Assisted Living Facility Coronavirus Reporting Act

II 116TH CONGRESS 2D SESSION S. 4184 To require States to meet assisted living facility reporting requirements to qualify for future COVID–19 response funds. IN THE SENATE OF THE UNITED STATES JULY 2, 2020 Ms. WARREN (for herself and Mr. MARKEY) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To require States to meet assisted living facility reporting requirements to qualify for future COVID–19 response funds. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Assisted Living Facil- 4 ity Coronavirus Reporting Act’’. 5 SEC. 2. DEFINITIONS. 6 In this Act: 7 (1) ASSISTED LIVING FACILITY.—The term 8 ‘‘assisted living facility’’ means— 9 (A) an adult care facility that— 10 VerDate Sep 11 2014 00:59 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 4184 IS (i) is licensed and regulated by the 1 State in which the facility is located (or, if 2 there is no State law providing for such li- 3 censing and regulation by the State, by the 4 municipality or other political subdivision 5 in which the facility is located); 6 (ii) makes available to residents sup- 7 portive services to assist the residents in 8 carrying out activities of daily living, such 9 as bathing, dressing, eating, getting in and 10 out of bed or chairs, walking, going out- 11 doors, using the toilet, laundry, home man- 12 agement, preparing meals, shopping for 13 personal items, obtaining and taking medi- 14 cation, managing money, using the tele- 15 phone, or performing light or heavy house- 16 work, and which may make available to 17 residents home health care services, such 18 as nursing and therapy; and 19 (iii) provides dwelling units for resi- 20 dents, each of which may contain a full 21 kitchen and bathroom, and which includes 22 common rooms and other facilities appro- 23 priate for the provision of supportive serv- 24 ices to the residents of the facility; 25 VerDate Sep 11 2014 00:59 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 4184 IS (B) an adult care facility that— 1 (i) is— 2 (I) licensed and regulated by the 3 State in which the facility is located 4 (or, if there is no State law providing 5 for such licensing and regulation by 6 the State, by the municipality or other 7 political subdivision in which the facil- 8 ity is located); and 9 (II) similar to a skilled nursing 10 facility, (as defined in section 1819(a) 11 of the Social Security Act (42 U.S.C. 12 1395i–3(a))), a nursing facility (as 13 defined in section 1919(a) of the So- 14 cial Security Act (42 U.S.C. 15 1396r(a))), or a board and care facil- 16 ity (as defined in section 1616(e) of 17 the Social Security Act (42 U.S.C. 18 1382e(e))); or 19 (ii) is subject to the identification, in- 20 vestigation, and resolution of complaints 21 by, or otherwise subject to the activities of, 22 a State Long-Term Care Ombudsman pro- 23 gram established under section 712 of the 24 VerDate Sep 11 2014 00:59 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 4184 IS Older Americans Act of 1965 (42 U.S.C. 1 3058g); or 2 (C) an adult care facility receiving Federal 3 funds through a State Medicaid program under 4 title XIX of the Social Security Act (42 U.S.C. 5 1396 et seq.), including through any waiver re- 6 lating to such a program granted under such 7 title or title XI of such Act (42 U.S.C. 1301 et 8 seq.). 9 (2) SECRETARY.—The term ‘‘Secretary’’ means 10 the Secretary of Health and Human Services. 11 SEC. 3. STATE REPORTING REQUIREMENTS FOR ASSISTED 12 LIVING FACILITIES AND COVID–19. 13 (a) IN GENERAL.—As a condition of receiving fund- 14 ing to combat the coronavirus pandemic under Federal 15 legislation enacted on or after the date of enactment of 16 this Act which designates such funding as being for emer- 17 gency requirements pursuant to section 251(b)(2)(A)(i) of 18 the Balanced Budget and Emergency Deficit Control Act 19 of 1985 (2 U.S.C. 901(b)(2)(A)(i)), a State shall do the 20 following: 21 (1) Within 30 days of the passage of this Act, 22 begin weekly reporting of the following information 23 for each assisted living facility located in the State 24 to the Centers for Disease Control and Prevention, 25 VerDate Sep 11 2014 00:59 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 4184 IS disaggregated by race, ethnicity, primary language, 1 sex, sexual orientation, gender identity, age, and dis- 2 ability status: 3 (A) The number of suspected and con- 4 firmed active cases of Coronavirus Disease 5 2019 (COVID–19) among residents and the 6 number of suspected and confirmed active cases 7 of COVID–19 among staff of the facility. 8 (B) The number of residents and staff of 9 the facility, respectively, who, since the last re- 10 port under this paragraph, contracted severe 11 respiratory infections related to COVID–19 12 that resulted in hospitalization and the number 13 that resulted in death, including deaths that oc- 14 curred outside of the facility. 15 (C) The number of COVID–19 diagnostic 16 tests conducted weekly on residents and staff of 17 the facility, respectively, and the percentage of 18 those tests that are positive among residents 19 and staff of the facility, respectively. 20 (D) The average time between testing a 21 resident and receiving the results of the test. 22 (E) The personal protective equipment, 23 hand hygiene supplies, ventilators, and medical 24 supplies in the facility. 25 VerDate Sep 11 2014 23:23 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 4184 IS (F) The total number of resident beds at, 1 residents living in, and staff employed by the 2 facility. 3 (G) Other information specified by the 4 Secretary. 5 (2) Within 30 days of the passage of this Act, 6 report for each assisted living facility in the State to 7 the Centers for Disease Control and Prevention, the 8 information specified in subparagraphs (A) through 9 (G) of paragraph (1) for the period of time between 10 January 1, 2020, and the passage of this Act, 11 disaggregated by race, ethnicity, primary language, 12 sex, sexual orientation, gender identity, age, and dis- 13 ability status. 14 (3) Within 30 days of the passage of this Act, 15 require each assisted living facility in the State to 16 inform the Centers for Medicare & Medicaid Serv- 17 ices, the Centers for Disease Control and Preven- 18 tion, State and local health officials, residents, their 19 representatives, and families of those residing in fa- 20 cilities by 5 p.m. the next calendar day following the 21 occurrence of either a single confirmed infection of 22 COVID–19 among the residents or staff of the facil- 23 ity or 3 or more residents or staff of the facility pre- 24 VerDate Sep 11 2014 00:59 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 4184 IS senting new-onset of respiratory symptoms within 72 1 hours of each other. This information shall— 2 (A) not include personally identifiable in- 3 formation; 4 (B) include information on mitigating ac- 5 tions implemented to prevent or reduce the risk 6 of transmission, including if normal operations 7 of the facility will be altered; and 8 (C) include any cumulative updates for 9 residents, their representatives, and families at 10 least weekly or by 5 p.m. the next calendar day 11 following the subsequent occurrence of— 12 (i) the identification of a confirmed 13 infection of COVID–19 among the resi- 14 dents or staff of the facility; or 15 (ii) 3 or more residents or staff pre- 16 senting new onset of respiratory symptoms 17 within 72 hours of each other. 18 (b) SUNSET.—The requirements of subsection (a) 19 shall terminate if and when the circumstances which led 20 to the public health emergency period described in section 21 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 22 1320b–5(g)(1)(B)) (relating to the coronavirus pandemic) 23 cease to exist and are unlikely to recur. 24 VerDate Sep 11 2014 00:59 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 4184 IS (c) GUIDANCE.—Within 15 days of the date of enact- 1 ment of this Act, the Secretary shall issue guidance to 2 States to ensure the information reported in (a) is re- 3 ported in an electronic, standardized format that matches, 4 to the extent practicable, the format applicable to informa- 5 tion reported to the Department of Health and Human 6 Services by skilled nursing facilities and nursing facilities 7 on COVID–19 under section 483.30(g) of title 42, Code 8 of Federal Regulations (as amended by the interim final 9 rule of the Centers for Medicare & Medicaid Services pub- 10 lished on May 8, 2020 (85 Fed. Reg. 27550)), to enable 11 the comparison of COVID–19 outbreaks across congregate 12 care settings. 13 (d) PUBLICATION OF INFORMATION.—The Secretary 14 shall publicly post on the website of the Department of 15 Health and Human Services, the information received by 16 the Department under section (a), and shall update such 17 information on a weekly basis. 18 (e) EXTENSIONS.—The Secretary may grant, at the 19 request of a State, a 30-day extension for the State report 20 the information required under paragraphs (1) and (2) of 21 subsection (a) to allow the State to develop the reporting 22 infrastructure necessary to gather such information from 23 assisted living facilities. 24 VerDate Sep 11 2014 00:59 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 4184 IS SEC. 4. APPLICATION OF NURSING FACILITY REPORTING 1 REQUIREMENTS TO ASSISTED LIVING FACILI- 2 TIES. 3 The Secretary shall provide that any COVID–19 re- 4 porting requirement that applies to skilled nursing facili- 5 ties (as defined in section 1819(a) of the Social Security 6 Act (42 U.S.C. 1395i–3(a))) or nursing facilities (as de- 7 fined in section 1919(a) of the Social Security Act (42 8 U.S.C. 1396r(a))) and is imposed on or after the date of 9 enactment of this Act under title XVIII or XIX of the 10 Social Security Act (42 U.S.C. 1395 et seq., 1396 et seq.) 11 or under a regulation promulgated under such title shall 12 apply in the same manner to assisted living facilities, 13 which shall report such information through the States 14 unless complying with such reporting requirement is not 15 practicable in the assisted living facility setting. 16 SEC. 5. GAO REPORT. 17 Not later than 2 years after the date of enactment 18 of this Act, the Comptroller General of the United States 19 shall conduct an evaluation, and submit to Congress, a 20 report including— 21 (1) what is known about how required reporting 22 of COVID–19 data on residents in nursing homes 23 during the pandemic was used to prevent or control 24 COVID–19 cases or deaths, and how this compares 25 VerDate Sep 11 2014 00:59 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 4184 IS to the experience of other congregate care facilities 1 without required reporting of this data; and 2 (2) any lessons learned from required reporting 3 of COVID–19 cases or deaths in nursing homes that 4 could be applied to other congregate care facilities 5 during the COVID–19 pandemic, if it continues, and 6 similar public health emergencies in the future. 7 Æ VerDate Sep 11 2014 00:59 Jul 14, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\S4184.IS S4184 pamtmann on DSKBC07HB2PROD with BILLS