Senior Safety and Dignity Act of 2006 - Amends title XVIII (Medicare) and title XIX (Medicaid) of the Social Security Act (SSA) to include in the nursing home patient's bill of rights the right to receive care from a creditable caregiver.
Requires a skilled nursing facility (SNF), before hiring a worker, to conduct a background check on the applicant. Prohibits the hiring of abusive workers or workers convicted of a relevant crime. Establishes civil penalties for violations of this Act, including knowing retention of SNF workers who fail background checks.
Applies such requirements and prohibitions to a long-term care facility or provider.
Directs the Secretary to establish a national criminal background check program, after evaluation of the pilot program under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, in order to prevent abuse of nursing facility and SNF residents and individuals receiving home health care services and other long-term care services under the Medicare or Medicaid programs. Requires the Federal Bureau of Investigation to conduct such criminal background checks.
Requires the national criminal background check program to be made available to a long-term care facility or provider.
Adds to the nursing home patient's bill of rights the right to a safe environment during an emergency or natural disaster.
Requires a SNF under Medicare and Medicaid to: (1) have a clear and preestablished disaster plan; and (2) inform residents and next-of-kin about it and the location of possible evacuation in case of an emergency disaster.
Applies the same requirement to other long-term care facilities.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6161 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 6161
To amend titles XVIII and XIX of the Social Security Act to expand the
nursing home patients' bill of rights to include the right to receive
care from a credible caregiver by requiring background checks on direct
access employees and the right to a safe environment during an
emergency or natural disaster by requiring nursing long-term care
facilities to establish disaster emergency and evacuation plans.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 25, 2006
Ms. Ginny Brown-Waite of Florida (for herself, Mr. Kirk, and Mr.
Fitzpatrick of Pennsylvania) 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 expand the
nursing home patients' bill of rights to include the right to receive
care from a credible caregiver by requiring background checks on direct
access employees and the right to a safe environment during an
emergency or natural disaster by requiring nursing long-term care
facilities to establish disaster emergency and evacuation plans.
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 ``Senior Safety and Dignity Act of
2006''.
SEC. 2. SECURING RIGHT TO RECEIVE CARE FROM A CREDIBLE CAREGIVER BY
REQUIRING PERFORMANCE OF BACKGROUND CHECKS ON DIRECT
ACCESS EMPLOYEES OF LONG-TERM CARE FACILITIES OR
PROVIDERS.
(a) Addition to Nursing Home Patients' Bill of Rights of Right To
Receive Care From a Credible Caregiver.--Sections 1819(c)(1)(A) and
1919(c)(1)(A) of the Social Security Act (42 U.S.C. 1395i-3(c)(1)(A),
1396r(c)(1)(A)) are each amended--
(1) by redesignating clause (xi) as clause (xiii); and
(2) by inserting after clause (x) the following new clause:
``(xi) Receipt of care from credible
caregiver.--The right to receive care from a
credible caregiver.''.
(b) Screening of Skilled Nursing Facility and Nursing Facility
Employee Applicants.--
(1) 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:
``(9) Screening of skilled nursing facility workers.--
``(A) Background checks on applicants.--Before
hiring a skilled nursing facility worker, a skilled
nursing facility shall conduct a background check on
the employee in accordance with such procedures as the
Secretary shall establish.
``(B) Prohibition on hiring of abusive workers.--
``(i) In general.--Subject to clause (ii),
a skilled nursing facility may not knowingly
employ any skilled nursing facility worker who
has any disqualifying information (as defined
in subparagraph (F)(ii)).
``(ii) Provisional employment.--A skilled
nursing facility may provide for a provisional
period of employment for a skilled nursing
facility worker pending completion of the
background check required under subparagraph
(A). Such facility shall maintain direct
supervision of the covered individual during
the worker's provisional period of employment.
``(C) Procedures.--The procedures established by
the Secretary under subparagraph (A) shall--
``(i) provide a process by which a skilled
nursing facility worker may appeal or dispute
the accuracy of the information obtained in a
background check conducted under this
paragraph;
``(ii) take into account the needs of
skilled nursing facilities that serve a low
volume of patients (as determined by the
Secretary) with respect to providing
supervision for provisional employees who are
awaiting the results of a background check
conducted under this paragraph; and
``(iii) provide for the reimbursement of
nursing facilities for 100 percent of the costs
incurred by such facilities in complying with
the requirements of this section.
``(D) Immunity from liability.--A skilled nursing
facility that, in denying employment for an applicant,
reasonably relies upon information about such applicant
provided by the criminal background check shall not be
liable in any action brought by such applicant based on
the employment determination resulting from the
information.
``(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 knowingly
continues to employ a skilled nursing facility
worker in violation of subparagraph (A) or (B)
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
section 1128(a); and
``(II) such other types of offenses
as the Secretary may specify in
regulations.
``(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) Skilled nursing facility worker.--
The term `skilled nursing facility worker'
means any individual 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 long-term care 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) 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:
``(9) Screening of nursing facility workers.--
``(A) Background checks on applicants.--Before
hiring a nursing facility worker, a nursing facility
shall conduct a background check on the employee in
accordance with such procedures as the Secretary shall
establish.
``(B) Prohibition on hiring of abusive workers.--
``(i) In general.--Subject to clause (ii),
a nursing facility may not knowingly employ any
nursing facility worker who has any
disqualifying information (as defined in
subparagraph (F)(ii)).
``(ii) Provisional employment.--A nursing
facility may provide for a provisional period
of employment for a nursing facility worker
pending completion of the background check
required under subparagraph (A). Such facility
shall maintain direct supervision of the
covered individual during the worker's
provisional period of employment.
``(C) Procedures.--The procedures established by
the Secretary under subparagraph (A) shall--
``(i) provide a process by which a nursing
facility worker may appeal or dispute the
accuracy of the information obtained in a
background check conducted under this
paragraph;
``(ii) take into account the needs of
nursing facilities that serve a low volume of
patients (as determined by the Secretary) with
respect to providing supervision for
provisional employees who are awaiting the
results of a background check conducted under
this paragraph; and
``(iii) provide for the reimbursement of
nursing facilities for 100 percent of the costs
incurred by such facilities in complying with
the requirements of this section.
``(D) Immunity from liability.--A nursing facility
that, in denying employment for an applicant,
reasonably relies upon information about such applicant
provided by the criminal background check shall not be
liable in any action brought by such applicant based on
the employment determination resulting from the
information.
``(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 knowingly continues to
employ a nursing facility worker in violation
of subparagraph (A) or (B) 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
section 1128(a); and
``(II) such other types of offenses
as the Secretary may specify in
regulations.
``(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) Nursing facility worker.--The term
`nursing facility worker' means any individual
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 long-term
care 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) Effective date.--The amendments made by this subsection
and subsection (a) shall take effect on the date that is 1 year
after the date on which the evaluation is completed under
subsection (d)(1).
(c) Application to Other Long-Term Care Facilities or Providers.--
(1) Medicare.--Part E 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 long-term care facilities and providers
``Sec. 1898.
``(a) In General.--The provisions of section 1819(b)(9) shall apply
to a long-term care facility or provider (as defined in subsection (b))
in the same manner as such provisions apply to a skilled nursing
facility.
``(b) Long-Term Care Facility or Provider.--In this section, the
term `long-term care facility or provider' means the following
facilities or providers which receive payment for services under this
title or title XIX:
``(1) A home health agency.
``(2) A provider of hospice care.
``(3) A long-term care hospital.
``(4) A provider of personal care services.
``(5) A residential care provider that arranges for, or
directly provides, long-term care services.
``(6) An intermediate care facility for the mentally
retarded (as defined in section 1905(d)).''.
(2) Medicaid.--Section 1902(a) of the Social Security Act
(42 U.S.C. 1396a) is amended--
(A) in paragraph (69), by striking ``and'' at the
end;
(B) in paragraph (70), by striking the period and
inserting ``; and''; and
(C) by inserting after paragraph (70) the
following:
``(71) provide that the provisions of section 1919(b)(9)
apply to a long-term care facility or provider (as defined in
section 1898(b)) in the same manner as such provisions apply to
a nursing facility.''.
(3) Effective date.--The amendments made by this subsection
shall take effect on the date that is 1 year after the date on
which the evaluation is completed under subsection (c)(1).
(d) National Criminal Background Check Program.--
(1) Completion of pilot program evaluation.--Not later than
the date that is 6 months after the completion of the pilot
program for national and State background checks on direct
patient access employees of long-term care facilities or
providers established under section 307 of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003
(Public Law 108-173), the Secretary shall complete the
evaluation required under subsection (e) of such section of
such Act.
(2) Establishment.--
(A) In general.--Not later than the date that is 1
year after the completion of the evaluation of the
program described in paragraph (1), the Secretary, in
consultation with the Attorney General, shall establish
a national criminal background check program in order
to prevent abuse of nursing facility and skilled
nursing facility residents and individuals receiving
home health care services and other long-term care
services under the medicare or medicaid programs,
taking into account the findings and recommendations
contained in the evaluation.
(B) Use in conducting required background checks.--
The national criminal background check program shall be
made available to a long-term care facility or provider
for the purpose of conducting criminal background
checks, including the criminal background checks
required under sections 1819(b)(9) and 1919(b)(9) of
the Social Security Act (42 U.S.C. 1395i-3(b),
1396r(b)) (as added by subsection (a)).
(C) Conduct of background checks by the federal
bureau of investigation.--The Secretary, in
consultation with the Attorney General, shall establish
procedures for the background checks to be conducted by
the Federal Bureau of Investigation, in cooperation
with appropriate State and Federal agencies.
(D) Consultation.--In establishing the national
criminal background check program, the Secretary shall
consult with appropriate interested parties,
including--
(i) representatives of long-term care
facilities or providers;
(ii) representatives of employees of long-
term care facilities or providers;
(iii) consumers of long-term care services;
(iv) consumer advocates; and
(v) appropriate Federal and State
officials.
(3) Definitions.--In this subsection:
(A) Long-term care facility or provider.--The term
``long-term care facility or provider'' means the
following facilities or providers which receive payment
for services under title XVIII or XIX of the Social
Security Act:
(i) A nursing facility (as defined in
subparagraph (B)).
(ii) A skilled nursing facility (as defined
in subparagraph (C)).
(iii) A home health agency.
(iv) A provider of hospice care (as defined
in section 1861(dd)(1) of the Social Security
Act) (42 U.S.C. 1395x(dd)(1)).
(v) A long-term care hospital (as described
in section 1886(d)(1)(B)(iv) of such Act) (42
U.S.C. 1395ww(d)(1)(B)(iv)).
(vi) A provider of personal care services.
(vii) A residential care provider that
arranges for, or directly provides, long-term
care services.
(viii) An intermediate care facility for
the mentally retarded (as defined in section
1905(d) of such Act) (42 U.S.C. 1396d(d)).
(B) Nursing facility.--The term ``nursing
facility'' has the meaning given such term in section
1919(a) of the Social Security Act (42 U.S.C.
1396r(a)).
(C) Skilled nursing facility.--The term ``skilled
nursing facility'' has the meaning given such term in
1819(a) of the Social Security Act (42 U.S.C. 1395i-
3(a)).
SEC. 3. SECURING THE RIGHT TO A SAFE ENVIRONMENT IN LONG-TERM CARE
FACILITIES DURING AN EMERGENCY OR NATURAL DISASTER BY
REQUIRING THESE FACILITIES TO ESTABLISH DISASTER
EMERGENCY AND EVACUATION PLANS.
(a) Addition to Nursing Home Patients' Bill of Rights of Right to a
Safe Environment During an Emergency or Natural Disaster.--Sections
1819(c)(1)(A) and 1919(c)(1)(A) of the Social Security Act (42 U.S.C.
1395i-3(c)(1)(A), 1396r(c)(1)(A)), as amended by section 2(a), are each
amended by inserting after clause (xi) the following new clause:
``(xii) Safe environment during emergency
or natural disaster.--The right to a safe
environment during an emergency or natural
disaster.''.
(b) Application Under Medicare.--Section 1819(d)(4) of such Act (42
U.S.C. 1395i-3(d)(4)) is amended--
(1) by redesignating subparagraph (B) as subparagraph (C);
and
(2) by inserting after subparagraph (A) the following new
subparagraph:
``(B) Disaster emergency and evacuation plans.--A
skilled nursing facility must--
``(i) have a clear and pre-established
disaster plan to ensure the safety of all its
patients during an emergency or natural
disaster and possible evacuation; and
``(ii) inform residents and next-of-kin
regarding such plan and the location of
possible evacuation in case of an emergency or
disaster.''.
(c) Medicaid.--Section 1919(d)(4) of such Act (42 U.S.C.
1396r(d)(4)) is amended--
(1) by redesignating subparagraph (B) as subparagraph (C);
and
(2) by inserting after subparagraph (A) the following new
subparagraph:
``(B) Disaster emergency and evacuation plans.--A
nursing facility must--
``(i) have a clear and pre-established
disaster plan to ensure the safety of all its
patients during an emergency or natural
disaster and possible evacuation; and
``(ii) inform residents and next-of-kin
regarding such plan and the location of
possible evacuation in case of an emergency or
disaster.''.
(d) Application to Other Long-Term Care Facilities.--Section
1898(a) of such Act, as added by section 2(c)(1), is amended by
inserting ``and section 1819(d)(4)(B)'' after ``section 1819(b)(1)''.
(e) Effective Date.--The amendments made by this section shall
apply as of the date that is one year after the date of the enactment
of this Act.
<all>
Introduced in House
Introduced in House
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 .
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