursing facility pursuant to subsection (b)(8)
that is accompanied by the information described in
subclauses (II) through (IV) of subsection
(b)(8)(A)(ii), a State, after checking appropriate
State records and finding no disqualifying information
(as defined in subsection (b)(8)(F)(ii)), shall submit
such request and information to the Attorney General
and shall request the Attorney General to conduct a
search and exchange of records with respect to the
individual as described in subparagraph (B).
``(B) Search and exchange of records by attorney
general.--Upon receipt of a submission pursuant to
subparagraph (A), the Attorney General shall direct a
search of the records of the Federal Bureau of
Investigation for any criminal history records
corresponding to the fingerprints and other positive
identification information submitted. The Attorney
General shall provide any corresponding information
resulting from the search to the State.
``(C) State reporting of information to skilled
nursing facility.--Upon receipt of the information
provided by the Attorney General pursuant to
subparagraph (B), the State shall--
``(i) review the information to determine
whether the individual has any conviction for a
relevant crime (as defined in subsection
(b)(8)(F)(i));
``(ii) report to the skilled nursing
facility the results of such review; and
``(iii) in the case of an individual with a
conviction for a relevant crime, report the
existence of such conviction of such individual
to the database established under section
1128E.
``(D) Fees for performance of criminal background
checks.--
``(i) Authority to charge fees.--
``(I) Attorney general.--The
Attorney General may charge a fee to
any State requesting a search and
exchange of records pursuant to this
paragraph and subsection (b)(8) for
conducting the search and providing the
records. The amount of such fee shall
not exceed the lesser of the actual
cost of such activities or $50. Such
fees shall be available to the Attorney
General, or, in the Attorney General's
discretion, to the Federal Bureau of
Investigation until expended.
``(II) State.--A State may charge a
skilled nursing facility a fee for
initiating the criminal
background check under this paragraph and subsection (b)(8), including
fees charged by the Attorney General, and for performing the review and
report required by subparagraph (C). The amount of such fee shall not
exceed the actual cost of such activities.
``(ii) Prohibition on charging applicants
or employees.--An entity may not impose on an
applicant for employment or an employee any
charges relating to the performance of a
background check under this paragraph.
``(E) Regulations.--
``(i) In general.--In addition to the
Secretary's authority to promulgate regulations
under this title, the Attorney General, in
consultation with the Secretary, may promulgate
such regulations as are necessary to carry out
the Attorney General's responsibilities under
this paragraph and subsection (b)(9), including
regulations regarding the security
confidentiality, accuracy, use, destruction,
and dissemination of information, audits and
recordkeeping, and the imposition of fees.
``(ii) Appeal procedures.--The Attorney
General, in consultation with the Secretary,
shall promulgate such regulations as are
necessary to establish procedures by which an
applicant or employee may appeal or dispute the
accuracy of the information obtained in a
background check conducted under this
paragraph. Appeals shall be limited to
instances in which an applicant or employee is
incorrectly identified as the subject of the
background check, or when information about the
applicant or employee has not been updated to
reflect changes in the applicant's or
employee's criminal record.
``(F) Report.--Not later than 2 years after the
date of enactment of this paragraph, the Attorney
General shall submit a report to Congress on--
``(i) the number of requests for searches
and exchanges of records made under this
section;
``(ii) the disposition of such requests;
and
``(iii) the cost of responding to such
requests.''.
(c) Application to Other Entities Providing Home Health or Long-
Term Care Services.--
(1) Medicaid.--Section 1902(a) of the Social Security Act
(42 U.S.C. 1396a) is amended--
(A) in paragraph (65), by striking the period and
inserting ``; and''; and
(B) by inserting after paragraph (65) the
following:
``(66) provide that any entity that is eligible to be paid
under the State plan for providing home health services or
long-term care services for which medical assistance is
available under the State plan to individuals requiring long-
term care complies with the requirements of subsections (b)(8)
and (e)(8) of section 1919.''.
(2) Medicare.--Part D of title XVIII of the Social Security
Act (42 U.S.C. 1395x et seq.) is amended by adding at the end
the following:
``application of skilled nursing facility preventive abuse provisions
to any provider of services or other entity providing home health or
long-term care services
``Sec. 1897. The requirements of subsections (b)(8) and (e)(6) of
section 1819 shall apply to any provider of services or any other
entity that is eligible to be paid under this title for providing home
health services or long-term care services to an individual entitled to
benefits under part A or enrolled under part B (including an individual
provided with a Medicare+Choice plan offered by a Medicare+Choice
organization under part C).''.
(d) Reimbursement of Reasonable Costs for Background Checks.--The
Secretary of Health and Human Services shall factor into any payment
system under titles XVIII and XIX of the Social Security Act the
reasonable costs of the requirements of sections 1819(b)(8) and
1919(b)(8) of such Act, as added by this section, incurred by any
entity subject to such requirements.
SEC. 3. INCLUSION OF ABUSIVE WORKERS IN THE DATABASE ESTABLISHED AS
PART OF NATIONAL HEALTH CARE FRAUD AND ABUSE DATA
COLLECTION PROGRAM.
(a) Inclusion of Abusive Acts Within a Long-Term Care Facility or
Provider.--Section 1128E(g)(1)(A) of the Social Security Act (42 U.S.C.
1320a-7e(g)(1)(A)) is amended--
(1) by redesignating clause (v) as clause (vi); and
(2) by inserting after clause (iv), the following:
``(v) A finding of abuse or neglect of a
patient or a resident of a long-term care
facility, or misappropriation of such a
patient's or resident's property.''.
(b) Coverage of Long-Term Care Facility or Provider Employees.--
Section 1128E(g)(2) of the Social Security Act (42 U.S.C. 1320a-
7e(g)(2)) is amended by inserting ``, and includes any individual of a
long-term care facility or provider (other than any volunteer) that has
direct access to a patient or resident of such a facility under an
employment or other contract, or both, with the facility or provider
(including individuals who are licensed or certified by the State to
provide services at the facility or through the provider, and
nonlicensed individuals, as defined by the Secretary, providing
services at the facility or through the provider, including nurse
assistants, nurse aides, home health aides, and personal care workers
and attendants)'' before the period.
(c) Reporting by Long-Term Care Facilities or Providers.--
(1) In general.--Section 1128E(b)(1) of the Social Security
Act (42 U.S.C. 1320a-7e(b)(1)) is amended by striking ``and
health plan'' and inserting ``, health plan, and long-term care
facility or provider''.
(2) Correction of information.--Section 1128E(c)(2) of the
Social Security Act (42 U.S.C. 1320a-7e(c)(2)) is amended by
striking ``and health plan'' and inserting ``, health plan, and
long-term care facility or provider''.
(d) Access to Reported Information.--Section 1128E(d)(1) of the
Social Security Act (42 U.S.C. 1320a-7e(d)(1)) is amended by striking
``and health plans'' and inserting ``, health plans, and long-term care
facilities or providers''.
(e) Mandatory Check of Database by Long-Term Care Facilities or
Providers.--Section 1128E(d) of the Social Security Act (42 U.S.C.
1320a-7e(d)) is amended by adding at the end the following:
``(3) Mandatory check of database by long-term care
facilities or providers.--A long-term care facility or provider
shall check the database maintained under this section prior to
hiring under an employment or other contract, or both, any
individual as an employee of such a facility or provider who
will have direct access to a patient or resident of the
facility or provider (including individuals who are licensed or
certified by the State to provide services at the facility or
through the provider, and nonlicensed individuals, as defined
by the Secretary, that will provide services at the facility or
through the provider, including nurse assistants, nurse aides,
home health aides, and personal care workers and
attendants).''.
(f) Definition of Long-Term Care Facility or Provider.--Section
1128E(g) of the Social Security Act (42 U.S.C. 1320a-7e(g)) is amended
by adding at the end the following:
``(6) Long-term care facility or provider.--The term `long-
term care facility or provider' means a skilled nursing
facility (as defined in section 1819(a)), a nursing facility
(as defined in section 1919(a)), a home health agency, a
hospice facility, an intermediate care facility for the
mentally retarded (as defined in section 1905(d)), or any other
facility that provides, or provider of, long-term care services
or home health services and receives payment for such services
under the medicare program under title XVIII or the medicaid
program under title XIX.''.
(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out the amendments made by this section,
$10,200,000 for fiscal year 2003.
SEC. 4. PREVENTION AND TRAINING DEMONSTRATION PROJECT.
(a) Establishment.--The Secretary of Health and Human Services
shall establish a demonstration program to provide grants to develop
information on best practices in patient abuse prevention training
(including behavior training and interventions) for managers and staff
of hospital and health care facilities.
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall be a public or private nonprofit entity
and prepare and submit to the Secretary of Health and Human Services an
application at such time, in such manner, and containing such
information as the Secretary may require.
(c) Use of Funds.--Amounts received under a grant under this
section shall be used to--
(1) examine ways to improve collaboration between State
health care survey and provider certification agencies, long-
term care ombudsman programs, the long-term care industry, and
local community members;
(2) examine patient care issues relating to regulatory
oversight, community involvement, and facility staffing and
management with a focus on staff training, staff stress
management, and staff supervision;
(3) examine the use of patient abuse prevention training
programs by long-term care entities, including the training
program developed by the National Association of Attorneys
General, and the extent to which such programs are used; and
(4) identify and disseminate best practices for preventing
and reducing patient abuse.
(d) Authorization of Appropriations.--There is authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 5. EFFECTIVE DATE.
The provisions of and amendments made by the Act shall apply,
without regard to whether implementing regulations are in effect, to
any individual applying for employment or hired for such employment--
(1) by any skilled nursing facility (as defined in section
1819(a) of the Social Security Act) or any nursing facility (as
defined in section 1919(a) of such Act), on or after the date
which is 6 months after the date of enactment of this Act,
(2) by any home health agency, on or after the date which
is 12 months after such date of enactment, and
(3) by any hospice facility, any intermediate care facility
for the mentally retarded (as defined in section 1905(d) of the
Social Security Act), or any other facility that provides long-
term care services and receives payment for such services under
the medicare program under title XVIII of such Act or the
medicaid program under title XIX of such Act, on or after the
date which is 18 months after such date of enactment.
<all>
Introduced in House
Introduced in House
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.
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.
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.
Referred to the Subcommittee on Health.
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