II

106TH CONGRESS

1ST SESSION S. 494

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.

IN THE SENATE OF THE UNITED STATES

MARCH 2, 1999

Mr. GRAHAM (for himself, Mr. GRASSLEY, Mr. ROTH, Mr. MOYNIHAN, Mr.

CHAFEE, Mr. ROCKEFELLER, Mr. MACK, Mr. BREAUX, Mr. KERREY, Ms.

MIKULSKI, Mr. BRYAN, Mr. HOLLINGS, Mr. INOUYE, Mr. HARKIN, Mr.

BAYH, Mr. ROBB, and Mr. MURKOWSKI) introduced the following bill;

which was read twice and referred to the Committee on Finance

A BILL

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.

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 ‘‘Nursing Home Resi5 dential Security Act of 1999’’.
2

•S 494 IS

1 SEC. 2. RESTRICTIONS ON TRANSFERS OR DISCHARGES OF

2 NURSING FACILITY RESIDENTS IN THE CASE

3 OF VOLUNTARY WITHDRAWAL FROM PAR4 TICIPATION UNDER THE MEDICAID PRO5 GRAM.

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

7 Security Act (42 U.S.C. 1396r(c)(2)) is amended by add8 ing at the end the following new subparagraph:

9 ‘‘(F) CONTINUING RIGHTS IN CASE OF

10 VOLUNTARY WITHDRAWAL FROM PARTICIPA11 TION.—

12 ‘‘(i) IN GENERAL.—In the case of a

13 nursing facility that voluntarily withdraws

14 from participation in a State plan under

15 this title but continues to provide services

16 of the type provided by nursing facilities—

17 ‘‘(I) the facility’s voluntary with18 drawal from participation is not an

19 acceptable basis for the transfer or

20 discharge of residents of the facility

21 who were residing in the facility on

22 the day before the effective date of the

23 withdrawal (including those residents

24 who were not entitled to medical as25 sistance as of such day);
3

•S 494 IS

1 ‘‘(II) the provisions of this sec2 tion continue to apply to such resi3 dents until the date of their discharge

4 from the facility; and

5 ‘‘(III) in the case of each individ6 ual who begins residence in the facil7 ity after the effective date of such

8 withdrawal, the facility shall provide

9 notice orally and in a prominent man10 ner in writing on a separate page at

11 the time the individual begins resi12 dence of the information described in

13 clause (ii) and shall obtain from each

14 such individual at such time an ac15 knowledgment of receipt of such infor16 mation that is in writing, signed by

17 the individual, and separate from

18 other documents signed by such indi19 vidual.

20 Nothing in this subparagraph shall be con21 strued as affecting any requirement of a

22 participation agreement that a nursing fa23 cility provide advance notice to the State

24 or the Secretary, or both, of its intention

25 to terminate the agreement.
4

•S 494 IS

1 ‘‘(ii) INFORMATION FOR NEW RESI2 DENTS.—The information described in this

3 clause for a resident is the following:

4 ‘‘(I) The facility is not participat5 ing in the program under this title

6 with respect to that resident.

7 ‘‘(II) The facility may transfer or

8 discharge the resident from the facil9 ity at such time as the resident is un10 able to pay the charges of the facility,

11 even though the resident may have be12 come eligible for medical assistance

13 for nursing facility services under this

14 title.

15 ‘‘(iii) CONTINUATION OF PAYMENTS

16 AND OVERSIGHT AUTHORITY.—Notwith17 standing any other provision of this title,

18 with respect to the residents described in

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

20 a facility described in clause (i) is deemed

21 to continue in effect under such plan after

22 the effective date of the facility’s voluntary

23 withdrawal from participation under the

24 State plan for purposes of—
5

•S 494 IS

1 ‘‘(I) receiving payments under

2 the State plan for nursing facility

3 services provided to such residents;

4 ‘‘(II) maintaining compliance

5 with all applicable requirements of

6 this title; and

7 ‘‘(III) continuing to apply the

8 survey, certification, and enforcement

9 authority provided under subsections

10 (g) and (h) (including involuntary ter11 mination of a participation agreement

12 deemed continued under this clause).

13 ‘‘(iv) NO APPLICATION TO NEW RESI14 DENTS.—This paragraph (other than sub15 clause (III) of clause (i)) shall not apply to

16 an individual who begins residence in a fa17 cility on or after the effective date of the

18 withdrawal from participation under this

19 subparagraph.’’.

20 (b) EFFECTIVE DATE.—The amendment made by

21 subsection (a) applies to voluntary withdrawals from par22 ticipation occurring on or after the date of the enactment

23 of this Act.

Æ