H. R. 540

One Hundred Sixth Congress

of the

United States of America

AT THE FIRST SESSION

Begun and held at the City of Washington on Wednesday,

the sixth day of January, one thousand nine hundred and ninety-nine

An Act

To amend title XIX of the Social Security Act to prohibit transfers or discharges

of residents of nursing facilities as a result of a voluntary withdrawal from

participation in the Medicaid Program.

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 Resident Protection Amendments of 1999’’.

SEC. 2. RESTRICTIONS ON TRANSFERS OR DISCHARGES OF NURSING

FACILITY RESIDENTS IN THE CASE OF VOLUNTARY WITHDRAWAL FROM PARTICIPATION UNDER THE MEDICAID

PROGRAM.

(a) IN GENERAL.—Section 1919(c)(2) of the Social Security Act

(42 U.S.C. 1396r(c)(2)) is amended by adding at the end the following new subparagraph:

‘‘(F) CONTINUING RIGHTS IN CASE OF VOLUNTARY WITH- DRAWAL FROM PARTICIPATION.— ‘‘(i) IN GENERAL.—In the case of a nursing facility

that voluntarily withdraws from participation in a

State plan under this title but continues to provide

services of the type provided by nursing facilities—

‘‘(I) the facility’s voluntary withdrawal from

participation is not an acceptable basis for the

transfer or discharge of residents of the facility

who were residing in the facility on the day before

the effective date of the withdrawal (including

those residents who were not entitled to medical

assistance as of such day);

‘‘(II) the provisions of this section continue

to apply to such residents until the date of their

discharge from the facility; and

‘‘(III) in the case of each individual who begins

residence in the facility after the effective date

of such withdrawal, the facility shall provide notice

orally and in a prominent manner in writing on

a separate page at the time the individual begins

residence of the information described in clause

(ii) and shall obtain from each such individual

at such time an acknowledgment of receipt of such

information that is in writing, signed by the

individual, and separate from other documents

signed by such individual.
H. R. 540—2

Nothing in this subparagraph shall be construed as

affecting any requirement of a participation agreement

that a nursing facility provide advance notice to the

State or the Secretary, or both, of its intention to

terminate the agreement.

‘‘(ii) INFORMATION FOR NEW RESIDENTS.—The

information described in this clause for a resident is

the following:

‘‘(I) The facility is not participating in the

program under this title with respect to that resident.

‘‘(II) The facility may transfer or discharge

the resident from the facility at such time as the

resident is unable to pay the charges of the facility,

even though the resident may have become eligible

for medical assistance for nursing facility services

under this title.

‘‘(iii) CONTINUATION OF PAYMENTS AND OVERSIGHT

AUTHORITY.—Notwithstanding any other provision of

this title, with respect to the residents described in

clause (i)(I), a participation agreement of a facility

described in clause (i) is deemed to continue in effect

under such plan after the effective date of the facility’s

voluntary withdrawal from participation under the

State plan for purposes of—

‘‘(I) receiving payments under the State plan

for nursing facility services provided to such residents;

‘‘(II) maintaining compliance with all

applicable requirements of this title; and

‘‘(III) continuing to apply the survey, certification, and enforcement authority provided under

subsections (g) and (h) (including involuntary

termination of a participation agreement deemed

continued under this clause).

‘‘(iv) NO APPLICATION TO NEW RESIDENTS.—This

paragraph (other than subclause (III) of clause (i))

shall not apply to an individual who begins residence

in a facility on or after the effective date of the withdrawal from participation under this subparagraph.’’.
H. R. 540—3

(b) EFFECTIVE DATE.—The amendment made by subsection (a)

applies to voluntary withdrawals from participation occurring on

or after the date of the enactment of this Act.

Speaker of the House of Representatives.

Vice President of the United States and

President of the Senate.