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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 3596 Introduced in Senate (IS)]

111th CONGRESS
  2d Session
                                S. 3596

 To establish the Culture of Safety Hospital Accountability Study and 
                         Demonstration Program.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             July 15, 2010

  Mrs. Hagan introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL

 
 To establish the Culture of Safety Hospital Accountability Study and 
                         Demonstration Program.

    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 ``Culture of Safety Hospital 
Accountability Act of 2010''.

SEC. 2. CULTURE OF SAFETY HOSPITAL ACCOUNTABILITY STUDY AND 
              DEMONSTRATION PROGRAM.

    (a) Study.--
            (1) In general.--The Secretary shall conduct a study that--
                    (A) examines existing activities and programs in 
                hospitals for quality assurance, patient safety, and 
                performance improvement and provides an analysis 
                regarding best practices with respect to such 
                activities and programs; and
                    (B) identifies best practices that should be 
                replicated in hospitals to improve patient safety and 
                quality of care, consistent with the provisions 
                included under the quality assessment and performance 
                improvement program, as required under the conditions 
                of participation for hospitals under Medicare.
            (2) Report.--Not later than 2 years after the date of 
        enactment of this Act, the Secretary shall prepare a report 
        containing the results of the study conducted under paragraph 
        (1). Such report shall be made available on the Internet 
        website of the Centers for Medicare & Medicaid Services.
    (b) Demonstration Program.--
            (1) In general.--The Secretary shall establish the Culture 
        of Safety Hospital Accountability demonstration program to 
        provide support for establishing partnerships and other 
        cooperative approaches between hospitals, State health care 
        agencies, and the Department of Health and Human Services to 
        promote and implement the best practices identified under 
        subsection (a), with the goal of improving the safety and 
        quality of care provided to Medicare beneficiaries and enhance 
        compliance with the conditions of participation for hospitals 
        under Medicare.
            (2) Duration.--The demonstration program shall operate 
        during a period of 3 years, beginning not later than 12 months 
        after completion of the report described in subsection (a)(2).
            (3) Scope.--
                    (A) States.--The Secretary shall select not less 
                than 4 States, but not more than 6 States, to 
                participate in the demonstration program.
                    (B) Hospitals.--The Secretary shall select not more 
                than 24 hospitals, within the States selected under 
                subparagraph (A), to participate in the demonstration 
                program. The hospitals selected under this subparagraph 
                shall satisfy criteria, as developed by the Secretary, 
                relating to compliance with the conditions of 
                participation for hospitals under Medicare.
            (4) Application.--A State or hospital that desires to 
        participate in the demonstration program shall submit to the 
        Secretary an application at such time, in such manner, and 
        containing such information as the Secretary may require.
            (5) Implementation.--
                    (A) Technical assistance.--The Secretary shall 
                provide participating hospitals with technical 
                assistance in implementation of the best practices 
                identified through the study under subsection (a).
                    (B) Hospital surveyors.--For each State 
                participating in the demonstration program, the 
                Secretary shall provide training to State surveyors 
                that is designed to--
                            (i) enhance knowledge of the disciplines of 
                        patient safety, quality assessment, and 
                        performance improvement;
                            (ii) increase skill in evaluating 
                        compliance with quality assessment and 
                        performance improvement programs required under 
                        the conditions of participation for hospitals 
                        under Medicare; and
                            (iii) focus investigations of complaints 
                        regarding hospital care on the hospital's 
                        quality assessment and performance improvement 
                        program.
            (6) Evaluation.--For each State and hospital participating 
        in the demonstration program, the Secretary shall evaluate the 
        following:
                    (A) The level of implementation of the best 
                practices identified under subsection (a) by the 
                participating hospitals and whether adoption of such 
                practices--
                            (i) improved quality and patient safety 
                        (including an analysis of changes in quality 
                        measures and other indicators of outcome and 
                        performance); and
                            (ii) resulted in a decrease in the 
                        seriousness or number of citations for 
                        deficiencies under the conditions of 
                        participation for hospitals under Medicare.
                    (B) The training provided to State surveyors and 
                whether such training resulted in enhanced proficiency 
                in evaluations of hospital quality assessment and 
                performance improvement programs.
            (7) Report.--Not later than 12 months after completion of 
        the demonstration program, the Secretary shall submit to 
        Congress a report containing an evaluation of such program, 
        including--
                    (A) the findings of the evaluation under paragraph 
                (6); and
                    (B) recommendations--
                            (i) in regard to whether the best practices 
                        identified under the demonstration program 
                        should be adopted by other hospitals, and how 
                        the Secretary can best promote adoption of such 
                        best practices;
                            (ii) in regard to whether the training for 
                        State surveyors developed under the 
                        demonstration program should be provided to all 
                        State surveyors; and
                            (iii) for such legislation and 
                        administrative action as the Secretary 
                        determines appropriate.
            (8) Waiver authority.--The Secretary may waive such 
        requirements under titles XI and XVIII of the Social Security 
        Act as may be necessary to carry out the demonstration program.
    (c) Funding.--For purposes of carrying out this Act, the Secretary 
shall provide for the transfer from the Federal Hospital Insurance 
Trust Fund under section 1817 of the Social Security Act (42 U.S.C. 
1395i) of $25,000,000, to the Centers for Medicare & Medicaid Services 
Program Management Account for the period of fiscal years 2010 through 
2017. Amounts transferred under the preceding sentence shall remain 
available until expended.
    (d) Alternative Remedies.--Section 1866(b) of the Social Security 
Act (42 U.S.C. 1395cc(b)) is amended by adding at the end the following 
new paragraph:
            ``(5)(A) The Secretary is authorized to promulgate 
        regulations that establish enforcement remedies that are in 
        addition to, or in lieu of, termination of an agreement under 
        this section for hospitals or critical access hospitals for 
        violations of health and safety requirements under this title. 
        Such remedies may include directed plans of correction that are 
        designed to--
                            ``(i) ensure compliance with requirements 
                        under this title (including conditions of 
                        participation for hospitals or critical access 
                        hospitals);
                            ``(ii) prevent recurrence of non-compliance 
                        with such requirements; and
                            ``(iii) improve the internal structures and 
                        processes within the hospital or critical 
                        access hospital for provision of continuous 
                        quality and safety enhancement.
                    ``(B) The regulations described under subparagraph 
                (A) may be promulgated by the Secretary before, during, 
                or after the evaluation described under section 2(b)(6) 
                of the Culture of Safety Hospital Accountability Act of 
                2010.''.
    (e) Non-Application of Paperwork Reduction Act.--Chapter 35 of 
title 44, United States Code (commonly referred to as the `Paperwork 
Reduction Act of 1995') shall not apply to this Act.
    (f) Definitions.--In this Act:
            (1) Demonstration program.--The term ``demonstration 
        program'' means the Culture of Safety Hospital Accountability 
        demonstration program conducted under this Act.
            (2) Hospital.--The term ``hospital'' means--
                    (A) an institution described under section 1861(e) 
                of the Social Security Act (42 U.S.C. 1395x(e)); or
                    (B) a critical access hospital (as described under 
                section 1861(mm)(1) of such Act (42 U.S.C. 
                1395x(mm)(1)).
            (3) Medicare.--The term ``Medicare'' means the program 
        established under title XVIII of the Social Security Act (42 
        U.S.C. 1395 et seq.).
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
                                 <all>
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