I 

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. 

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 Residents 

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1 passionate Treatment in Long Term Care Facilities Act’’ 

2 or the ‘‘PROTECT Long Term Care Facilities Act’’. 

3 SEC. 2. INCREASED ENFORCEMENT UNDER MEDICARE AND 

4 MEDICAID FOR SKILLED NURSING FACILI5 TIES AND NURSING FACILITIES DURING THE 

6 COVID–19 EMERGENCY PERIOD AND OTHER 

7 INFECTIOUS DISEASE OUTBREAK PERIODS. 

8 (a) ADDITIONAL FUNDING TO STATE SURVEY AGEN9 CIES.— 

10 (1) APPROPRIATIONS.—Out of any funds in the 

11 Treasury not otherwise appropriated, there is appro12 priated to the Secretary of Health and Human Serv13 ices $100,000,000 for fiscal year 2021 to be pro14 vided, in addition to any funds otherwise made avail15 able and in accordance with paragraph (2), to State 

16 survey and certification agencies (described in sub17 section (f) of section 1128I of the Social Security 

18 Act (42 U.S.C. 1320a–7j)) for the following pur19 poses: 

20 (A) To complete surveys conducted pursu21 ant to the amendments made by subsection (b) 

22 for facilities (as defined in subsection (a) of 

23 such section 1128I). 

24 (B) To increase investigations and surveys 

25 performed pursuant to sections 1919(g)(4) of 


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1 such Act (42 U.S.C. 1396r(g)(2)) and 

2 1819(g)(4) of such Act (42 U.S.C. 1395i– 

3 3(g)(4)) based on criteria developed pursuant to 

4 paragraph (7)(B) of section 1819(h) of such 

5 Act, as added by subsection (b)(1)(C), and 

6 paragraph (10)(B) of section 1919(h) of such 

7 Act, as added by subsection (b)(2)(C). 

8 (C) To purchase personal protective equip9 ment for surveyors to conduct surveys and in10 vestigations of facilities (as defined in sub11 section (a) of such section 1128I) to ensure 

12 worker safety. 

13 (D) To increase staffing levels at such 

14 State survey and certification agencies. 

15 (2) ALLOCATION OF FUNDING.—The Secretary 

16 shall allocate funds appropriated under paragraph 

17 (1) based on the following prioritization: 

18 (A) First to State survey and certification 

19 agencies (as described in subsection (f) of such 

20 section 1128I) serving populations with a high 

21 burden, as defined by the Secretary of Health 

22 and Human Services, of COVID–19. 

23 (B) Second to such agencies preparing for, 

24 or working to mitigate, a COVID–19 surge or 

25 any similar infectious disease outbreak. 


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1 (C) Third to such agencies serving a high 

2 number, as defined by the Secretary, of low-in3 come, uninsured, or under-insured populations, 

4 including medically underserved populations. 

5 (D) Fourth to such agencies, as deter6 mined by the Secretary, based on the size of 

7 their nursing home population. 

8 (E) Fifth to any other such agencies. 

9 (b) SPECIAL RULES DURING COVID–19 EMER10 GENCY PERIOD AND OTHER INFECTIOUS DISEASE OUT11 BREAK PERIODS.— 

12 (1) MEDICARE.— 

13 (A) IN GENERAL.—Section 1819(g)(2) of 

14 the Social Security Act (42 U.S.C. 1395i– 

15 3(g)(2)) is amended by adding at the end the 

16 following new subparagraph: 

17 ‘‘(F) COVID–19 EMERGENCY PERIOD AND

18 OTHER INFECTIOUS DISEASE OUTBREAK PERI19 ODS.— 

20 ‘‘(i) IN GENERAL.—Notwithstanding 

21 any other provision of this paragraph, dur22 ing an infectious disease outbreak period 

23 (as defined in clause (ii)), with respect to 

24 a State, the following shall apply: 


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1 ‘‘(I) Each skilled nursing facility 

2 shall be subject to a standard survey 

3 under subparagraph (A) not later 

4 than 4 weeks after the beginning of 

5 such period and every 6 months after 

6 the date of the previous standard sur7 vey conducted under such subpara8 graph. 

9 ‘‘(II) Follow-up surveys under 

10 this paragraph shall be conducted 

11 based on if the skilled nursing facility 

12 is found to be— 

13 ‘‘(aa) a facility with sub14 standard quality of care; 

15 ‘‘(bb) a facility not in sub16 stantial compliance; 

17 ‘‘(cc) a facility reporting less 

18 than three hours of direct care 

19 staff per resident per day; 

20 ‘‘(dd) a facility that has re21 ported no registered nurses for 

22 four or more days in a quarter; 

23 or 


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1 ‘‘(ee) a facility with an over2 all score of 2 or less stars on 

3 nursing home compare. 

4 ‘‘(III) In the case of a skilled 

5 nursing facility which is found under 

6 a standard survey or extended survey 

7 to be in substantial compliance, State 

8 survey and certification agencies (de9 scribed in subsection (f) of section 

10 1128I) shall have flexibility with re11 gards to the timing of conducting 

12 such a follow-up standard survey. 

13 ‘‘(IV) A skilled nursing facility 

14 which is found, under a standard sur15 vey or extended survey, to have pro16 vided substandard quality of care 

17 shall be treated as being identified by 

18 the Secretary as having substantially 

19 failed to meet applicable requirement 

20 of this Act for purposes of subsection 

21 (f)(8). 

22 ‘‘(V) In the case of a skilled 

23 nursing facility that is subject to an 

24 extended survey under subparagraph 

25 (B), such extended survey shall be 


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1 conducted as soon as practical after 

2 the standard survey for such facility, 

3 but not later than 4 weeks after the 

4 date of completion of such standard 

5 survey. 

6 ‘‘(VI) A skilled nursing facility 

7 which is found, under a standard sur8 vey or extended survey to have pro9 vided substandard quality of care 

10 shall be surveyed at least once every 6 

11 months, thereafter until the infectious 

12 disease outbreak period ends. 

13 ‘‘(VII) Surveys under this para14 graph shall be conducted in a manner 

15 that prioritizes skilled nursing facili16 ties located in towns (or counties, if 

17 municipal-level is not available) with 

18 higher infection rate, as identified by 

19 the Secretary, and facilities with pre20 vious violations of requirements of 

21 this Act. 

22 ‘‘(VIII) Any skilled nursing facil23 ity reporting (as determined by the 

24 Centers for Medicare & Medicaid 

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1 rect care staff time per resident per 

day, with 1 2 ⁄2 hour of registered nurse 

3 time included or any skilled nursing 

4 facility that has reported no registered 

5 nurse for four or more days. 

6 ‘‘(ii) INFECTIOUS DISEASE OUTBREAK

7 PERIOD DEFINED.—For purposes of this 

8 subparagraph, the term ‘infectious disease 

9 outbreak period’ means any of the fol10 lowing periods: 

11 ‘‘(I) COVID–19 EMERGENCY PE12 RIOD.—The emergency period de13 scribed in section 1135(g)(1)(B). 

14 ‘‘(II) OTHER INFECTIOUS DIS15 EASE OUTBREAK PERIODS.— 

16 ‘‘(aa) The period beginning 

17 on the date a nationwide emer18 gency related to a public health 

19 emergency is declared pursuant 

20 to the Stafford Act, a Major Dis21 aster Declaration, or the Na22 tional Emergencies Act and end23 ing on the date that is 6 months 

24 after the date on which the dec25 laration pursuant to the Stafford 


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1 Act, a Major Disaster Declara2 tion, or the National Emer3 gencies Act, as applicable, ends, 

4 whichever is the latest. 

5 ‘‘(bb) The period during 

6 which there exists a public health 

7 emergency related to an infec8 tious disease outbreak declared 

9 by the Secretary pursuant to sec10 tion 319 of the Public Health 

11 Service Act. 

12 ‘‘(cc) With respect to a 

13 skilled nursing facility in a State 

14 with respect to which the Gov15 ernor has declared an emergency 

16 or major disaster (as defined by 

17 the State) with respect to an in18 fectious disease outbreak, the pe19 riod for which such declaration is 

20 in effect with respect to such 

21 State.’’. 

22 (B) INTERNET PORTAL AND HOTLINE

23 NUMBER.—Section 1819(e) of the Social Secu24 rity Act (42 U.S.C. 1395i–3(e)) is amended by 

25 adding at the end the following new paragraph: 


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1 ‘‘(6) INTERNET PORTAL AND HOTLINE NUM2 BER.—By not later than one year after the date of 

3 the enactment of this paragraph, the State shall 

4 have in place and maintain an Internet portal and 

5 hotline number (which may be such a portal or hot6 line in existence before the date of the enactment of 

7 this paragraph) for staff of nursing facilities, resi8 dents of such facilities, family of such residents, the 

9 State long-term care ombudsman (established under 

10 title III or VII of the Older Americans Act of 1965 

11 in accordance with section 712 of the Act), or the 

12 general public to report violations of requirements of 

13 this section by such facilities. The Secretary shall es14 tablish a process under which each violation so re15 ported shall be preliminarily investigated by a State 

16 survey and certification agency (described in sub17 section (f) of section 1128I) and based on the re18 sults of such preliminary investigation may be sub19 ject to a subsequent more comprehensive investiga20 tion by such agency, in coordination with the Sec21 retary.’’. 

22 (C) INCREASED PENALTIES.—Section 

23 1819(h) of the Social Security Act (42 U.S.C. 

24 1395i–3(h)) is amended by adding at the end 

25 the following new paragraph: 


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1 ‘‘(7) SPECIAL RULES DURING COVID–19 EMER2 GENCY PERIOD AND OTHER INFECTIOUS DISEASE

3 OUTBREAK PERIODS.— 

4 ‘‘(A) IN GENERAL.—Notwithstanding any 

5 other provision of this subsection, during an in6 fectious disease outbreak period (as defined in 

7 subsection (g)(2)(F)(ii)), with respect to a 

8 State, the following shall apply: 

9 ‘‘(i) In the cases of an outbreak spe10 cific violation, a civil monetary penalty 

11 under paragraph (2)(B)(ii)(I) may not be 

12 waived or reduced by the Secretary. 

13 ‘‘(ii) In the case of a repeat deficiency 

14 relating to any violation of a skilled nurs15 ing facility during a 15-month period, any 

16 civil monetary penalty under paragraph 

17 (2)(B)(ii)(I), shall be doubled. 

18 ‘‘(iii) In the case of a second outbreak 

19 specific violation of a skilled nursing facil20 ity during such period, the facility shall be 

21 treated as being identified by the Secretary 

22 (or may be identified by the top State 

23 health official, in accordance with a proc24 ess specified by the Secretary) as having 

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1 quirement of this Act for purposes of sub2 section (f)(8) for the remainder of such pe3 riod. 

4 ‘‘(B) OUTBREAK SPECIFIC VIOLATION.— 

5 For purposes of this paragraph, the Secretary, 

6 through the Centers for Medicare & Medicaid 

7 Services, shall develop the following: 

8 ‘‘(i) In the case of an infectious dis9 ease outbreak period with respect to 

10 COVID–19, criteria for determining an 

11 outbreak specific violation with respect to 

12 COVID–19, including— 

13 ‘‘(I) criteria specified by the Cen14 ters for Disease Control and Preven15 tion relating to infection rates, mor16 tality rates, and hospitalization rates; 

17 and 

18 ‘‘(II) criteria for staff shortages, 

19 overcrowding (and ability to cohort), 

20 and insufficient personal protective 

21 equipment. 

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1 mining an outbreak specific violation spe2 cific to such outbreak period.’’. 

3 (D) REPORTING.—Section 1819(d)(4) of 

4 the Social Security Act (42 U.S.C. 1395i– 

5 3(d)(4)) is amended by adding at the end the 

6 following new subparagraph: 

7 ‘‘(C) COVID–19 AND INFECTIOUS DIS8 EASE OUTBREAK REPORTING AND NOTIFICA9 TION.— 

10 ‘‘(i) IN GENERAL.—A skilled nursing 

11 facility must, with respect to an infectious 

12 disease outbreak period (as defined in sub13 section (g)(2)(F)(ii))— 

14 ‘‘(I) electronically submit, at a 

15 frequency specified by the Secretary, 

16 but no less than once weekly and in a 

17 standardized format specified by the 

18 Secretary, to the National Healthcare 

19 Safety Network of the Centers for 

20 Disease Control and Prevention infor21 mation on— 

22 ‘‘(aa) the number of sus23 pected and confirmed cases 

24 among residents and staff of the 

25 facility, of— 


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1 ‘‘(AA) in the case of 

2 the period described in sub3 clause (I) of such section, 

4 COVID–19 (including with 

5 respect to residents of the 

6 facility previously treated for 

7 COVID–19); and 

8 ‘‘(BB) in the case of 

9 the period described in sub10 clause (II) of such section, 

11 the infectious disease that is 

12 the reason for which such 

13 period is declared (including 

14 with respect to residents of 

15 the facility previously treat16 ed for such infectious dis17 ease); 

18 ‘‘(bb) the number of deaths 

19 (including residents who die out20 side the facility and deaths re21 lated to COVID–19 or the infec22 tious disease, as applicable) 

23 among residents and staff of the 

24 facility; 


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1 ‘‘(cc) the amount of personal 

2 protective equipment and hand 

3 hygiene supplies in the facility, 

4 including how many days supply; 

5 ‘‘(dd) ventilator capacity 

6 and related supplies in the facil7 ity; 

8 ‘‘(ee) the number of resident 

9 beds at the facility and census; 

10 ‘‘(ff) access to COVID–19 

11 or the infectious disease, as ap12 plicable, testing available in the 

13 facility for residents of the facil14 ity; 

15 ‘‘(gg) any staffing shortages; 

16 and 

17 ‘‘(hh) any other information 

18 specified by the Secretary; and 

19 ‘‘(II) in the case of the occur20 rence at the facility of either a single 

21 confirmed infection of COVID–19 or 

22 the infectious disease (as applicable) 

23 or of three or more residents or staff 

24 at the facility with new-onset of res25 piratory symptoms occurring within 


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1 72 hours of each other, inform resi2 dents of the facility, representatives of 

3 such residents, and families of the 

4 residents of such occurrence by not 

5 later than 5 p.m. on the calendar day 

6 following such occurrence. 

7 ‘‘(ii) INFORMATION.—The information 

8 provided under clause (ii)(II) must— 

9 ‘‘(I) not include personally identi10 fiable information; 

11 ‘‘(II) include information on miti12 gating actions implemented to prevent 

13 or reduce the risk of transmission, in14 cluding if normal operations of the fa15 cility will be altered; and 

16 ‘‘(III) include any cumulative up17 dates for residents, representatives, 

18 and families at least weekly (or, in the 

19 case of a subsequent occurrence de20 scribed in such clause (ii)(II), by not 

21 later than 5 p.m. on the calendar day 

22 following such subsequent occur23 rence). 

24 ‘‘(iii) CMS POSTING.—The informa25 tion submitted under clause (ii)(I) shall be 


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1 publicly posted on a weekly basis by the 

2 Centers for Medicare & Medicaid Service 

3 to support protecting the health and safety 

4 of residents, personnel, and the general 

5 public.’’. 

6 (2) MEDICAID.— 

7 (A) IN GENERAL.—Section 1919(g)(2) of 

8 the Social Security Act (42 U.S.C. 1396r(g)(2)) 

9 is amended by adding at the end the following 

10 new subparagraph: 

11 ‘‘(F) COVID–19 EMERGENCY PERIOD AND

12 OTHER INFECTIOUS DISEASE OUTBREAK PERI13 ODS.— 

14 ‘‘(i) IN GENERAL.—Notwithstanding 

15 any other provision of this paragraph, dur16 ing an infectious disease outbreak period 

17 (as defined in clause (ii)), with respect to 

18 a State, the following shall apply: 

19 ‘‘(I) Each nursing facility shall 

20 be subject to a standard survey under 

21 subparagraph (A) not later than 4 

22 weeks after the beginning of such pe23 riod and every 6 months after the 

24 date of the previous standard survey 

25 conducted under such subparagraph. 


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1 ‘‘(II) Follow-up surveys under 

2 this paragraph shall be conducted 

3 based on if the skilled nursing facility 

4 is found to be— 

5 ‘‘(aa) a facility with sub6 standard quality of care; 

7 ‘‘(bb) a facility not in sub8 stantial compliance; 

9 ‘‘(cc) a facility reporting less 

10 than three hours of direct care 

11 staff per resident per day; 

12 ‘‘(dd) a facility that has re13 ported no registered nurses for 

14 four or more days in a quarter; 

15 or 

16 ‘‘(ee) a facility with an over17 all score of 2 or less stars on 

18 nursing home compare. 

19 ‘‘(III) In the case of a nursing 

20 facility which is found under a stand21 ard survey or extended survey to be in 

22 substantial compliance, State survey 

23 and certification agencies (described 

24 in subsection (f) of section 1128I) 

25 shall have flexibility with regards to 


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1 the timing of conducting such a fol2 low-up standard survey. 

3 ‘‘(IV) A nursing facility which is 

4 found, under a standard survey or ex5 tended survey, to have provided sub6 standard quality of care shall be treat7 ed as being identified by the Secretary 

8 as having substantially failed to meet 

9 applicable requirement of this Act for 

10 purposes of subsection (f)(10). 

11 ‘‘(V) In the case of a nursing fa12 cility that is subject to an extended 

13 survey under subparagraph (B), such 

14 extended survey shall be conducted as 

15 soon as practical after the standard 

16 survey for such facility, but not later 

17 than 4 weeks after the date of comple18 tion of such standard survey. 

19 ‘‘(VI) A nursing facility which is 

20 found, under a standard survey or ex21 tended survey to have provided sub22 standard quality of care shall be sur23 veyed at least once every 6 months, 

24 thereafter until the infectious disease 

25 outbreak period ends. 


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1 ‘‘(VII) Surveys under this para2 graph shall be conducted in a manner 

3 that prioritizes nursing facilities lo4 cated in towns (or counties, if munic5 ipal-level is not available) with higher 

6 infection rate, as identified by the 

7 Secretary, and facilities with previous 

8 violations of requirements of this Act. 

9 ‘‘(VIII) Any skilled nursing facil10 ity reporting (as determined by the 

11 Centers for Medicare & Medicaid 

12 Services) fewer than three hours of di13 rect care staff time per resident per 

day, with 1 14 ⁄2 hour of registered nurse 

15 time included or any skilled nursing 

16 facility that has reported no registered 

17 nurse for four or more days. 

18 ‘‘(ii) INFECTIOUS DISEASE OUTBREAK

19 PERIOD DEFINED.—For purposes of this 

20 subparagraph, the term ‘infectious disease 

21 outbreak period’ means any of the fol22 lowing periods: 

23 ‘‘(I) COVID–19 EMERGENCY PE24 RIOD.—The emergency period de25 scribed in section 1135(g)(1)(B). 


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1 ‘‘(II) OTHER INFECTIOUS DIS2 EASE OUTBREAK PERIODS.— 

3 ‘‘(aa) The period beginning 

4 on the date a nationwide emer5 gency related to a public health 

6 emergency is declared pursuant 

7 to the Stafford Act, a Major Dis8 aster Declaration, or the Na9 tional Emergencies Act and end10 ing on the date that is 6 months 

11 after the date on which the dec12 laration pursuant to the Stafford 

13 Act, a Major Disaster Declara14 tion, or the National Emer15 gencies Act, as applicable, ends, 

16 whichever is the latest. 

17 ‘‘(bb) The period during 

18 which there exists a public health 

19 emergency related to an infec20 tious disease outbreak declared 

21 by the Secretary pursuant to sec22 tion 319 of the Public Health 

23 Service Act. 

24 ‘‘(cc) With respect to a 

25 nursing facility in a State with 


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1 respect to which the Governor 

2 has declared an emergency or 

3 major disaster (as defined by the 

4 State) with respect to an infec5 tious disease outbreak, the period 

6 for which such declaration is in 

7 effect with respect to such 

8 State.’’. 

9 (B) INTERNET PORTAL AND HOTLINE

10 NUMBER.—Section 1919(e) of the Social Secu11 rity Act (42 U.S.C. 1396r(e)) is amended by 

12 adding at the end the following new paragraph: 

13 ‘‘(9) INTERNET PORTAL AND HOTLINE NUM14 BER.—By not later than one year after the date of 

15 the enactment of this paragraph, the State shall 

16 have in place and maintain an Internet portal and 

17 hotline number (which may be such a portal or hot18 line in existence before the date of the enactment of 

19 this paragraph) for staff of nursing facilities, resi20 dents of such facilities, family of such residents, the 

21 State long-term care ombudsman (established under 

22 title III or VII of the Older Americans Act of 1965 

23 in accordance with section 712 of the Act), or the 

24 general public to report violations of requirements of 

25 this section by such facilities. The Secretary shall esVerDate Sep 11 2014 03:26 Nov 01, 2020 Jkt 019200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\H8574.IH H8574

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1 tablish a process under which each violation so re2 ported shall be preliminarily investigated by a State 

3 survey and certification agency (described in sub4 section (f) of section 1128I) and based on the re5 sults of such preliminary investigation may be sub6 ject to a subsequent more comprehensive investiga7 tion by such agency, in coordination with the Sec8 retary.’’. 

9 (C) INCREASED PENALTIES.—Section 

10 1919(h) of the Social Security Act (42 U.S.C. 

11 1396r(h)) is amended by adding at the end the 

12 following new paragraph: 

13 ‘‘(10) SPECIAL RULES DURING COVID–19 EMER14 GENCY PERIOD AND OTHER INFECTIOUS DISEASE

15 OUTBREAK PERIODS.— 

16 ‘‘(A) IN GENERAL.—Notwithstanding any 

17 other provision of this subsection, during an in18 fectious disease outbreak period (as defined in 

19 subsection (g)(2)(F)(ii)), with respect to a 

20 State, the following shall apply: 

21 ‘‘(i) In the cases of an outbreak spe22 cific violation, a civil monetary penalty 

23 under paragraph (3)(B)(ii)(I) may not be 

24 waived or reduced by the Secretary. 


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1 ‘‘(ii) In the case of a repeat deficiency 

2 relating to any violation of a nursing facil3 ity during a 15-month period, any civil 

4 monetary penalty under paragraph 

5 (3)(B)(ii)(I) shall be doubled. 

6 ‘‘(iii) In the case of a second outbreak 

7 specific violation of a nursing facility dur8 ing such period, the facility shall be treat9 ed as being identified by the Secretary (or 

10 may be identified by the top State health 

11 official, in accordance with a process speci12 fied by the Secretary) as having substan13 tially failed to meet applicable requirement 

14 of this Act for purposes of subsection 

15 (f)(10) for the remainder of such period. 

16 ‘‘(B) OUTBREAK SPECIFIC VIOLATION.— 

17 For purposes of this paragraph, the Secretary, 

18 through the Centers for Medicare & Medicaid 

19 Services, shall develop the following: 

20 ‘‘(i) In the case of an infectious dis21 ease outbreak period with respect to 

22 COVID–19, criteria for determining an 

23 outbreak specific violation with respect to 

24 COVID–19, including— 


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1 ‘‘(I) Criteria specified by the 

2 Centers for Disease Control and Pre3 vention relating to infection rates, 

4 mortality rates, and hospitalization 

5 rates. 

6 ‘‘(II) Criteria for staff shortages, 

7 overcrowding (and ability to cohort), 

8 and insufficient personal protective 

9 equipment. 

10 ‘‘(ii) In the case of an infectious dis11 ease outbreak period other than with re12 spect to COVID–19, criteria for deter13 mining an outbreak specific violation spe14 cific to such outbreak period.’’. 

15 (D) REPORTING.—Section 1919(d)(4) of 

16 the Social Security Act (42 U.S.C. 1396r(d)(4)) 

17 is amended by adding at the end the following 

18 new subparagraph: 

19 ‘‘(C) COVID–19 AND INFECTIOUS DIS20 EASE OUTBREAK REPORTING AND NOTIFICA21 TION.— 

22 ‘‘(i) IN GENERAL.—A nursing facility 

23 must, with respect to an infectious disease 

24 outbreak period (as defined in subsection 

25 (g)(2)(F)(ii))— 


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1 ‘‘(I) electronically submit, at a 

2 frequency specified by the Secretary, 

3 but no less than once weekly and in a 

4 standardized format specified by the 

5 Secretary, to the National Healthcare 

6 Safety Network of the Centers for 

7 Disease Control and Prevention infor8 mation on— 

9 ‘‘(aa) the number of sus10 pected and confirmed cases 

11 among residents and staff of the 

12 facility, of— 

13 ‘‘(AA) in the case of 

14 the period described in sub15 clause (I) of such section, 

16 COVID–19 (including with 

17 respect to residents of the 

18 facility previously treated for 

19 COVID–19); and 

20 ‘‘(BB) in the case of 

21 the period described in sub22 clause (II) of such section, 

23 the infectious disease that is 

24 the reason for which such 

25 period is declared (including 


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1 with respect to residents of 

2 the facility previously treat3 ed for such infectious dis4 ease); 

5 ‘‘(bb) the number of deaths 

6 (including residents who die out7 side the facility and deaths re8 lated to COVID–19 or the infec9 tious disease, as applicable) 

10 among residents and staff of the 

11 facility; 

12 ‘‘(cc) the amount of personal 

13 protective equipment and hand 

14 hygiene supplies in the facility, 

15 including how many days supply; 

16 ‘‘(dd) ventilator capacity 

17 and related supplies in the facil18 ity; 

19 ‘‘(ee) the number of resident 

20 beds at the facility and census; 

21 ‘‘(ff) access to COVID–19 

22 or the infectious disease, as ap23 plicable, testing available in the 

24 facility for residents of the facil25 ity; 


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•HR 8574 IH

1 ‘‘(gg) any staffing shortages; 

2 and 

3 ‘‘(hh) any other information 

4 specified by the Secretary; and 

5 ‘‘(II) in the case of the occur6 rence at the facility of either a single 

7 confirmed infection of COVID–19 or 

8 the infectious disease (as applicable) 

9 or of three or more residents or staff 

10 at the facility with new-onset of res11 piratory symptoms occurring within 

12 72 hours of each other, inform resi13 dents of the facility, representatives of 

14 such residents, and families of the 

15 residents of such occurrence by not 

16 later than 5 p.m. on the calendar day 

17 following such occurrence. 

18 ‘‘(ii) INFORMATION.—The information 

19 provided under clause (ii)(II) must— 

20 ‘‘(I) not include personally identi21 fiable information; 

22 ‘‘(II) include information on miti23 gating actions implemented to prevent 

24 or reduce the risk of transmission, inVerDate Sep 11 2014 03:26 Nov 01, 2020 Jkt 019200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6201 E:\BILLS\H8574.IH H8574

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•HR 8574 IH

1 cluding if normal operations of the fa2 cility will be altered; and 

3 ‘‘(III) include any cumulative up4 dates for residents, representatives, 

5 and families at least weekly (or, in the 

6 case of a subsequent occurrence de7 scribed in such clause (ii)(II), by not 

8 later than 5 p.m. on the calendar day 

9 following such subsequent occur10 rence). 

11 ‘‘(iii) CMS POSTING.—The informa12 tion submitted under clause (ii)(I) shall be 

13 publicly posted on a weekly basis by the 

14 Centers for Medicare & Medicaid Service 

15 to support protecting the health and safety 

16 of residents, personnel, and the general 

17 public’’. 

Æ 


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