I 

117TH CONGRESS 

1ST SESSION H. R. 331 

To amend titles XVIII and XIX of the Social Security Act to provide flexibility in training and competency requirements for skilled nursing facility 

and nursing facility nursing aides under the Medicare and Medicaid 

programs. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 15, 2021 

Mr. KELLER (for himself and Ms. WILD) introduced the following bill; which 

was referred to the Committee on Ways and Means, and in addition to 

the Committee on Energy and Commerce, 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 provide flexibility in training and competency requirements for skilled nursing facility and nursing facility 

nursing aides under the Medicare and Medicaid programs. 

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 ‘‘Nurses Certification 

5 And Recognition of Experience Act of 2021’’ or the 

6 ‘‘Nurses CARE Act of 2021’’. 


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1 SEC. 2. PROVIDING FLEXIBILITY IN TRAINING AND COM2 PETENCY REQUIREMENTS FOR SKILLED 

3 NURSING FACILITY AND NURSING FACILITY 

4 NURSING AIDES UNDER THE MEDICARE AND 

5 MEDICAID PROGRAMS. 

6 (a) IN GENERAL.—Sections 1819(b)(5) and 

7 1919(b)(5) of the Social Security Act (42 U.S.C. 1395i– 

8 3(b)(5), 1396r(b)(5)) are each amended— 

9 (1) in subparagraph (A)(i)(I), by inserting ‘‘(or, 

10 in the case of a specified individual (as defined in 

11 subparagraph (H)(ii)), meets the requirement de12 scribed in subparagraph (H)(i))’’ after ‘‘subsection 

13 (e)(1)(A)’’; and 

14 (2) by adding at the end the following new sub15 paragraph: 

16 ‘‘(H) COVID–19 TRAINING AND COM17 PETENCY REQUIREMENT FLEXIBILITY.— 

18 ‘‘(i) IN GENERAL.—For purposes of 

19 subparagraph (A)(i)(I), the requirement 

20 described in this clause is, with respect to 

21 a specified individual (as defined in clause 

22 (ii)), that the individual demonstrates com23 petency in work as a nursing aide 

24 through— 


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1 ‘‘(I) the successful completion of 

2 a nursing aide examination approved 

3 by the State; 

4 ‘‘(II) certification of competency 

5 by a site administrator of a nursing 

6 aide apprenticeship program approved 

7 by the State; or 

8 ‘‘(III) an assessment by the facil9 ity in each of the areas and skills de10 scribed in section 583.152(b) of title 

11 42, Code of Federal Regulations (or a 

12 successor regulation). 

13 ‘‘(ii) SPECIFIED INDIVIDUAL DE14 FINED.—For purposes of this subpara15 graph, the term ‘specified individual’ 

16 means an individual who, during the emer17 gency period described in section 

18 1135(g)(1)(B)— 

19 ‘‘(I) completed a nursing aide 

20 training program and competency as21 sessment (whether online or other22 wise) approved by the State; and 

23 ‘‘(II) completed a minimum of 80 

24 hours of work as a temporary nurse 

25 aide, in supervised practical nurse 


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1 aide training, in on-the-job nursing 

2 aide training, or in in-service nursing 

3 aide education, under the supervision 

4 of a registered nurse or a licensed 

5 practical nurse.’’. 

6 (b) INCLUSION ON REGISTRY.—Section 

7 1819(e)(2)(A) and 1919(e)(2)(A) of the Social Security 

8 Act (42 U.S.C. 1395i–3(e)(2)(A), 1396r(e)(2)(A)) are 

9 each amended by inserting ‘‘, or any specified individual 

10 (as defined in clause (ii) of subsection (b)(5)(H)(ii)) who 

11 meets the requirement described in clause (i) of such sub12 section’’ before the period at the end. 

13 (c) EDUCATIONAL AND OUTREACH ACTIVITIES.— 

14 The Secretary of Health and Human Services shall under15 take outreach and educational activities for purposes of 

16 informing States of— 

17 (1) the effects of the amendments made by this 

18 section; and 

19 (2) what actions States may take with respect 

20 to the training and assessment of nursing aides in 

21 such State that will comply with the provisions of 

22 such amendments. 

Æ 


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