PREPARE LTC Act

I 116TH CONGRESS 2D SESSION H. R. 8568 To amend title XVIII and title XIX of the Social Security Act to codify certain infection control and emergency preparedness regulations, to pro- hibit a reduction in the frequency of surveys of skilled nursing facilities and nursing facilities, to prohibit the waiver of certain reporting require- ments, and for other purposes. IN THE HOUSE OF REPRESENTATIVES OCTOBER 9, 2020 Mr. PASCRELL (for himself, Ms. SHERRILL, Mrs. WATSON COLEMAN, Mr. BEYER, Mr. PAYNE, Mr. DOGGETT, Ms. SHALALA, Ms. JUDY CHU of California, and Mr. KILDEE) introduced the following bill; which was re- ferred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently de- termined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII and title XIX of the Social Security Act to codify certain infection control and emergency preparedness regulations, to prohibit a reduction in the frequency of surveys of skilled nursing facilities and nursing facilities, to prohibit the waiver of certain report- ing requirements, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 23:04 Oct 31, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 8568 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Promoting Restoration 2 of Emergency Preparedness and Advancing Response to 3 Epidemics in Long-Term Care Act’’ or the ‘‘PREPARE 4 LTC Act’’. 5 SEC. 2. CODIFYING INFECTION CONTROL AND EMERGENCY 6 PREPAREDNESS REGULATIONS FOR SKILLED 7 NURSING FACILITIES AND NURSING FACILI- 8 TIES AS A REQUIREMENT FOR PARTICIPA- 9 TION UNDER THE MEDICARE AND MEDICAID 10 PROGRAMS. 11 (a) INFECTION CONTROL REGULATIONS.— 12 (1) MEDICARE.—Section 1819(d)(3) of the So- 13 cial Security Act (42 U.S.C. 1395i–3(d)(3)) is 14 amended— 15 (A) by redesignating subparagraphs (A) 16 and (B) as clauses (i) and (ii), respectively, and 17 moving such clauses 2 ems to the right; 18 (B) by striking ‘‘ENVIRONMENT.— A 19 skilled nursing facility must—’’ and inserting 20 ‘‘ENVIRONMENT.— 21 ‘‘(A) IN GENERAL.—A skilled nursing fa- 22 cility must—’’; and 23 (C) by adding at the end the following new 24 subparagraph: 25 VerDate Sep 11 2014 23:04 Oct 31, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 8568 IH ‘‘(B) APPLICATION STATEMENT.—For pur- 1 poses of carrying out this paragraph, the Sec- 2 retary shall apply by reference the provisions of 3 section 483.80 of title 42, Code of Federal Reg- 4 ulations (as in effect on the date of the enact- 5 ment of the Promoting Restoration of Emer- 6 gency Preparedness and Advancing Response to 7 Epidemics in Long-Term Care Act), except in 8 applying subsection (g) of such regulation— 9 ‘‘(i) any reference to COVID-19 shall 10 be treated as a reference to an infectious 11 disease outbreak, as defined in subpara- 12 graph (C); and 13 ‘‘(ii) any reference to ventilator capac- 14 ity shall be treated as a reference to med- 15 ical equipment and supplies critical to the 16 infectious disease outbreak, including ven- 17 tilator capacity. 18 ‘‘(C) INFECTIOUS DISEASE OUTBREAK DE- 19 FINED.—For purposes of subparagraph (B), 20 the term ‘infectious disease outbreak’ means 21 any of the following periods: 22 ‘‘(i) COVID-19 EMERGENCY PERIOD.— 23 The emergency period described in section 24 VerDate Sep 11 2014 23:16 Nov 02, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 8568 IH 1135(g)(1)(B) of the Social Security Act 1 (42 U.S.C. 1320b–5(g)(1)(B)). 2 ‘‘(ii) OTHER INFECTIOUS DISEASE 3 OUTBREAK PERIODS.— 4 ‘‘(I) The period beginning on the 5 date a nationwide emergency related 6 to a public health emergency is de- 7 clared pursuant to the Stafford Act, a 8 Major Disaster Declaration, or the 9 National Emergencies Act and ending 10 on the date that is 6 months after the 11 date on which the declaration pursu- 12 ant to the Stafford Act, a Major Dis- 13 aster Declaration, or the National 14 Emergencies Act, as applicable, ends, 15 whichever is the latest. 16 ‘‘(II) The period during which 17 there exists a public health emergency 18 related to an infectious disease out- 19 break declared by the Secretary pur- 20 suant to section 319 of the Public 21 Health Service Act. 22 ‘‘(III) With respect to a skilled 23 nursing facility in a State with respect 24 to which the Governor has declared an 25 VerDate Sep 11 2014 23:16 Nov 02, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 8568 IH emergency or major disaster (as de- 1 fined by the State) with respect to an 2 infectious disease outbreak, the period 3 for which such declaration is in effect 4 with respect to such State.’’. 5 (2) MEDICAID.—Section 1919(d)(3) of the So- 6 cial Security Act (42 U.S.C. 1396r(d)(3)) is amend- 7 ed— 8 (A) by redesignating subparagraphs (A) 9 and (B) as clauses (i) and (ii), respectively, and 10 moving such clauses 2 ems to the right; 11 (B) by striking ‘‘ENVIRONMENT.— A nurs- 12 ing facility must—’’ and inserting ‘‘ENVIRON- 13 MENT.— 14 ‘‘(A) IN GENERAL.—A nursing facility 15 must—’’; and 16 (C) by adding at the end the following new 17 subparagraph: 18 ‘‘(B) APPLICATION STATEMENT.—For pur- 19 poses of carrying out this paragraph, the Sec- 20 retary shall apply by reference the provisions of 21 section 483.80 of title 42, Code of Federal Reg- 22 ulations (as in effect on the date of the enact- 23 ment of the Promoting Restoration of Emer- 24 gency Preparedness and Advancing Response to 25 VerDate Sep 11 2014 23:04 Oct 31, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 8568 IH Epidemics in Long-Term Care Act), except in 1 applying subsection (g) of such regulation— 2 ‘‘(i) any reference to COVID-19 shall 3 be treated as a reference to an infectious 4 disease outbreak, as defined in subpara- 5 graph (C); and 6 ‘‘(ii) any reference to ventilator capac- 7 ity shall be treated as a reference to med- 8 ical equipment and supplies critical to the 9 infectious disease outbreak, including ven- 10 tilator capacity. 11 ‘‘(C) INFECTIOUS DISEASE OUTBREAK DE- 12 FINED.—The term ‘infectious disease outbreak’ 13 has the meaning given such term in section 14 1819(d)(3)(C).’’. 15 (b) EMERGENCY PREPAREDNESS REGULATIONS.— 16 (1) MEDICARE.—Section 1819(d) is amended 17 by adding at the end the following new paragraph: 18 ‘‘(5) EMERGENCY PREPAREDNESS.—A skilled 19 nursing facility shall meet the requirements applica- 20 ble to skilled nursing facilities under the provisions 21 of section 483.73 of title 42, Code of Federal Regu- 22 lations (as in effect on the date of the enactment of 23 the Restoring Safety and Transparency for Long- 24 Term Care Residents Act).’’. 25 VerDate Sep 11 2014 23:04 Oct 31, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 8568 IH (2) MEDICAID.—Section 1919(d) is amended by 1 adding at the end the following new paragraph: 2 ‘‘(5) EMERGENCY PREPAREDNESS.—A nursing 3 facility shall meet the requirements applicable to 4 nursing facilities under the provisions of section 5 483.73 of title 42, Code of Federal Regulations (as 6 in effect on the date of the enactment of the Pro- 7 moting Restoration of Emergency Preparedness and 8 Advancing Response to Epidemics in Long-Term 9 Care Act).’’. 10 (c) REQUIREMENT TO ISSUE GUIDANCE.—Not later 11 than 90 days after the date of the enactment of this Act, 12 the Secretary of Health and Human Services shall issue 13 guidance to carry out the amendments made by this sec- 14 tion. 15 (d) PUBLIC AVAILABILITY OF DATA ON DEFI- 16 CIENCIES IN INFECTION CONTROL AND DIRECT CARE 17 STAFFING IN SKILLED NURSING FACILITIES.—Not later 18 than 2 weeks after the beginning of a period of an infec- 19 tious disease outbreak (as defined in subparagraph (C) of 20 subsection (d)(3) of section 1819 of the Social Security 21 Act (42 U.S.C. 1395i–3), as added by subsection (a)(1)), 22 (or, in the case of the COVID-19 emergency period de- 23 scribed in section 1135(g)(1)(B) of such Act (42 U.S.C. 24 1320b–5(g)(1)(B)), not later than 60 days after the date 25 VerDate Sep 11 2014 23:16 Nov 02, 2020 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 8568 IH of the enactment of this Act), the Administrator of the 1 Centers for Medicare & Medicaid Services shall make pub- 2 licly available on the internet website of the Centers for 3 Medicare & Medicaid Services data on deficiencies identi- 4 fied during the survey process described under subsection 5 (g) of such section, with respect to infection control and 6 direct care staffing in a skilled nursing facility (as defined 7 in subsection (a) of such section). Such data so posted, 8 with respect to an infectious disease outbreak (as defined 9 in subparagraph (C) of such subsection (d)(3)), shall be 10 updated every two weeks until the end of the period of 11 such outbreak. 12 SEC. 3. PROHIBITION ON REDUCING FREQUENCY OF 13 STANDARD SURVEYS. 14 (a) MEDICARE.—Section 1819(g)(2)(A)(iii) is 15 amended by adding at the end the following new sub- 16 clause: 17 ‘‘(III) PROHIBITION ON REDUC- 18 ING FREQUENCY OF SURVEYS CON- 19 DUCTED DURING AN INFECTIOUS DIS- 20 EASE OUTBREAK.—The Secretary 21 shall not reduce the frequency of sur- 22 veys conducted under this section dur- 23 ing an infectious disease outbreak (as 24 defined in subsection (d)(3)(C)).’’. 25 VerDate Sep 11 2014 23:04 Oct 31, 2020 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 8568 IH (b) MEDICAID.—Section 1919(g)(2)(A)(iii) is amend- 1 ed by adding at the end the following new subclause: 2 ‘‘(I) PROHIBITION ON REDUCING 3 FREQUENCY OF SURVEYS CONDUCTED 4 DURING AN INFECTIOUS DISEASE 5 OUTBREAK.—The Secretary shall not 6 reduce the frequency of surveys con- 7 ducted under this section during an 8 infectious disease outbreak (as defined 9 in section 1819(d)(3)(C)).’’. 10 SEC. 4. PROHIBITION ON WAIVING SUBMISSIONS OF DI- 11 RECT CARE STAFFING INFORMATION. 12 Section 1128I(g) of the Social Security Act (42 13 U.S.C. 1320a–7j(g)) is amended— 14 (1) in paragraph (3), by striking ‘‘and’’ at the 15 end; 16 (2) in paragraph (4), by striking the period and 17 inserting ‘‘; and’’; 18 (3) by inserting after paragraph (4) the fol- 19 lowing new paragraph: 20 ‘‘(5) shall be submitted not less frequently than 21 quarterly, on a schedule specified by the Secretary.’’; 22 and 23 (4) by adding at the end the following new sen- 24 tence: ‘‘The Secretary shall not waive the require- 25 VerDate Sep 11 2014 23:16 Nov 02, 2020 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 8568 IH ments of this subsection in the case of an infectious 1 disease outbreak (as defined in section 2 1819(d)(3)(C)).’’. 3 SEC. 5. GAO STUDY AND REPORT. 4 Not later than one year after the end of the COVID- 5 19 emergency period (as described in section 6 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 7 1320b–5(g)(1)(B)), the Comptroller General of the United 8 States shall submit to the Committee on Ways and Means 9 of the House of Representatives and the Committee on 10 Finance of the Senate a report analyzing deficiencies dur- 11 ing such period in infection control measures and direct 12 care staffing requirements for skilled nursing facilities (as 13 defined in section 1819(a) of the Social Security Act (42 14 U.S.C. 1395i–3(a))), as reported by the Administrator 15 under section 2(d)(1). 16 SEC. 6. EFFECTIVE DATE. 17 The amendments made by this Act shall apply with 18 respect to skilled nursing facilities and nursing facilities 19 beginning on the date of the enactment of this Act. 20 Æ VerDate Sep 11 2014 23:16 Nov 02, 2020 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\H8568.IH H8568 pbinns on DSKJLVW7X2PROD with BILLS