```

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8574 Introduced in House (IH)]

<DOC>

116th CONGRESS
  2d Session
                                H. R. 8574

 To amend titles XVIII and XIX of the Social Security Act to increase 
enforcement under Medicare and Medicaid for skilled nursing facilities 
 and nursing facilities during the COVID-19 emergency period and other 
      infectious disease outbreak periods, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            October 9, 2020

   Ms. Sherrill (for herself, Mr. Pascrell, Mrs. Watson Coleman, Mr. 
Sires, Mr. Beyer, Mr. Payne, Mr. Doggett, Ms. Shalala, Ms. Judy Chu of 
 California, and Mr. Kildee) introduced the following bill; which was 
 referred to the Committee on Energy and Commerce, and in addition to 
   the Committee on Ways and Means, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL

 
 To amend titles XVIII and XIX of the Social Security Act to increase 
enforcement under Medicare and Medicaid for skilled nursing facilities 
 and nursing facilities during the COVID-19 emergency period and other 
      infectious disease outbreak periods, and for other purposes.

    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 ``Protecting Residents with Oversight, 
Transparency, and Enforcement for Compassionate Treatment in Long Term 
Care Facilities Act'' or the ``PROTECT Long Term Care Facilities Act''.

SEC. 2. INCREASED ENFORCEMENT UNDER MEDICARE AND MEDICAID FOR SKILLED 
              NURSING FACILITIES AND NURSING FACILITIES DURING THE 
              COVID-19 EMERGENCY PERIOD AND OTHER INFECTIOUS DISEASE 
              OUTBREAK PERIODS.

    (a) Additional Funding to State Survey Agencies.--
            (1) Appropriations.--Out of any funds in the Treasury not 
        otherwise appropriated, there is appropriated to the Secretary 
        of Health and Human Services $100,000,000 for fiscal year 2021 
        to be provided, in addition to any funds otherwise made 
        available and in accordance with paragraph (2), to State survey 
        and certification agencies (described in subsection (f) of 
        section 1128I of the Social Security Act (42 U.S.C. 1320a-7j)) 
        for the following purposes:
                    (A) To complete surveys conducted pursuant to the 
                amendments made by subsection (b) for facilities (as 
                defined in subsection (a) of such section 1128I).
                    (B) To increase investigations and surveys 
                performed pursuant to sections 1919(g)(4) of such Act 
                (42 U.S.C. 1396r(g)(2)) and 1819(g)(4) of such Act (42 
                U.S.C. 1395i-3(g)(4)) based on criteria developed 
                pursuant to paragraph (7)(B) of section 1819(h) of such 
                Act, as added by subsection (b)(1)(C), and paragraph 
                (10)(B) of section 1919(h) of such Act, as added by 
                subsection (b)(2)(C).
                    (C) To purchase personal protective equipment for 
                surveyors to conduct surveys and investigations of 
                facilities (as defined in subsection (a) of such 
                section 1128I) to ensure worker safety.
                    (D) To increase staffing levels at such State 
                survey and certification agencies.
            (2) Allocation of funding.--The Secretary shall allocate 
        funds appropriated under paragraph (1) based on the following 
        prioritization:
                    (A) First to State survey and certification 
                agencies (as described in subsection (f) of such 
                section 1128I) serving populations with a high burden, 
                as defined by the Secretary of Health and Human 
                Services, of COVID-19.
                    (B) Second to such agencies preparing for, or 
                working to mitigate, a COVID-19 surge or any similar 
                infectious disease outbreak.
                    (C) Third to such agencies serving a high number, 
                as defined by the Secretary, of low-income, uninsured, 
                or under-insured populations, including medically 
                underserved populations.
                    (D) Fourth to such agencies, as determined by the 
                Secretary, based on the size of their nursing home 
                population.
                    (E) Fifth to any other such agencies.
    (b) Special Rules During COVID-19 Emergency Period and Other 
Infectious Disease Outbreak Periods.--
            (1) Medicare.--
                    (A) In general.--Section 1819(g)(2) of the Social 
                Security Act (42 U.S.C. 1395i-3(g)(2)) is amended by 
                adding at the end the following new subparagraph:
                    ``(F) COVID-19 emergency period and other 
                infectious disease outbreak periods.--
                            ``(i) In general.--Notwithstanding any 
                        other provision of this paragraph, during an 
                        infectious disease outbreak period (as defined 
                        in clause (ii)), with respect to a State, the 
                        following shall apply:
                                    ``(I) Each skilled nursing facility 
                                shall be subject to a standard survey 
                                under subparagraph (A) not later than 4 
                                weeks after the beginning of such 
                                period and every 6 months after the 
                                date of the previous standard survey 
                                conducted under such subparagraph.
                                    ``(II) Follow-up surveys under this 
                                paragraph shall be conducted based on 
                                if the skilled nursing facility is 
                                found to be--
                                            ``(aa) a facility with 
                                        substandard quality of care;
                                            ``(bb) a facility not in 
                                        substantial compliance;
                                            ``(cc) a facility reporting 
                                        less than three hours of direct 
                                        care staff per resident per 
                                        day;
                                            ``(dd) a facility that has 
                                        reported no registered nurses 
                                        for four or more days in a 
                                        quarter; or
                                            ``(ee) a facility with an 
                                        overall score of 2 or less 
                                        stars on nursing home compare.
                                    ``(III) In the case of a skilled 
                                nursing facility which is found under a 
                                standard survey or extended survey to 
                                be in substantial compliance, State 
                                survey and certification agencies 
                                (described in subsection (f) of section 
                                1128I) shall have flexibility with 
                                regards to the timing of conducting 
                                such a follow-up standard survey.
                                    ``(IV) A skilled nursing facility 
                                which is found, under a standard survey 
                                or extended survey, to have provided 
                                substandard quality of care shall be 
                                treated as being identified by the 
                                Secretary as having substantially 
                                failed to meet applicable requirement 
                                of this Act for purposes of subsection 
                                (f)(8).
                                    ``(V) In the case of a skilled 
                                nursing facility that is subject to an 
                                extended survey under subparagraph (B), 
                                such extended survey shall be conducted 
                                as soon as practical after the standard 
                                survey for such facility, but not later 
                                than 4 weeks after the date of 
                                completion of such standard survey.
                                    ``(VI) A skilled nursing facility 
                                which is found, under a standard survey 
                                or extended survey to have provided 
                                substandard quality of care shall be 
                                surveyed at least once every 6 months, 
                                thereafter until the infectious disease 
                                outbreak period ends.
                                    ``(VII) Surveys under this 
                                paragraph shall be conducted in a 
                                manner that prioritizes skilled nursing 
                                facilities located in towns (or 
                                counties, if municipal-level is not 
                                available) with higher infection rate, 
                                as identified by the Secretary, and 
                                facilities with previous violations of 
                                requirements of this Act.
                                    ``(VIII) Any skilled nursing 
                                facility reporting (as determined by 
                                the Centers for Medicare & Medicaid 
                                Services) fewer than three hours of 
                                direct care staff time per resident per 
                                day, with \1/2\ hour of registered 
                                nurse time included or any skilled 
                                nursing facility that has reported no 
                                registered nurse for four or more days.
                            ``(ii) Infectious disease outbreak period 
                        defined.--For purposes of this subparagraph, 
                        the term `infectious disease outbreak period' 
                        means any of the following periods:
                                    ``(I) COVID-19 emergency period.--
                                The emergency period described in 
                                section 1135(g)(1)(B).
                                    ``(II) Other infectious disease 
                                outbreak periods.--
                                            ``(aa) The period beginning 
                                        on the date a nationwide 
                                        emergency related to a public 
                                        health emergency is declared 
                                        pursuant to the Stafford Act, a 
                                        Major Disaster Declaration, or 
                                        the National Emergencies Act 
                                        and ending on the date that is 
                                        6 months after the date on 
                                        which the declaration pursuant 
                                        to the Stafford Act, a Major 
                                        Disaster Declaration, or the 
                                        National Emergencies Act, as 
                                        applicable, ends, whichever is 
                                        the latest.
                                            ``(bb) The period during 
                                        which there exists a public 
                                        health emergency related to an 
                                        infectious disease outbreak 
                                        declared by the Secretary 
                                        pursuant to section 319 of the 
                                        Public Health Service Act.
                                            ``(cc) With respect to a 
                                        skilled nursing facility in a 
                                        State with respect to which the 
                                        Governor has declared an 
                                        emergency or major disaster (as 
                                        defined by the State) with 
                                        respect to an infectious 
                                        disease outbreak, the period 
                                        for which such declaration is 
                                        in effect with respect to such 
                                        State.''.
                    (B) Internet portal and hotline number.--Section 
                1819(e) of the Social Security Act (42 U.S.C. 1395i-
                3(e)) is amended by adding at the end the following new 
                paragraph:
            ``(6) Internet portal and hotline number.--By not later 
        than one year after the date of the enactment of this 
        paragraph, the State shall have in place and maintain an 
        Internet portal and hotline number (which may be such a portal 
        or hotline in existence before the date of the enactment of 
        this paragraph) for staff of nursing facilities, residents of 
        such facilities, family of such residents, the State long-term 
        care ombudsman (established under title III or VII of the Older 
        Americans Act of 1965 in accordance with section 712 of the 
        Act), or the general public to report violations of 
        requirements of this section by such facilities. The Secretary 
        shall establish a process under which each violation so 
        reported shall be preliminarily investigated by a State survey 
        and certification agency (described in subsection (f) of 
        section 1128I) and based on the results of such preliminary 
        investigation may be subject to a subsequent more comprehensive 
        investigation by such agency, in coordination with the 
        Secretary.''.
                    (C) Increased penalties.--Section 1819(h) of the 
                Social Security Act (42 U.S.C. 1395i-3(h)) is amended 
                by adding at the end the following new paragraph:
            ``(7) Special rules during covid-19 emergency period and 
        other infectious disease outbreak periods.--
                    ``(A) In general.--Notwithstanding any other 
                provision of this subsection, during an infectious 
                disease outbreak period (as defined in subsection 
                (g)(2)(F)(ii)), with respect to a State, the following 
                shall apply:
                            ``(i) In the cases of an outbreak specific 
                        violation, a civil monetary penalty under 
                        paragraph (2)(B)(ii)(I) may not be waived or 
                        reduced by the Secretary.
                            ``(ii) In the case of a repeat deficiency 
                        relating to any violation of a skilled nursing 
                        facility during a 15-month period, any civil 
                        monetary penalty under paragraph (2)(B)(ii)(I), 
                        shall be doubled.
                            ``(iii) In the case of a second outbreak 
                        specific violation of a skilled nursing 
                        facility during such period, the facility shall 
                        be treated as being identified by the Secretary 
                        (or may be identified by the top State health 
                        official, in accordance with a process 
                        specified by the Secretary) as having 
                        substantially failed to meet applicable 
                        requirement of this Act for purposes of 
                        subsection (f)(8) for the remainder of such 
                        period.
                    ``(B) Outbreak specific violation.--For purposes of 
                this paragraph, the Secretary, through the Centers for 
                Medicare & Medicaid Services, shall develop the 
                following:
                            ``(i) In the case of an infectious disease 
                        outbreak period with respect to COVID-19, 
                        criteria for determining an outbreak specific 
                        violation with respect to COVID-19, including--
                                    ``(I) criteria specified by the 
                                Centers for Disease Control and 
                                Prevention relating to infection rates, 
                                mortality rates, and hospitalization 
                                rates; and
                                    ``(II) criteria for staff 
                                shortages, overcrowding (and ability to 
                                cohort), and insufficient personal 
                                protective equipment.
                            ``(ii) In the case of an infectious disease 
                        outbreak period other than with respect to 
                        COVID-19, criteria for determining an outbreak 
                        specific violation specific to such outbreak 
                        period.''.
                    (D) Reporting.--Section 1819(d)(4) of the Social 
                Security Act (42 U.S.C. 1395i-3(d)(4)) is amended by 
                adding at the end the following new subparagraph:
                    ``(C) COVID-19 and infectious disease outbreak 
                reporting and notification.--
                            ``(i) In general.--A skilled nursing 
                        facility must, with respect to an infectious 
                        disease outbreak period (as defined in 
                        subsection (g)(2)(F)(ii))--
                                    ``(I) electronically submit, at a 
                                frequency specified by the Secretary, 
                                but no less than once weekly and in a 
                                standardized format specified by the 
                                Secretary, to the National Healthcare 
                                Safety Network of the Centers for 
                                Disease Control and Prevention 
                                information on--
                                            ``(aa) the number of 
                                        suspected and confirmed cases 
                                        among residents and staff of 
                                        the facility, of--

                                                    ``(AA) in the case 
                                                of the period described 
                                                in subclause (I) of 
                                                such section, COVID-19 
                                                (including with respect 
                                                to residents of the 
                                                facility previously 
                                                treated for COVID-19); 
                                                and

                                                    ``(BB) in the case 
                                                of the period described 
                                                in subclause (II) of 
                                                such section, the 
                                                infectious disease that 
                                                is the reason for which 
                                                such period is declared 
                                                (including with respect 
                                                to residents of the 
                                                facility previously 
                                                treated for such 
                                                infectious disease);

                                            ``(bb) the number of deaths 
                                        (including residents who die 
                                        outside the facility and deaths 
                                        related to COVID-19 or the 
                                        infectious disease, as 
                                        applicable) among residents and 
                                        staff of the facility;
                                            ``(cc) the amount of 
                                        personal protective equipment 
                                        and hand hygiene supplies in 
                                        the facility, including how 
                                        many days supply;
                                            ``(dd) ventilator capacity 
                                        and related supplies in the 
                                        facility;
                                            ``(ee) the number of 
                                        resident beds at the facility 
                                        and census;
                                            ``(ff) access to COVID-19 
                                        or the infectious disease, as 
                                        applicable, testing available 
                                        in the facility for residents 
                                        of the facility;
                                            ``(gg) any staffing 
                                        shortages; and
                                            ``(hh) any other 
                                        information specified by the 
                                        Secretary; and
                                    ``(II) in the case of the 
                                occurrence at the facility of either a 
                                single confirmed infection of COVID-19 
                                or the infectious disease (as 
                                applicable) or of three or more 
                                residents or staff at the facility with 
                                new-onset of respiratory symptoms 
                                occurring within 72 hours of each 
                                other, inform residents of the 
                                facility, representatives of such 
                                residents, and families of the 
                                residents of such occurrence by not 
                                later than 5 p.m. on the calendar day 
                                following such occurrence.
                            ``(ii) Information.--The information 
                        provided under clause (ii)(II) must--
                                    ``(I) not include personally 
                                identifiable information;
                                    ``(II) include information on 
                                mitigating actions implemented to 
                                prevent or reduce the risk of 
                                transmission, including if normal 
                                operations of the facility will be 
                                altered; and
                                    ``(III) include any cumulative 
                                updates for residents, representatives, 
                                and families at least weekly (or, in 
                                the case of a subsequent occurrence 
                                described in such clause (ii)(II), by 
                                not later than 5 p.m. on the calendar 
                                day following such subsequent 
                                occurrence).
                            ``(iii) CMS posting.--The information 
                        submitted under clause (ii)(I) shall be 
                        publicly posted on a weekly basis by the 
                        Centers for Medicare & Medicaid Service to 
                        support protecting the health and safety of 
                        residents, personnel, and the general 
                        public.''.
            (2) Medicaid.--
                    (A) In general.--Section 1919(g)(2) of the Social 
                Security Act (42 U.S.C. 1396r(g)(2)) is amended by 
                adding at the end the following new subparagraph:
                    ``(F) COVID-19 emergency period and other 
                infectious disease outbreak periods.--
                            ``(i) In general.--Notwithstanding any 
                        other provision of this paragraph, during an 
                        infectious disease outbreak period (as defined 
                        in clause (ii)), with respect to a State, the 
                        following shall apply:
                                    ``(I) Each nursing facility shall 
                                be subject to a standard survey under 
                                subparagraph (A) not later than 4 weeks 
                                after the beginning of such period and 
                                every 6 months after the date of the 
                                previous standard survey conducted 
                                under such subparagraph.
                                    ``(II) Follow-up surveys under this 
                                paragraph shall be conducted based on 
                                if the skilled nursing facility is 
                                found to be--
                                            ``(aa) a facility with 
                                        substandard quality of care;
                                            ``(bb) a facility not in 
                                        substantial compliance;
                                            ``(cc) a facility reporting 
                                        less than three hours of direct 
                                        care staff per resident per 
                                        day;
                                            ``(dd) a facility that has 
                                        reported no registered nurses 
                                        for four or more days in a 
                                        quarter; or
                                            ``(ee) a facility with an 
                                        overall score of 2 or less 
                                        stars on nursing home compare.
                                    ``(III) In the case of a nursing 
                                facility which is found under a 
                                standard survey or extended survey to 
                                be in substantial compliance, State 
                                survey and certification agencies 
                                (described in subsection (f) of section 
                                1128I) shall have flexibility with 
                                regards to the timing of conducting 
                                such a follow-up standard survey.
                                    ``(IV) A nursing facility which is 
                                found, under a standard survey or 
                                extended survey, to have provided 
                                substandard quality of care shall be 
                                treated as being identified by the 
                                Secretary as having substantially 
                                failed to meet applicable requirement 
                                of this Act for purposes of subsection 
                                (f)(10).
                                    ``(V) In the case of a nursing 
                                facility that is subject to an extended 
                                survey under subparagraph (B), such 
                                extended survey shall be conducted as 
                                soon as practical after the standard 
                                survey for such facility, but not later 
                                than 4 weeks after the date of 
                                completion of such standard survey.
                                    ``(VI) A nursing facility which is 
                                found, under a standard survey or 
                                extended survey to have provided 
                                substandard quality of care shall be 
                                surveyed at least once every 6 months, 
                                thereafter until the infectious disease 
                                outbreak period ends.
                                    ``(VII) Surveys under this 
                                paragraph shall be conducted in a 
                                manner that prioritizes nursing 
                                facilities located in towns (or 
                                counties, if municipal-level is not 
                                available) with higher infection rate, 
                                as identified by the Secretary, and 
                                facilities with previous violations of 
                                requirements of this Act.
                                    ``(VIII) Any skilled nursing 
                                facility reporting (as determined by 
                                the Centers for Medicare & Medicaid 
                                Services) fewer than three hours of 
                                direct care staff time per resident per 
                                day, with \1/2\ hour of registered 
                                nurse time included or any skilled 
                                nursing facility that has reported no 
                                registered nurse for four or more days.
                            ``(ii) Infectious disease outbreak period 
                        defined.--For purposes of this subparagraph, 
                        the term `infectious disease outbreak period' 
                        means any of the following periods:
                                    ``(I) COVID-19 emergency period.--
                                The emergency period described in 
                                section 1135(g)(1)(B).
                                    ``(II) Other infectious disease 
                                outbreak periods.--
                                            ``(aa) The period beginning 
                                        on the date a nationwide 
                                        emergency related to a public 
                                        health emergency is declared 
                                        pursuant to the Stafford Act, a 
                                        Major Disaster Declaration, or 
                                        the National Emergencies Act 
                                        and ending on the date that is 
                                        6 months after the date on 
                                        which the declaration pursuant 
                                        to the Stafford Act, a Major 
                                        Disaster Declaration, or the 
                                        National Emergencies Act, as 
                                        applicable, ends, whichever is 
                                        the latest.
                                            ``(bb) The period during 
                                        which there exists a public 
                                        health emergency related to an 
                                        infectious disease outbreak 
                                        declared by the Secretary 
                                        pursuant to section 319 of the 
                                        Public Health Service Act.
                                            ``(cc) With respect to a 
                                        nursing facility in a State 
                                        with respect to which the 
                                        Governor has declared an 
                                        emergency or major disaster (as 
                                        defined by the State) with 
                                        respect to an infectious 
                                        disease outbreak, the period 
                                        for which such declaration is 
                                        in effect with respect to such 
                                        State.''.
                    (B) Internet portal and hotline number.--Section 
                1919(e) of the Social Security Act (42 U.S.C. 1396r(e)) 
                is amended by adding at the end the following new 
                paragraph:
            ``(9) Internet portal and hotline number.--By not later 
        than one year after the date of the enactment of this 
        paragraph, the State shall have in place and maintain an 
        Internet portal and hotline number (which may be such a portal 
        or hotline in existence before the date of the enactment of 
        this paragraph) for staff of nursing facilities, residents of 
        such facilities, family of such residents, the State long-term 
        care ombudsman (established under title III or VII of the Older 
        Americans Act of 1965 in accordance with section 712 of the 
        Act), or the general public to report violations of 
        requirements of this section by such facilities. The Secretary 
        shall establish a process under which each violation so 
        reported shall be preliminarily investigated by a State survey 
        and certification agency (described in subsection (f) of 
        section 1128I) and based on the results of such preliminary 
        investigation may be subject to a subsequent more comprehensive 
        investigation by such agency, in coordination with the 
        Secretary.''.
                    (C) Increased penalties.--Section 1919(h) of the 
                Social Security Act (42 U.S.C. 1396r(h)) is amended by 
                adding at the end the following new paragraph:
            ``(10) Special rules during covid-19 emergency period and 
        other infectious disease outbreak periods.--
                    ``(A) In general.--Notwithstanding any other 
                provision of this subsection, during an infectious 
                disease outbreak period (as defined in subsection 
                (g)(2)(F)(ii)), with respect to a State, the following 
                shall apply:
                            ``(i) In the cases of an outbreak specific 
                        violation, a civil monetary penalty under 
                        paragraph (3)(B)(ii)(I) may not be waived or 
                        reduced by the Secretary.
                            ``(ii) In the case of a repeat deficiency 
                        relating to any violation of a nursing facility 
                        during a 15-month period, any civil monetary 
                        penalty under paragraph (3)(B)(ii)(I) shall be 
                        doubled.
                            ``(iii) In the case of a second outbreak 
                        specific violation of a nursing facility during 
                        such period, the facility shall be treated as 
                        being identified by the Secretary (or may be 
                        identified by the top State health official, in 
                        accordance with a process specified by the 
                        Secretary) as having substantially failed to 
                        meet applicable requirement of this Act for 
                        purposes of subsection (f)(10) for the 
                        remainder of such period.
                    ``(B) Outbreak specific violation.--For purposes of 
                this paragraph, the Secretary, through the Centers for 
                Medicare & Medicaid Services, shall develop the 
                following:
                            ``(i) In the case of an infectious disease 
                        outbreak period with respect to COVID-19, 
                        criteria for determining an outbreak specific 
                        violation with respect to COVID-19, including--
                                    ``(I) Criteria specified by the 
                                Centers for Disease Control and 
                                Prevention relating to infection rates, 
                                mortality rates, and hospitalization 
                                rates.
                                    ``(II) Criteria for staff 
                                shortages, overcrowding (and ability to 
                                cohort), and insufficient personal 
                                protective equipment.
                            ``(ii) In the case of an infectious disease 
                        outbreak period other than with respect to 
                        COVID-19, criteria for determining an outbreak 
                        specific violation specific to such outbreak 
                        period.''.
                    (D) Reporting.--Section 1919(d)(4) of the Social 
                Security Act (42 U.S.C. 1396r(d)(4)) is amended by 
                adding at the end the following new subparagraph:
                    ``(C) COVID-19 and infectious disease outbreak 
                reporting and notification.--
                            ``(i) In general.--A nursing facility must, 
                        with respect to an infectious disease outbreak 
                        period (as defined in subsection 
                        (g)(2)(F)(ii))--
                                    ``(I) electronically submit, at a 
                                frequency specified by the Secretary, 
                                but no less than once weekly and in a 
                                standardized format specified by the 
                                Secretary, to the National Healthcare 
                                Safety Network of the Centers for 
                                Disease Control and Prevention 
                                information on--
                                            ``(aa) the number of 
                                        suspected and confirmed cases 
                                        among residents and staff of 
                                        the facility, of--

                                                    ``(AA) in the case 
                                                of the period described 
                                                in subclause (I) of 
                                                such section, COVID-19 
                                                (including with respect 
                                                to residents of the 
                                                facility previously 
                                                treated for COVID-19); 
                                                and

                                                    ``(BB) in the case 
                                                of the period described 
                                                in subclause (II) of 
                                                such section, the 
                                                infectious disease that 
                                                is the reason for which 
                                                such period is declared 
                                                (including with respect 
                                                to residents of the 
                                                facility previously 
                                                treated for such 
                                                infectious disease);

                                            ``(bb) the number of deaths 
                                        (including residents who die 
                                        outside the facility and deaths 
                                        related to COVID-19 or the 
                                        infectious disease, as 
                                        applicable) among residents and 
                                        staff of the facility;
                                            ``(cc) the amount of 
                                        personal protective equipment 
                                        and hand hygiene supplies in 
                                        the facility, including how 
                                        many days supply;
                                            ``(dd) ventilator capacity 
                                        and related supplies in the 
                                        facility;
                                            ``(ee) the number of 
                                        resident beds at the facility 
                                        and census;
                                            ``(ff) access to COVID-19 
                                        or the infectious disease, as 
                                        applicable, testing available 
                                        in the facility for residents 
                                        of the facility;
                                            ``(gg) any staffing 
                                        shortages; and
                                            ``(hh) any other 
                                        information specified by the 
                                        Secretary; and
                                    ``(II) in the case of the 
                                occurrence at the facility of either a 
                                single confirmed infection of COVID-19 
                                or the infectious disease (as 
                                applicable) or of three or more 
                                residents or staff at the facility with 
                                new-onset of respiratory symptoms 
                                occurring within 72 hours of each 
                                other, inform residents of the 
                                facility, representatives of such 
                                residents, and families of the 
                                residents of such occurrence by not 
                                later than 5 p.m. on the calendar day 
                                following such occurrence.
                            ``(ii) Information.--The information 
                        provided under clause (ii)(II) must--
                                    ``(I) not include personally 
                                identifiable information;
                                    ``(II) include information on 
                                mitigating actions implemented to 
                                prevent or reduce the risk of 
                                transmission, including if normal 
                                operations of the facility will be 
                                altered; and
                                    ``(III) include any cumulative 
                                updates for residents, representatives, 
                                and families at least weekly (or, in 
                                the case of a subsequent occurrence 
                                described in such clause (ii)(II), by 
                                not later than 5 p.m. on the calendar 
                                day following such subsequent 
                                occurrence).
                            ``(iii) CMS posting.--The information 
                        submitted under clause (ii)(I) shall be 
                        publicly posted on a weekly basis by the 
                        Centers for Medicare & Medicaid Service to 
                        support protecting the health and safety of 
                        residents, personnel, and the general public''.
                                 <all>
```