Nursing Home Patient Protection and Standards Act of 2011 - Amends title XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require testing programs in skilled nursing facility (SNF) survey and certification techniques to be sufficiently rigorous to ensure that surveyors are adequately prepared to survey and certify SNFs in a consistent and accurate manner.
Directs the Secretary of Health and Human Services (HHS) to establish requirements: (1) for the qualification and compensation of members of a survey team, and (2) that a state employs an adequate number of individuals as members of survey teams to ensure adequate oversight of SNFs. Requires the Secretary, in addition to the training and testing program, to require that state and federal surveyors regularly complete an adequate number of continuing education courses meeting certain requirements for content and rigor of material.
Requires covered individuals to report to the Secretary instances where surveys fail to report or under report an issue in a facility that could impact the safety or quality of care of its residents. Adds whistleblower protections for such individuals.
Adds penalties for inappropriately influencing a surveyor.
Requires the Secretary to establish an advisory committee on surveys.
Requires survey team supervisors to review each conducted survey to ensure that any identified issues affecting quality of care are consistently and appropriately described and rated.
[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2522 Introduced in House (IH)]
112th CONGRESS
1st Session
H. R. 2522
To amend titles XVIII and XIX of the Social Security Act to improve
oversight of nursing facilities under the Medicare and Medicaid
programs by preventing inappropriate influence over surveyors, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 13, 2011
Ms. Roybal-Allard 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 improve
oversight of nursing facilities under the Medicare and Medicaid
programs by preventing inappropriate influence over surveyors, and for
other purposes.
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 ``Nursing Home Patient Protection and
Standards Act of 2011''.
SEC. 2. IMPROVING THE RIGOR OF TESTING FOR SURVEYORS.
(a) Medicare.--Section 1819(g)(2)(E)(iii) of the Social Security
Act (42 U.S.C. 1395i-3(g)(2)(E)(iii)) is amended by adding the
following at the end: ``The testing program must be sufficiently
rigorous (as determined by the Secretary) to ensure that surveyors are
adequately prepared to survey and certify facilities in a consistent
and accurate manner.''
(b) Medicaid.--Section 1919(g)(2)(E)(iii) of the Social Security
Act (42 U.S.C. 1396r(g)(2)(E)(iii)) is amended by adding the following
at the end: ``The testing program must be sufficiently rigorous (as
determined by the Secretary) to ensure that surveyors are adequately
prepared to survey and certify facilities in a consistent and accurate
manner.''
SEC. 3. ENSURING ADEQUATE STAFFING AND TRAINING FOR STATE SURVEYS OF
NURSING HOMES.
(a) Medicare.--Section 1819(g)(2)(E) of the Social Security Act (42
U.S.C. 1395i-3(g)(2)(E)) is amended by adding at the end the following:
``(iv) Adequate qualified staff for survey
teams.--The Secretary, in consultation with the
advisory committee under subparagraph (F),
shall establish requirements for the
qualifications and compensation of members of a
survey team under this subsection and require
that a State employs an adequate number of
individuals as members of survey teams to
ensure adequate oversight of skilled nursing
facilities.
``(v) Continuing education.--In addition to
the training and testing program required under
clause (iii), the Secretary shall require that
State and Federal surveyors regularly complete
an adequate amount (as determined by the
Secretary) of continuing education courses that
meet requirements determined by the Secretary
for content and the rigor of the material
covered by such courses. An individual shall
not serve as a member of a survey team unless
the individual is in compliance with the
requirements of this clause.''.
(b) Medicaid.--Section 1919(g)(2)(E) of the Social Security Act (42
U.S.C. 1396r(g)(2)(E)) is amended by adding at the end the following:
``(iv) Adequate qualifed staff for survey
teams.--The Secretary, in consultation with the
advisory committee under subparagraph (F),
shall establish requirements for the
qualifications and compensation of members of a
survey team under this subsection and require
that a State employs an adequate number of
individuals as members of survey teams to
ensure adequate oversight of skilled nursing
facilities.
``(v) Continuing education.--In addition to
the training and testing program required under
clause (iii), the Secretary shall require that
State and Federal surveyors regularly complete
an adequate amount (as determined by the
Secretary) of continuing education courses that
meet requirements determined by the Secretary
for content and the rigor of the material
covered by such courses. No individual shall
serve as a member of a survey team unless the
individual is in compliance with the
requirements of this clause.''.
SEC. 4. ENSURING THE INDEPENDENCE AND IMPARTIALITY OF SURVEYORS.
(a) In General.--
(1) Medicare.--Section 1819(g) of the Social Security Act
(42 U.S.C. 1395i-3(g)) is amended by adding the following at
the end:
``(6) Reporting of inaccuracies.--
``(A) Covered individual defined.--For purposes of
this paragraph, the term `covered individual' means an
individual--
``(i) who is a member of a State survey
team under this subsection; or
``(ii) who is an employee of the State
department or agency that conducts surveys
under this section.
``(B) Reporting requirement.--A covered individual
shall report to the Secretary any instance in which the
individual suspects that--
``(i) a survey under this subsection fails
to report or under reports an issue in a
facility that could impact the safety or
quality of care of the residents in such
facility; or
``(ii) a member of the survey team or an
employee of the State survey agency was
inappropriately influenced (through the
offering of monetary awards or through undue
pressure) to alter the results of the survey.
``(C) Response to report.--If the Secretary
receives a report under subparagraph (B), the Secretary
shall take appropriate action, as determined by the
Secretary, to ensure the accuracy of the survey.
``(D) Penalties for inappropriately influencing a
surveyor.--Subject to subparagraph (H), any individual
(including an employee of a skilled nursing facility or
any affiliated corporate entity, a representative of
the skilled nursing facility industry, a member of a
State survey team, an employee of the State department
or agency that conducts surveys under this section, or
an elected official) who attempts to inappropriately
influence (as defined by the Secretary through
regulations) the results of a survey under this
subsection, or the actions of a member of a survey team
or an employee of a survey agency, shall be subject to
a civil money penalty not to exceed $10,000. The
provisions of section 1128A (other than subsections (a)
and (b)) shall apply to a civil money penalty under the
previous sentence in the same manner as such provisions
apply to a penalty or proceeding under section
1128A(a).
``(E) Whistleblower protections.--With respect to a
covered individual, any officer or employee of the
State may not--
``(i) discharge, demote, suspend, threaten,
harass, or deny a promotion or other
employment-related benefit to such individual,
or in any other manner discriminate against an
individual in the terms and conditions of
employment because the individual submitted a
report under subparagraph (B); or
``(ii) file a complaint or a report against
the individual with the appropriate State
professional disciplinary agency because the
individual submitted a report under
subparagraph (B).
``(F) Penalties for violating whistleblower
protections.--Subject to subparagraph (H), any officer
or employee of a State who engages in an activity that
is prohibited by subparagraph (E) shall be subject to a
civil money penalty not to exceed $50,000. The
provisions of section 1128A (other than subsections (a)
and (b)) shall apply to a civil money penalty under the
previous sentence in the same manner as such provisions
apply to a penalty or proceeding under section
1128A(a).
``(G) Requirement to post notice.--Each State shall
post conspicuously in an appropriate location a sign
(in a form specified by the Secretary) specifying the
rights of covered individuals under this section. Such
sign shall include--
``(i) a statement that a covered individual
may file a complaint with the Secretary
describing any violations of the provisions of
this paragraph by an employee or officer of a
State; and
``(ii) information concerning the form and
manner in which such a complaint should be
filed.
``(H) Construction related to legislative
oversight.--For purposes of this paragraph, to the
extent that a member of a State legislature requests
that a covered individual appear at a hearing of a
committee of such legislature or asks questions of such
individual during such a hearing, the actions of such
member shall not be construed in a manner that would
subject such member to a penalty under this
paragraph.''.
(2) Medicaid.--Section 1919(g) of the Social Security Act
(42 U.S.C. 1396r(g)) is amended by adding the following at the
end:
``(6) Reporting of inaccuracies.--
``(A) Covered individual defined.--For purposes of
this paragraph, the term `covered individual' means an
individual--
``(i) who is a member of a State survey
team under this subsection; or
``(ii) who is an employee of the State
department or agency that conducts surveys
under this section.
``(B) Reporting requirement.--A covered individual
shall report to the Secretary any instance in which the
individual suspects that--
``(i) a survey under this subsection fails
to report or under reports an issue in a
facility that could impact the safety or
quality of care of the residents in such
facility; or
``(ii) a member of the survey team or an
employee of the State survey agency was
inappropriately influenced (through the
offering of monetary awards or through undue
pressure) to alter the results of the survey.
``(C) Response to report.--If the Secretary
receives a report under subparagraph (B), the Secretary
shall take appropriate action, as determined by the
Secretary, to ensure the accuracy of the survey.
``(D) Penalties for inappropriately influencing a
surveyor.--Subject to subparagraph (H), any individual
(including an employee of a skilled nursing facility or
any affiliated corporate entity, a representative of
the skilled nursing facility industry, a member of a
State survey team, an employee of the State department
or agency that conducts surveys under this section, or
an elected official) who attempts to inappropriately
influence (as defined by the Secretary through
regulations) the results of a survey under this
subsection, or the actions of a member of a survey team
or an employee of a survey agency, shall be subject to
a civil money penalty not to exceed $10,000. The
provisions of section 1128A (other than subsections (a)
and (b)) shall apply to a civil money penalty under the
previous sentence in the same manner as such provisions
apply to a penalty or proceeding under section
1128A(a).
``(E) Whistleblower protections.--With respect to a
covered individual, any officer or employee of the
State may not--
``(i) discharge, demote, suspend, threaten,
harass, or deny a promotion or other
employment-related benefit to such individual,
or in any other manner discriminate against an
individual in the terms and conditions of
employment because the individual submitted a
report under subparagraph (B); or
``(ii) file a complaint or a report against
the individual with the appropriate State
professional disciplinary agency because the
individual submitted a report under
subparagraph (B).
``(F) Penalties for violating whistleblower
protections.--Subject to subparagraph (H), any officer
or employee of a State who engages in an activity that
is prohibited by subparagraph (E) shall be subject to a
civil money penalty not to exceed $50,000. The
provisions of section 1128A (other than subsections (a)
and (b)) shall apply to a civil money penalty under the
previous sentence in the same manner as such provisions
apply to a penalty or proceeding under section
1128A(a).
``(G) Requirement to post notice.--Each State shall
post conspicuously in an appropriate location a sign
(in a form specified by the Secretary) specifying the
rights of covered individuals under this section. Such
sign shall include--
``(i) a statement that a covered individual
may file a complaint with the Secretary
describing any violations of the provisions of
this paragraph by an employee or officer of a
State; and
``(ii) information concerning the form and
manner in which such a complaint should be
filed.
``(H) Construction related to legislative
oversight.--For purposes of this paragraph, to the
extent that a member of a State legislature requests
that a covered individual appear at a hearing of a
committee of such legislature or asks questions of such
individual during such a hearing, the actions of such
member shall not be construed in a manner that would
subject such member to a penalty under this
paragraph.''.
(b) Conforming Amendments.--
(1) Section 1819(f)(2)(B)(iii)(I)(c) of the Social Security
Act is amended by inserting ``, a civil monetary penalty
described in section 1919(g)(6)(D) of not less than $10,000''
after ``of not less than $5,000''.
(2) Section 1919(f)(2)(B)(iii)(I)(c) of the Social Security
Act is amended by inserting ``, a civil monetary penalty
described in (g)(6)(D) of not less than $10,000'' after ``of
not less than $5,000''.
SEC. 5. ADVISORY COMMITTEE.
(a) Medicare.--Section 1819(g)(2) of the Social Security Act (42
U.S.C. 1395i-3(g)(2)) is amended by adding at the end the following:
``(F) Advisory committee.--
``(i) Establishment.--The Secretary shall
establish an advisory committee on surveys
under this paragraph.
``(ii) Membership.--The membership of the
advisory committee under clause (i) shall
include advocates for residents of skilled
nursing facilities, members of survey teams
under this subsection, and nursing home
administrators.
``(iii) Recommended standards.--The
advisory committee under clause (i) shall make
recommendations to the Secretary on standards
for--
``(I) the adequate staffing of
survey teams under this subsection;
``(II) the training of members of
such teams; and
``(III) disclosing any contact
between such members and individuals
associated with skilled nursing
facilities, and limiting such contact
to prevent inappropriate influence of
such members by such individuals.
``(iv) Other recommendations.--The advisory
committee under clause (i) may also make
recommendations to the Secretary on any other
issue that would improve the survey process
under this paragraph.''.
(b) Medicaid.--Section 1919(g)(2) of the Social Security Act (42
U.S.C. 1396r(g)(2)) is amended by adding at the end the following:
``(F) Advisory committee.--
``(i) Establishment.--The Secretary shall
establish an advisory committee on surveys
under this paragraph.
``(ii) Membership.--The membership of the
advisory committee under clause (i) shall
include advocates for residents of nursing
facilities, members of survey teams under this
subsection, and nursing home administrators.
``(iii) Recommended standards.--The
advisory committee under clause (i) shall make
recommendations to the Secretary on standards
for--
``(I) the adequate staffing of
survey teams under this subsection;
``(II) the training of members of
such teams; and
``(III) disclosing any contact
between such members and individuals
associated with nursing facilities, and
limiting such contact to prevent
inappropriate influence of such members
by such individuals.
``(iv) Other recommendations.--The advisory
committee under clause (i) may also make
recommendations to the Secretary on any other
issue that would improve the survey process
under this paragraph.''.
SEC. 6. REVIEW OF SURVEYS.
(a) Medicare.--Section 1819(g)(2)(D) of the Social Security Act (42
U.S.C. 1395i-3(g)(2)(D)) is amended--
(1) by striking ``Each State'' and inserting the following:
``(i) In general.--Each State''; and
(2) by adding at the end the following new clause:
``(ii) Review of surveys.--The supervisor
of the survey team shall review each survey
conducted under this subsection to ensure that
any issues that impact quality of care that are
identified by such surveys are consistently and
appropriately described and rated by the survey
team.''.
(b) Medicaid.--Section 1919(g)(2)(D) of the Social Security Act (42
U.S.C. 1396r(g)(2)(D)) is amended--
(1) by striking ``Each State'' and inserting the following:
``(i) In general.--Each State''; and
(2) by adding at the end the following new clause:
``(ii) Review of surveys.--The supervisor
of the survey team shall review each survey
conducted under this subsection to ensure that
any issues that impact quality of care that are
identified by such surveys are consistently and
appropriately described and rated by the survey
team.''.
<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 Subcommittee on Health.
Referred to the Subcommittee on Health.
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