II 

111TH CONGRESS 

2D SESSION S. 3407 

To improve the quality of care in nursing homes, help families make informed 

decisions, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 25, 2010 

Mr. FEINGOLD introduced the following bill; which was read twice and 

referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To improve the quality of care in nursing homes, help 

families make informed decisions, 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 ‘‘Improving the Quality 

5 of Care in Nursing Homes Act of 2010’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) The Institute of Medicine published the 

9 1986 report Improving the Quality of Care in Nurs10 ing Homes, which laid out recommendations for polVerDate Mar 15 2010 02:46 May 26, 2010 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3407.IS S3407

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1 icy and regulatory changes for Federal oversight of 

2 nursing homes. 

3 (2) The Omnibus Budget Reconciliation Act of 

4 1987 incorporated many of those recommendations 

5 as part of the amendments made by subtitle C of 

6 title IV of such Act. 

7 (3) Since the enactment of the Omnibus Budget 

8 Reconciliation Act of 1987, there has been little sys9 tematic evaluation or review of the effectiveness of 

10 the survey and certification system in measuring and 

11 improving the quality of care for nursing home resi12 dents as well as ensuring compliance with the re13 quirements of participation by nursing homes par14 ticipating in Medicare or Medicaid. 

15 SEC. 3. STUDY AND REPORT BY THE INSTITUTE OF MEDI16 CINE. 

17 (a) IN GENERAL.—The Secretary of Health and 

18 Human Services shall enter into an agreement with the 

19 Institute of Medicine to conduct a study on the following: 

20 (1) The current structure and methods for sur21 veying and evaluating nursing homes. 

22 (2) The nature of the relationship between the 

23 Centers for Medicare & Medicaid Services and nurs24 ing homes and how it affects efforts to improve qual25 ity. 


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1 (3) The relationship between the Centers for 

2 Medicare & Medicaid Services and State agencies. 

3 (4) The methodology used by the Centers for 

4 Medicare & Medicaid Services to survey and evaluate 

5 nursing homes. 

6 (5) An evaluation of how the States and the 

7 District of Columbia implement the Federal require8 ments and the resulting variations and differences. 

9 (6) The objectivity and accuracy of the survey 

10 process and criteria used to assess nursing homes. 

11 (7) The effectiveness of the current enforcement 

12 system in promoting and encouraging systemic orga13 nizational change leading to measurable and sus14 tained quality improvement within the nursing home. 

15 (8) Whether the current system effectively un16 derstands and measures nursing homes that are un17 dergoing or have completed culture change activities. 

18 (9) Whether the current system effectively al19 lows states and other stakeholders to engage in inno20 vative ways to pursue quality improvement. 

21 (10) Alternatives to the current system. 

22 (b) REPORT.—The agreement entered into under 

23 subsection (a) shall provide for the Institute of Medicine 

24 to submit to the Secretary of Health and Human Services 

25 and the Congress, not later than 18 months after the date 


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1 of the enactment of this Act, a report containing a descrip2 tion of— 

3 (1) the results of the study conducted under 

4 this section; and 

5 (2) the conclusions and recommendations of the 

6 Institute of Medicine regarding changes in regu7 latory policies and procedures to enhance the ability 

8 of the regulatory system to assure that nursing 

9 home residents receive quality care. 

10 SEC. 4. AUTHORIZATION OF APPROPRIATIONS. 

11 To carry out this Act, there are authorized to be ap12 propriated such sums as may be necessary. 

Æ 


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