I 

116TH CONGRESS 

2D SESSION H. R. 5681 

To amend the Public Health Service Act to require hospitals to submit 

notice to the Secretary of Health and Human Services before closing 

all or certain units or departments, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 27, 2020 

Mr. BRENDAN F. BOYLE of Pennsylvania introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to require hospitals 

to submit notice to the Secretary of Health and Human 

Services before closing all or certain units or departments, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Protecting Commu5 nities from Hospital Closures Act of 2020’’. 


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1 SEC. 2. HOSPITAL CLOSINGS. 

2 (a) IN GENERAL.—Part C of title III of the Public 

3 Health Service Act (42 U.S.C. 248 et seq.) is amended 

4 by adding at the end the following: 

5 ‘‘SEC. 327B. HOSPITAL CLOSINGS. 

6 ‘‘(a) NOTICE REQUIREMENT.— 

7 ‘‘(1) REQUIREMENT.—A hospital shall provide 

8 written notice to the Secretary of a determination— 

9 ‘‘(A) to close all or most of its units or de10 partments (in this section referred to as a ‘gen11 eral hospital closing’); or 

12 ‘‘(B) to close an emergency treatment unit 

13 or department, a labor and delivery unit or de14 partment, or any other type of unit or depart15 ment that the Secretary determines, by regula16 tion, might significantly impact the health and 

17 welfare of an affected community such that ad18 vanced notice and planning is warranted (in 

19 this section referred to as a ‘significant impact 

20 unit closing’). 

21 ‘‘(2) TIMING.—A hospital shall give notice re22 quired by paragraph (1)— 

23 ‘‘(A) upon making a determination to close 

24 described in such paragraph; and 

25 ‘‘(B) in no event less than 180 days from 

26 the anticipated date of the closing. 


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1 ‘‘(b) PROHIBITION AGAINST CLOSING EXCEPT PUR2 SUANT TO CLOSURE PLAN.— 

3 ‘‘(1) PROHIBITION.—A hospital shall not close 

4 any unit or department as part of a general hospital 

5 closing or a significant impact unit closing except 

6 pursuant to a written closure plan that has been ap7 proved by the Secretary with respect to such unit or 

8 department. 

9 ‘‘(2) APPROVAL STANDARD.—The Secretary 

10 shall approve a closure plan with respect to the clos11 ing of a unit or department only if the Secretary de12 termines that the closure plan adequately address13 es— 

14 ‘‘(A) continuity of patient care; and 

15 ‘‘(B) the health and safety needs of the 

16 community served by the unit or department. 

17 ‘‘(3) MODIFICATION.—The Secretary may con18 dition approval under paragraph (2) on the agree19 ment by the hospital to modify the closure plan to 

20 include such conditions as the Secretary determines 

21 to be necessary meet the approval standard of para22 graph (2). 

23 ‘‘(4) NOTIFICATION TO CONGRESS.—The Sec24 retary shall promptly provide written notice to the 

25 Congress upon receiving, approving, rejecting, or reVerDate Sep 11 2014 00:25 Jan 28, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5681.IH H5681

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1 quiring a modification to a closure plan under this 

2 section. 

3 ‘‘(c) CLOSURE PLANS.— 

4 ‘‘(1) INITIAL CLOSURE PLAN.—A hospital seek5 ing to carry out a general hospital closing or a sig6 nificant impact unit closing shall submit to the Sec7 retary— 

8 ‘‘(A) not later than 120 days before the 

9 anticipated date of the closing, an initial closure 

10 plan; and 

11 ‘‘(B) not less than every 2 weeks there12 after, through the completion of the proposed 

13 closing, updates on the progress of the hospital 

14 in— 

15 ‘‘(i) finalizing the closure plan; and 

16 ‘‘(ii) implementing the closing. 

17 ‘‘(2) MEETINGS, DISCUSSIONS, AND DOCU18 MENTS.—Upon receipt of a closure plan from a hos19 pital, the Secretary may, for the purpose of evalu20 ating the proposed plan and overseeing the imple21 mentation of the plan, require— 

22 ‘‘(A) attendance at meetings, and involve23 ment in discussions, by executive staff and ad24 ministrators of the hospital; and 


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1 ‘‘(B) provision by the hospital to the Sec2 retary of relevant information and documents. 

3 ‘‘(3) CONTENTS OF CLOSURE PLAN.—A closure 

4 plan under this section shall address the following: 

5 ‘‘(A) The reasons for the closing. 

6 ‘‘(B) Any plans for the closing of all major 

7 departments and units of the hospital, including 

8 with respect to— 

9 ‘‘(i) continuity of patient care in each 

10 department and unit; and 

11 ‘‘(ii) the transfer of patients to other 

12 facilities. 

13 ‘‘(C) Plans with respect to specialized pro14 grams or groups of patients particularly vulner15 able to interruptions in medical care, such as 

16 cancer chemotherapy or prenatal care. 

17 ‘‘(D) Any plans for the closure of an emer18 gency department, including diversion to other 

19 hospital emergency departments and the inter20 face with emergency medical services. 

21 ‘‘(E) Written agreements with other health 

22 care providers to accept responsibility for con23 tinuing the care of patients receiving ongoing 

24 care at the hospital. 

25 ‘‘(F) Plans for— 


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1 ‘‘(i) how all medical records (including 

2 paper and electronic records) will be main3 tained throughout and after the closing; 

4 and 

5 ‘‘(ii) how those medical records will be 

6 made available to former patients and the 

7 physicians who provide care for such pa8 tients. 

9 ‘‘(G) Plans for the maintenance, transfer, 

10 and disposal of pharmaceuticals, chemicals, haz11 ardous substances, and other similar materials 

12 located at the unit or department subject to the 

13 closing. 

14 ‘‘(H) The anticipated timeline for closing 

15 the units or departments subject to the closing. 

16 ‘‘(I) A communications and engagement 

17 plan with respect to the affected community, in18 cluding plans for a public meeting to be held in 

19 the affected community. 

20 ‘‘(J) Changes in the hospital’s governing 

21 body, administration, and medical staff leader22 ship as the closure is implemented. 

23 ‘‘(K) A plan regarding the hospital’s ef24 forts to assist affected workers and students 

25 with— 


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1 ‘‘(i) finding suitable employment and 

2 educational opportunities; and 

3 ‘‘(ii) continuation of insurance. 

4 ‘‘(L) Plans to address the effects on bar5 gaining for represented employees. 

6 ‘‘(M) An assurance that existing agree7 ments between the hospital and its employees, 

8 and agreements subject to collective bargaining 

9 with an organization that represents hospital 

10 employees, will be honored. 

11 ‘‘(N) Plans with respect to maintaining on12 going hospital security. 

13 ‘‘(O) Plans for supervising compliance 

14 with, and updates of, the closure plan. 

15 ‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec16 tion shall be construed as creating obligations for the Fed17 eral Government to relieve, discharge, perform, indemnify, 

18 or assume liability for any obligation or responsibility of 

19 a hospital or any of its officers, directors, or affiliates. 

20 ‘‘(e) VIOLATIONS.— 

21 ‘‘(1) DETERMINATION OF VIOLATION.—If the 

22 Secretary determines that a hospital has violated or 

23 is violating any provision of this section, the Sec24 retary may institute an action in a Federal court of 


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1 competent jurisdiction to compel compliance with 

2 this section. 

3 ‘‘(2) JUDICIAL REMEDIES.—If a court finds, 

4 pursuant to an action instituted pursuant to para5 graph (1), that a hospital has violated or is violating 

6 any provision of this section, the court may— 

7 ‘‘(A) enjoin the hospital from carrying out 

8 any action in furtherance of closing a unit or 

9 department until the hospital has given proper 

10 notice and otherwise complied with this section; 

11 ‘‘(B) appoint a special master or tem12 porary manager to ensure that the hospital sub13 mits a closure plan in accordance with this sec14 tion and complies with such closure plan; and 

15 ‘‘(C) grant such other and further relief as 

16 the court may deem just, proper, and equitable 

17 under the circumstances.’’. 

18 (b) APPLICABILITY.—The amendment made by sub19 section (a) applies with respect to any closing that occurs 

20 after the date of enactment of this Act. 

Æ 


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