II 

117TH CONGRESS 

1ST SESSION S. 317 

To amend titles XVIII and XIX of the Social Security Act to improve 

the quality of care for residents of and workers in skilled nursing facilities and nursing facilities during the COVID–19 emergency period, and 

for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 12, 2021 

Mr. BOOKER (for himself and Mr. BLUMENTHAL) introduced the following 

bill; which was read twice and referred to the Committee on Finance 

A BILL 

To amend titles XVIII and XIX of the Social Security Act 

to improve the quality of care for residents of and workers in skilled nursing facilities and nursing facilities during the COVID–19 emergency period, 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 ‘‘Quality Care for Nurs5 ing Home Residents and Workers During COVID–19 

6 Act’’. 


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1 SEC. 2. IMPROVING QUALITY OF CARE IN SKILLED NURS2 ING FACILITIES AND NURSING FACILITIES 

3 DURING COVID–19 EMERGENCY PERIOD. 

4 (a) MEDICARE.—Section 1819 of the Social Security 

5 Act (42 U.S.C. 1395i–3) is amended by adding at the end 

6 the following new subsection: 

7 ‘‘(k) ADDITIONAL REQUIREMENTS DURING CERTAIN

8 PUBLIC HEALTH EMERGENCY.— 

9 ‘‘(1) SKILLED NURSING FACILITIES.— 

10 ‘‘(A) IN GENERAL.—During the portion of 

11 the emergency period defined in paragraph 

12 (1)(B) of section 1135(g) beginning on or after 

13 the date of the enactment of this subsection, a 

14 skilled nursing facility shall comply with the 

15 quality of care requirements described in sub16 paragraph (B), the worker safety requirements 

17 described in subparagraph (C), and the trans18 parency requirements described in subpara19 graph (D). 

20 ‘‘(B) QUALITY OF CARE REQUIREMENTS.— 

21 The quality of care requirements described in 

22 this subparagraph are each of the following: 

23 ‘‘(i) Employ, on a full-time basis, an 

24 infection preventionist who— 

25 ‘‘(I) has primary professional 

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1 nology, microbiology, epidemiology, or 

2 other related field; 

3 ‘‘(II) is qualified by education, 

4 training, experience or certification; 

5 and 

6 ‘‘(III) has completed specialized 

7 training in infection prevention and 

8 control. 

9 ‘‘(ii) In the case of a resident who 

10 elects to reside with a family member of 

11 such resident for any portion of the emer12 gency period described in subparagraph 

13 (A), guarantee the right of such resident to 

14 resume residency in the facility at any time 

15 during the 180-day period immediately fol16 lowing the end of such emergency period. 

17 ‘‘(iii) Notwithstanding subparagraphs 

18 (A) and (B) of subsection (c)(2), permit a 

19 resident to remain in the facility and not 

20 discharge or transfer the resident from the 

21 facility unless— 

22 ‘‘(I) the State survey agency ap23 proves the discharge or transfer; 

24 ‘‘(II) in the case of a transfer, 

25 the transfer is to a facility dedicated 


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1 to the care of residents who have been 

2 diagnosed with COVID–19 if the resi3 dent has been diagnosed with 

4 COVID–19, or a facility dedicated to 

5 the care of residents who have not 

6 been diagnosed with COVID–19 if the 

7 resident has not been diagnosed with 

8 COVID–19; 

9 ‘‘(III) before effecting the dis10 charge or transfer, the facility records 

11 the reasons in the resident’s clinical 

12 record; 

13 ‘‘(IV) at least 72 hours in ad14 vance of the discharge or transfer, the 

15 facility provides a notice of the dis16 charge or transfer to the resident (or 

17 legal representative of the resident, if 

18 applicable), including the reasons 

19 therefor and the items described in 

20 clause (iii) of subsection (c)(2)(B); 

21 and 

22 ‘‘(V) the resident (or legal rep23 resentative of the resident, if applica24 ble) acknowledges receipt of the notice 

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1 vides written consent to the discharge 

2 or transfer. 

3 ‘‘(iv) Test (on a weekly basis) each 

4 resident for COVID–19, or, in the case 

5 that the facility does not have a sufficient 

6 number of testing kits for COVID–19, 

7 screen each resident for symptoms of 

8 COVID–19 and report (on a daily basis 

9 until the facility has a sufficient number of 

10 such testing kits) to the State survey agen11 cy that the facility does not have a suffi12 cient number of such testing kits and what 

13 steps the facility is taking to procure a suf14 ficient number of such testing kits. 

15 ‘‘(v) Ensure there is an adequate 

16 number of employees to assist residents in 

17 communicating with family members and 

18 friends through phone calls, e-mail, and 

19 virtual communications on at least a week20 ly basis, without regard to whether a resi21 dent has been diagnosed with COVID–19. 

22 ‘‘(C) WORKER SAFETY REQUIREMENTS.— 

23 The worker safety requirements described in 

24 this subparagraph are each of the following: 


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1 ‘‘(i) In the case the facility is not oth2 erwise subject to the Occupational Safety 

3 and Health Act of 1970 (or a State occu4 pational safety and health plan that is ap5 proved under section 18(c) of such Act), 

6 comply with the Bloodborne Pathogens 

7 standard under section 1910.1030 of title 

8 29, Code of Federal Regulations (or a suc9 cessor regulation). 

10 ‘‘(ii) In the case of a predicted short11 age of personal protective equipment, re12 port such predicted shortage to the State 

13 health department of the State in which 

14 the facility is located at least 24 hours in 

15 advance of when such predicted shortage is 

16 expected to occur. 

17 ‘‘(iii) Educate each employee on the 

18 transmission of COVID–19. 

19 ‘‘(iv) Notwithstanding any other pro20 vision of law, provide at least two weeks of 

21 paid sick leave to each employee. 

22 ‘‘(v) Before each employee’s shift, test 

23 the employee for COVID–19, or, in the 

24 case that the facility does not have a suffi25 cient number of testing kits for COVID– 


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1 19, screen each employee for symptoms of 

2 COVID–19 and report (on a daily basis 

3 until the facility has a sufficient number of 

4 such testing kits) to the State survey agen5 cy that the facility does not have a suffi6 cient number of such testing kits and what 

7 steps the facility is taking to procure a suf8 ficient number of such testing kits. 

9 ‘‘(D) TRANSPARENCY REQUIREMENTS.— 

10 The transparency requirements described in 

11 this subparagraph are each of the following: 

12 ‘‘(i) Report (on a daily basis) to the 

13 State survey agency, the Centers for Medi14 care & Medicaid Services, and the Centers 

15 for Disease Control and Prevention each of 

16 the following: 

17 ‘‘(I) The number of confirmed 

18 and suspected cases COVID–19 

19 among residents and staff, including 

20 the age and race or ethnicity of such 

21 residents and staff. 

22 ‘‘(II) The number of deaths re23 lated to COVID–19 among residents 

24 and staff, including the age and race 


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1 or ethnicity of such residents and 

2 staff. 

3 ‘‘(III) The total number of 

4 deaths (without regard to whether a 

5 death is related to COVID–19) among 

6 residents and staff. 

7 ‘‘(IV) The amount of personal 

8 protective equipment available and 

9 any projected need regarding such 

10 equipment. 

11 ‘‘(V) Information on staffing lev12 els that would otherwise be required 

13 to be submitted through the Payroll14 Based Journal of the Centers for 

15 Medicare & Medicaid Services. 

16 ‘‘(VI) The number of residents 

17 and staff who have been tested for 

18 COVID–19. 

19 ‘‘(ii) In the case that a resident or 

20 employee is diagnosed with COVID–19 or 

21 dies as a result of COVID–19, notify all 

22 residents, legal representatives of residents, 

23 and employees not later than 12 hours 

24 after such diagnosis is made or such death 

25 occurs. 


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1 ‘‘(iii) At any time three or more resi2 dents or employees have newly onset 

3 COVID–19 symptoms, notify all residents, 

4 legal representatives of residents, and em5 ployees not later than 72 hours after such 

6 three or more residents or employees are 

7 known to the facility. 

8 ‘‘(iv) In the case that a resident or 

9 employee is suspected to have or is diag10 nosed with COVID–19, post a notice of 

11 such suspicion or diagnosis at each en12 trance of the facility for the remaining por13 tion of the emergency period described in 

14 subparagraph (A). 

15 ‘‘(v) For each day of the portion of 

16 the emergency period described in subpara17 graph (A), post a notice at each entrance 

18 of the facility with the information re19 quired under subsection (b)(8) for such 

20 day. 

21 ‘‘(2) STATES AND FEDERAL GOVERNMENT.— 

22 ‘‘(A) PUBLIC AVAILABILITY OF INFORMA23 TION.— 

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1 ceiving any information required under 

2 paragraph (1)(D)(i), the Administrator of 

3 the Centers for Medicare & Medicaid Serv4 ices, in coordination with the Director of 

5 the Centers for Disease Control and Pre6 vention, shall make such information pub7 licly available on the Nursing Home Com8 pare website of the Centers for Medicare & 

9 Medicaid Services and the COVIDView 

10 website of the Centers for Disease Control 

11 and Prevention. 

12 ‘‘(ii) HIPAA COMPLIANT INFORMA13 TION ONLY.—Information may only be 

14 made publicly available under clause (i) if 

15 the disclosure of such information would 

16 otherwise be permitted under the Federal 

17 regulations (concerning the privacy of indi18 vidually identifiable health information) 

19 promulgated under section 264(c) of the 

20 Health Insurance Portability and Account21 ability Act of 1996 (42 U.S.C. 1320d–2 

22 note). 

23 ‘‘(B) DESIGNATION OF COVID–19 FACILI24 TIES.—For purposes of paragraph 

25 (1)(B)(iii)(II)— 


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1 ‘‘(i) the Administrator of the Centers 

2 for Medicare & Medicaid Services shall 

3 specify criteria (which shall include the 

4 provision of the services of a registered 

5 nurse on a 24-hours basis) for each State 

6 survey agency to carry out the designation 

7 requirement described in clause (ii) with 

8 respect to skilled nursing facilities; and 

9 ‘‘(ii) each State survey agency shall 

10 designate a skilled nursing facility in the 

11 State as a facility dedicated to the care of 

12 residents who have been diagnosed with 

13 COVID–19 if such facility meets the cri14 teria specified by the Administrator under 

15 clause (i). 

16 ‘‘(C) REMOTE MONITORING AND SUR17 VEYS.—A State survey agency shall— 

18 ‘‘(i) remotely monitor all skilled nurs19 ing facilities with at least one resident or 

20 employee who has been diagnosed with 

21 COVID–19; 

22 ‘‘(ii) in addition to surveys required 

23 under subsection (g), conduct a survey of 

24 a skilled nursing facility, in the same man25 ner and subject to the same requirements 


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1 applicable to standard surveys conducted 

2 under subsection (g), if the facility has a 

3 ratio of the number of deaths resulting 

4 from COVID–19 to the number of 

5 COVID–19 diagnoses that exceeds 5 per6 cent, or the State survey agency receives a 

7 COVID–19 or staffing related immediate 

8 jeopardy complaint regarding the facility; 

9 and 

10 ‘‘(iii) ensure that each survey team 

11 that conducts a survey under clause (ii) 

12 has adequate personal protective equip13 ment while conducting such survey. 

14 ‘‘(3) CIVIL MONEY PENALTIES.—The Secretary 

15 shall impose a civil money penalty against the opera16 tors of a skilled nursing facility in an amount equal 

17 to $10,000 per day for each violation of a require18 ment described in subparagraph (B), (C), or (D) of 

19 paragraph (1) or the reporting of false information 

20 under clause (i) of such subparagraph (D). The pro21 visions of section 1128A (other than subsections (a) 

22 and (b)) shall apply to a civil money penalty under 

23 the previous sentence in the same manner as such 

24 provisions apply to a penalty or proceeding under 

25 section 1128A(a).’’. 


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1 (b) MEDICAID.—Section 1919 of the Social Security 

2 Act (42 U.S.C. 1396r) is amended by adding at the end 

3 the following new subsection: 

4 ‘‘(k) ADDITIONAL REQUIREMENTS DURING CERTAIN

5 PUBLIC HEALTH EMERGENCY.— 

6 ‘‘(1) NURSING FACILITIES.— 

7 ‘‘(A) IN GENERAL.—During the portion of 

8 the emergency period defined in paragraph 

9 (1)(B) of section 1135(g) beginning on or after 

10 the date of the enactment of this subsection, a 

11 nursing facility shall comply with the quality of 

12 care requirements described in subparagraph 

13 (B), the worker safety requirements described 

14 in subparagraph (C), and the transparency re15 quirements described in subparagraph (D). 

16 ‘‘(B) QUALITY OF CARE REQUIREMENTS.— 

17 The quality of care requirements described in 

18 this subparagraph are each of the following: 

19 ‘‘(i) Employ, on a full-time basis, an 

20 infection preventionist who— 

21 ‘‘(I) has primary professional 

22 training in nursing, medical tech23 nology, microbiology, epidemiology, or 

24 other related field; 


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1 ‘‘(II) is qualified by education, 

2 training, experience or certification; 

3 and 

4 ‘‘(III) has completed specialized 

5 training in infection prevention and 

6 control. 

7 ‘‘(ii) In the case of a resident who 

8 elects to reside with a family member of 

9 such resident for any portion of the emer10 gency period described in subparagraph 

11 (A), guarantee the right of such resident to 

12 resume residency in the facility at any time 

13 during the 180-day period immediately fol14 lowing the end of such emergency period. 

15 ‘‘(iii) Notwithstanding subparagraphs 

16 (A) and (B) of subsection (c)(2), permit a 

17 resident to remain in the facility and not 

18 discharge or transfer the resident from the 

19 facility unless— 

20 ‘‘(I) the State survey agency ap21 proves the discharge or transfer; 

22 ‘‘(II) in the case of a transfer, 

23 the transfer is to a facility dedicated 

24 to the care of residents who have been 

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1 dent has been diagnosed with 

2 COVID–19, or a facility dedicated to 

3 the care of residents who have not 

4 been diagnosed with COVID–19 if the 

5 resident has not been diagnosed with 

6 COVID–19; 

7 ‘‘(III) before effecting the dis8 charge or transfer, the facility records 

9 the reasons in the resident’s clinical 

10 record; 

11 ‘‘(IV) at least 72 hours in ad12 vance of the discharge or transfer, the 

13 facility provides a notice of the dis14 charge or transfer to the resident (or 

15 legal representative of the resident, if 

16 applicable), including the reasons 

17 therefor and the items described in 

18 clause (iii) of subsection (c)(2)(B); 

19 and 

20 ‘‘(V) the resident (or legal rep21 resentative of the resident, if applica22 ble) acknowledges receipt of the notice 

23 described in subclause (IV) and pro24 vides written consent to the discharge 

25 or transfer. 


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1 ‘‘(iv) Test (on a weekly basis) each 

2 resident for COVID–19, or, in the case 

3 that the facility does not have a sufficient 

4 number of testing kits for COVID–19, 

5 screen each resident for symptoms of 

6 COVID–19 and report (on a daily basis 

7 until the facility has a sufficient number of 

8 such testing kits) to the State survey agen9 cy that the facility does not have a suffi10 cient number of such testing kits and what 

11 steps the facility is taking to procure a suf12 ficient number of such testing kits. 

13 ‘‘(v) Ensure there is an adequate 

14 number of employees to assist residents in 

15 communicating with family members and 

16 friends through phone calls, e-mail, and 

17 virtual communications on at least a week18 ly basis, without regard to whether a resi19 dent has been diagnosed with COVID–19. 

20 ‘‘(C) WORKER SAFETY REQUIREMENTS.— 

21 The worker safety requirements described in 

22 this subparagraph are each of the following: 

23 ‘‘(i) In the case the facility is not oth24 erwise subject to the Occupational Safety 

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1 pational safety and health plan that is ap2 proved under section 18(c) of such Act), 

3 comply with the Bloodborne Pathogens 

4 standard under section 1910.1030 of title 

5 29, Code of Federal Regulations (or a suc6 cessor regulation). 

7 ‘‘(ii) In the case of a predicted short8 age of personal protective equipment, re9 port such predicted shortage to the State 

10 health department of the State in which 

11 the facility is located at least 24 hours in 

12 advance of when such predicted shortage is 

13 expected to occur. 

14 ‘‘(iii) Educate each employee on the 

15 transmission of COVID–19. 

16 ‘‘(iv) Notwithstanding any other pro17 vision of law, provide at least two weeks of 

18 paid sick leave to each employee. 

19 ‘‘(v) Before each employee’s shift, test 

20 the employee for COVID–19, or, in the 

21 case that the facility does not have a suffi22 cient number of testing kits for COVID– 

23 19, screen each employee for symptoms of 

24 COVID–19 and report (on a daily basis 

25 until the facility has a sufficient number of 


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1 such testing kits) to the State survey agen2 cy that the facility does not have a suffi3 cient number of such testing kits and what 

4 steps the facility is taking to procure a suf5 ficient number of such testing kits. 

6 ‘‘(D) TRANSPARENCY REQUIREMENTS.— 

7 The transparency requirements described in 

8 this subparagraph are each of the following: 

9 ‘‘(i) Report (on a daily basis) to the 

10 State survey agency, the Centers for Medi11 care & Medicaid Services, and the Centers 

12 for Disease Control and Prevention each of 

13 the following: 

14 ‘‘(I) The number of confirmed 

15 and suspected cases COVID–19 

16 among residents and staff, including 

17 the age and race or ethnicity of such 

18 residents and staff. 

19 ‘‘(II) The number of deaths re20 lated to COVID–19 among residents 

21 and staff, including the age and race 

22 or ethnicity of such residents and 

23 staff. 

24 ‘‘(III) The total number of 

25 deaths (without regard to whether a 


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1 death is related to COVID–19) among 

2 residents and staff. 

3 ‘‘(IV) The amount of personal 

4 protective equipment available and 

5 any projected need regarding such 

6 equipment. 

7 ‘‘(V) Information on staffing lev8 els that would otherwise be required 

9 to be submitted through the Payroll10 Based Journal of the Centers for 

11 Medicare & Medicaid Services. 

12 ‘‘(VI) The number of residents 

13 and staff who have been tested for 

14 COVID–19. 

15 ‘‘(ii) In the case that a resident or 

16 employee is diagnosed with COVID–19 or 

17 dies as a result of COVID–19, notify all 

18 residents, legal representatives of residents, 

19 and employees not later than 12 hours 

20 after such diagnosis is made or such death 

21 occurs. 

22 ‘‘(iii) At any time three or more resi23 dents or employees have newly onset 

24 COVID–19 symptoms, notify all residents, 

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1 ployees not later than 72 hours after such 

2 three or more residents or employees are 

3 known to the facility. 

4 ‘‘(iv) In the case that a resident or 

5 employee is suspected to have or is diag6 nosed with COVID–19, post a notice of 

7 such suspicion or diagnosis at each en8 trance of the facility for the remaining por9 tion of the emergency period described in 

10 subparagraph (A). 

11 ‘‘(v) For each day of the portion of 

12 the emergency period described in subpara13 graph (A), post a notice at each entrance 

14 of the facility with the information re15 quired under subsection (b)(8) for such 

16 day. 

17 ‘‘(2) STATES AND FEDERAL GOVERNMENT.— 

18 ‘‘(A) PUBLIC AVAILABILITY OF INFORMA19 TION.— 

20 ‘‘(i) IN GENERAL.—As soon as pos21 sible, but not later than 24 hours after re22 ceiving any information required under 

23 paragraph (1)(D)(i), the Administrator of 

24 the Centers for Medicare & Medicaid Serv25 ices, in coordination with the Director of 


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1 the Centers for Disease Control and Pre2 vention, shall make such information pub3 licly available on the Nursing Home Com4 pare website of the Centers for Medicare & 

5 Medicaid Services and the COVIDView 

6 website of the Centers for Disease Control 

7 and Prevention. 

8 ‘‘(ii) HIPAA COMPLIANT INFORMA9 TION ONLY.—Information may only be 

10 made publicly available under clause (i) if 

11 the disclosure of such information would 

12 otherwise be permitted under the Federal 

13 regulations (concerning the privacy of indi14 vidually identifiable health information) 

15 promulgated under section 264(c) of the 

16 Health Insurance Portability and Account17 ability Act of 1996 (42 U.S.C. 1320d–2 

18 note). 

19 ‘‘(B) DESIGNATION OF COVID–19 FACILI20 TIES.—For purposes of paragraph 

21 (1)(B)(iii)(II)— 

22 ‘‘(i) the Administrator of the Centers 

23 for Medicare & Medicaid Services shall 

24 specify criteria (which shall include the 

25 provision of the services of a registered 


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1 nurse on a 24-hours basis) for each State 

2 survey agency to carry out the designation 

3 requirement described in clause (ii) with 

4 respect to nursing facilities; and 

5 ‘‘(ii) each State survey agency shall 

6 designate a nursing facility in the State as 

7 a facility dedicated to the care of residents 

8 who have been diagnosed with COVID–19 

9 if such facility meets the criteria specified 

10 by the Administrator under clause (i). 

11 ‘‘(C) REMOTE MONITORING AND SUR12 VEYS.—A State survey agency shall— 

13 ‘‘(i) remotely monitor all nursing fa14 cilities with at least one resident or em15 ployee who has been diagnosed with 

16 COVID–19; 

17 ‘‘(ii) in addition to surveys required 

18 under subsection (g), conduct a survey of 

19 a nursing facility, in the same manner and 

20 subject to the same requirements applica21 ble to standard surveys conducted under 

22 subsection (g), if the facility has a ratio of 

23 the number of deaths resulting from 

24 COVID–19 to the number of COVID–19 

25 diagnoses that exceeds 5 percent, or the 


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1 State survey agency receives a COVID–19 

2 or staffing related immediate jeopardy 

3 complaint regarding the facility; and 

4 ‘‘(iii) ensure that each survey team 

5 that conducts a survey under clause (ii) 

6 has adequate personal protective equip7 ment while conducting such survey. 

8 ‘‘(3) CIVIL MONEY PENALTIES.—The Secretary 

9 shall impose a civil money penalty against the opera10 tors of a nursing facility in an amount equal to 

11 $10,000 per day for each violation of a requirement 

12 described in subparagraph (B), (C), or (D) of para13 graph (1) or the reporting of false information under 

14 clause (i) of such subparagraph (D). The provisions 

15 of section 1128A (other than subsections (a) and 

16 (b)) shall apply to a civil money penalty under the 

17 previous sentence in the same manner as such provi18 sions apply to a penalty or proceeding under section 

19 1128A(a).’’. 

20 SEC. 3. FUNDING FOR STATE STRIKE TEAMS FOR RESI21 DENT AND EMPLOYEE SAFETY IN SKILLED 

22 NURSING FACILITIES AND NURSING FACILI23 TIES. 

24 (a) IN GENERAL.—Of the amounts made available 

25 under subsection (c), the Secretary of Health and Human 


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1 Services (referred to in this section as the ‘‘Secretary’’) 

2 shall allocate such amounts among the States, in a man3 ner that takes into account the percentage of skilled nurs4 ing facilities and nursing facilities in each State that have 

5 residents or employees who have been diagnosed with 

6 COVID–19, for purposes of establishing and implementing 

7 strike teams in accordance with subsection (b). 

8 (b) USE OF FUNDS.—A State that receives funds 

9 under this section shall use such funds to establish and 

10 implement a strike team that will be deployed to a skilled 

11 nursing facility or nursing facility in the State, not later 

12 than 72 hours after three or more residents or employees 

13 of the facility are diagnosed with or suspected of having 

14 COVID–19, to assist the facility in separating residents 

15 and employees who have been exposed to COVID–19 from 

16 those residents and employees who have not been so ex17 posed, supervising testing for COVID–19, ensuring any 

18 applicable whistleblower protections are being enforced, 

19 and such other needs as determined necessary by the 

20 strike team. Such strike team shall include members of 

21 the National Guard, public health officials from State and 

22 local health departments, experts in geriatrics and long23 term care medicine, representatives of residents or con24 sumers, and representatives of workers. 


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1 (c) AUTHORIZATION OF APPROPRIATIONS.—For pur2 poses of carrying out this section, there is authorized to 

3 be appropriated $500,000,000. 

4 (d) DEFINITIONS.—In this section: 

5 (1) NURSING FACILITY.—The term ‘‘nursing 

6 facility’’ means a nursing facility under the Medicaid 

7 program under title XIX of the Social Security Act 

8 (42 U.S.C. 1396 et seq.). 

9 (2) SKILLED NURSING FACILITY.—The term 

10 ‘‘skilled nursing facility’’ means a skilled nursing fa11 cility under the Medicare program under title XVIII 

12 of the Social Security Act (42 U.S.C. 1395 et seq.). 

13 SEC. 4. REINSTITUTION OF REQUIREMENTS WAIVED FOR 

14 SKILLED NURSING FACILITIES AND NURSING 

15 FACILITIES DURING COVID–19 EMERGENCY 

16 PERIOD. 

17 (a) IN GENERAL.—With respect to requirements that 

18 the Administrator of the Centers for Medicare & Medicaid 

19 Services (referred to in this section as the ‘‘Adminis20 trator’’) waived for skilled nursing facilities and nursing 

21 facilities under section 1135 or 1812(f) of the Social Secu22 rity Act (42 U.S.C. 1320b–5, 1395d(f)) for the period be23 ginning on March 1, 2020, and ending on the last day 

24 of the emergency period defined in subsection (g)(1)(B) 

25 of such section 1135, the Administrator shall terminate 


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1 the waiver of such requirements before the last day of such 

2 emergency period upon the determination that skilled 

3 nursing facilities and nursing facilities have the capacity 

4 to comply with such requirements and that such waiver 

5 is no longer necessary. 

6 (b) PLAN FOR CONDUCTING WAIVED OR POSTPONED

7 SURVEYS.—With respect to any survey under section 

8 1819(g) or 1919(g) of the Social Security Act (42 U.S.C. 

9 1395i–3(g), 1396r(g)) that is waived or postponed during 

10 the period beginning on March 1, 2020, and ending on 

11 the last day of the emergency period described in sub12 section (a), the Administrator shall develop a plan for con13 ducting such survey after such last day. 

14 (c) TRAINING AND CERTIFICATION OF NURSE

15 AIDES.—With respect to any nurse aide with respect to 

16 whom the Administrator waived the application of the re17 quirements under section 483.35(d) of title 42, Code of 

18 Federal Regulations, for the period beginning on March 

19 1, 2020, and ending on the last day of the emergency pe20 riod described in subsection (a), the Administrator shall 

21 prohibit the skilled nursing facility or nursing facility em22 ploying such nurse aide from retaining such nurse aide 

23 after such last day unless such nurse aide satisfies applica24 ble training and certification requirements under such sec25 tion not later than 15 days after such last day. 


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1 (d) DEFINITIONS.—In this section: 

2 (1) NURSING FACILITY.—The term ‘‘nursing 

3 facility’’ means a nursing facility under the Medicaid 

4 program under title XIX of the Social Security Act 

5 (42 U.S.C. 1396 et seq.). 

6 (2) SKILLED NURSING FACILITY.—The term 

7 ‘‘skilled nursing facility’’ means a skilled nursing fa8 cility under the Medicare program under title XVIII 

9 of the Social Security Act (42 U.S.C. 1395 et seq.). 

10 SEC. 5. GUIDANCE FOR CERTAIN RESIDENTIAL CARE FA11 CILITIES DURING COVID–19 EMERGENCY PE12 RIOD. 

13 Not later than 15 days after the date of the enact14 ment of this Act, the Secretary of Health and Human 

15 Services (referred to in this section as the ‘‘Secretary’’) 

16 shall issue guidance for long-term health care facilities, 

17 including assisted living facilities, other residential care fa18 cilities, and such facilities that are temporary during the 

19 emergency period defined in section 1135(g)(1)(B) of the 

20 Social Security Act (42 U.S.C. 1320b–5(g)(1)(B)), that 

21 are not subject to oversight by the Centers for Medicare 

22 & Medicaid Services on providing access to virtual visita23 tion during any portion of such emergency period in which 

24 in-person visitation is restricted and ensuring appropriate 


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1 infection control and prevention and employee safety dur2 ing such emergency period. Such guidance shall include— 

3 (1) steps that health care facilities described in 

4 this subsection should take to provide residents with 

5 access to virtual visitation, including through the 

6 purchase or installation of devices purchased for the 

7 use or benefit of individual or multiple residents, 

8 that allows residents to communicate with their fam9 ilies during such emergency period; 

10 (2) options for such facilities in notifying resi11 dents and resident representatives of such access to 

12 virtual visitation and how the facility is addressing 

13 any operational issues related to such access to vir14 tual visitation; and 

15 (3) steps that health care facilities described in 

16 this subsection should take to provide residents and 

17 employees with appropriate infection control and 

18 prevention, based on requirements for skilled nurs19 ing facilities under subsection (k) of section 1819 of 

20 the Social Security Act (42 U.S.C. 1395i–3), as 

21 added by section 2(a), and requirements for nursing 

22 facilities under subsection (k) of section 1919 of 

23 such Act (42 U.S.C. 1396r), as added by section 

24 2(b). 

Æ 


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