Nursing Home Fire Safety Act of 2004 - Amends title XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require automatic fire sprinkler systems in all Medicare and Medicaid funded nursing facilities and provide for reimbursement of the additional costs incurred with respect to installing such systems.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4967 Introduced in House (IH)]
108th CONGRESS
2d Session
H. R. 4967
To amend titles XVIII and XIX of the Social Security Act to require
automatic fire sprinkler systems in all nursing facilities
participating in the Medicare or Medicaid Programs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 22, 2004
Mr. Larson of Connecticut introduced the following bill; which was
referred to the Committee on Ways and Means, and in addition to the
Committee on Energy and Commerce, 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
automatic fire sprinkler systems in all nursing facilities
participating in the Medicare or 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; FINDINGS.
(a) Short Title.--This Act may be cited as the ``Nursing Home Fire
Safety Act of 2004''.
(b) Findings.--Congress finds the following:
(1) On February 26, 2003, a fire at a Hartford,
Connecticut, nursing facility without an automatic fire
sprinkler system claimed the lives of 16 patients.
(2) On September 27, 2003, a fire at a Nashville,
Tennessee, nursing facility without an automatic fire sprinkler
system claimed the lives of 15 patients.
(3) The National Fire Protection Association finds no
record of a multiple death fire in a nursing facility equipped
with an automatic fire sprinkler system.
(4) An estimated 1.5 million of the nation's elderly
population reside in nursing facilities.
(5) The Centers for Medicare and Medicaid Services
estimates that of the approximate 17,000 nursing facilities
nationwide, about 25 percent do not have an automatic fire
sprinkler system.
(6) Many State governments lack requirements for their
nursing facilities that were not originally equipped with
automatic fire sprinkler systems to be retrofitted with such
systems.
(7) Automatic fire sprinkler systems greatly improve the
chances of survival for older adults in the event of a fire.
SEC. 2. REQUIRING AUTOMATIC FIRE SPRINKLER SYSTEMS IN MEDICARE AND
MEDICAID FUNDED NURSING FACILITIES.
(a) Requirement for Medicare Skilled Nursing Facilities.--
(1) In general.--Section 1819(d)(2) of the Social Security
Act (42 U.S.C. 1395i-3(d)(2)) is amended--
(A) in subparagraph (B), by inserting ``, subject
to subparagraph (C)'' after ``except that''; and
(B) by adding at the end the following new
subparagraph:
``(C) Automatic fire sprinkler system.--
``(i) In general.--A skilled nursing
facility shall be equipped with an operational
automatic fire sprinkler system that meets the
requirements for such a system under the
National Fire Protection Association's Standard
for the Installation of Sprinkler Systems (1999
edition), or, at the option of a facility, such
later edition of standard as the Secretary may
recognize.
``(ii) Period for compliance and disclosure
of compliance for current facilities.--In the
case of a skilled nursing facility that is
providing extended care services for which
payment is made under this title as of the date
of the enactment of this subparagraph and that
was not in compliance with the requirement of
clause (i) as of such date--
``(I) the requirement of clause (i)
shall not apply until such date, not
earlier than 3 years and not later than
5 years after the date of the enactment
of this subparagraph, as the Secretary
shall specify; and
``(II) the facility shall provide
for public disclosure, in a form and
manner specified by the Secretary, of
whether the facility is in compliance
with the standard described in clause
(i).
``(iii) Treatment of earlier state
deadline.--Nothing in clause (ii)(I) shall be
construed to prevent a State from establishing
a deadline for the installation of automatic
fire sprinkler systems for skilled nursing
facilities that is earlier than the deadline
specified by the Secretary under such
clause.''.
(2) Reimbursement of additional costs.--Section 1888(e) of
such Act (42 U.S.C. 1395yy(e)) is amended--
(A) in paragraph (1) by striking ``and (12)'' and
inserting ``(12), and (13)''; and
(B) by adding at the end the following new
paragraph:
``(13) Additional amount to amortize for costs of
installing automatic fire sprinkler system.--
``(A) In general.--In the case of a skilled nursing
facility that, as of a date that is on or after
September 11, 2003, is participating in the program
under this title, is not participating in the program
under title XIX, and does not have installed an
automatic fire sprinkler system that met the
requirements described in section 1819(d)(2)(C), and
which subsequently incurs expenses in order to meet
such requirements, in addition to any other payments
made to the facility under this subsection, there shall
be paid, in an amortized manner over a five year
period, an amount equal to the reasonable amount
incurred by the facility in meeting such requirements,
less the amount of any payment made before October 1,
2004, under this title or title XIX that is directly
attributable (such as through depreciation) to such
expenses. Such payments shall be made by the Secretary
in such form and manner as the Secretary shall specify
and based upon the presentation of such information as
the Secretary requires.
``(B) No effect on other payments.--The additional
payment under subparagraph (A) shall not affect the
amount of any other payment made under this subsection
and the incurred expenses described in subparagraph (A)
shall not be taken into account in making any other
payments to a facility under this title.''.
(b) Requirement for Medicaid Nursing Facilities.--
(1) In general.--Section 1919(d)(2) of the Social Security
Act (42 U.S.C. 1396r(d)(2)) is amended--
(A) in subparagraph (B), by inserting ``, subject
to subparagraph (C)'' after ``except that''; and
(B) by adding at the end the following new
subparagraph:
``(C) Automatic fire sprinkler system.--
``(i) In general.--A nursing facility shall
be equipped with an operational automatic fire
sprinkler system that meets the requirements
for such a system under the National Fire
Protection Association's Standard for the
Installation of Sprinkler Systems (1999
edition), or, at the option of a facility, such
later edition of standard as the Secretary may
recognize.
``(ii) Period for compliance and disclosure
of compliance for current facilities.--In the
case of a nursing facility that is providing
nursing facility services for which payment is
made under this title as of the date of the
enactment of this subparagraph and that was not
in compliance with the requirement of clause
(i) as of such date--
``(I) the requirement of clause (i)
shall not apply until such date, not
earlier than 3 years and not later than
5 years after the date of the enactment
of this subparagraph, as the Secretary
shall specify; and
``(II) the facility shall provide
for public disclosure, in a form and
manner specified by the Secretary, of
whether the facility is in compliance
with the standard described in clause
(i).
``(iii) Treatment of earlier state
deadline.--Nothing in clause (ii)(I) shall be
construed to prevent a State from establishing
a deadline for the installation of automatic
fire sprinkler systems for nursing facilities
that is earlier than the deadline specified by
the Secretary under such clause.''.
(2) Reimbursement of additional costs.--Section
1902(a)(13)(A) of such Act (42 U.S.C. 1396a(a)(13)(A)) is
amended--
(A) by striking ``and'' at the end of clause (iii);
(B) by striking ``; and'' at the end of clause (iv)
and inserting ``, and''; and
(C) by adding at the end the following new clause:
``(v) in the case of nursing facility
services furnished by a nursing facility that,
as of a date that is on or after September 11,
2003, is participating in the program under
this title but does not have installed an
automatic fire sprinkler system that met the
requirements described in section
1919(d)(2)(C), and that subsequently incurs
expenses in order to meet such requirements,
such rates shall provide for the payment, in an
amortized manner over a five year period and in
addition to the payment amounts otherwise
provided, of an amount equal to the reasonable
amount incurred by the facility in meeting such
requirements, less the payment amounts under
this title or title XVIII made before October
1, 2004, that are directly attributable (such
as through depreciation) to such expenses, and
the payment rates otherwise provided shall not
take into account such costs incurred in
meeting such requirements; and''.
(3) Full federal payment.--
(A) In general.--The third sentence of section 1905
of such Act (42 U.S.C. 1396d) is amended by inserting
before the period at the end the following: ``and with
respect to amounts expended as medical assistance in
providing the payment amounts required under section
1902(a)(13)(A)(v)''.
(B) Conforming amendment to apply to territories.--
Section 1108 of such Act (42 U.S.C. 1308) is amended--
(i) in subsection (f), by striking
``subsection (g)'' and inserting ``subsections
(g) and (h)''; and
(ii) by adding at the end the following new
subsection:
``(h) Exception for Payment for Automatic Fire Sprinkler Systems.--
The limitations on payments under subsection (f) shall not apply to
payments that are attributable to payments for medical assistance for
expenditures made under section 1902(a)(13)(A)(v).''.
(c) Reduction in Tax Basis.--Section 1016(a) of the Internal
Revenue Code of 1986 is amended by striking ``and'' at the end of
paragraph (27), by striking the period at the end of paragraph (28) and
inserting ``, and'', and by adding at the end the following new
paragraph:
``(29) in the case of property with respect to which any
payment is made under section 1888(e)(13) or 1902(a)(13)(A)(v)
of the Social Security Act, by reducing the basis of such
property by the amount of such payment.''.
(d) Effective Date.--The amendments made by this section shall take
effect on the date of the enactment of this Act, except that the
amendments made by subsections (a)(2) and (b)(2) shall apply to
payments to facilities for periods beginning on or after October 1,
2004, regardless of whether the payments are for expenses incurred
before, on, or after such date.
<all>
Introduced in House
Introduced in House
Sponsor introductory remarks on measure. (CR E1495-1496)
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 Ways and Means, and in addition to the Committee on Energy and Commerce, 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 Ways and Means, and in addition to the Committee on Energy and Commerce, 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, for a period to be subsequently determined by the Chairman.
Referred to the Subcommittee on Health.
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