amended by adding at the end the following
new paragraph:
‘‘(8) REQUIREMENT FOR BACKGROUND CHECKS
FOR DIRECT CARE PERSONNEL.—A nursing facility
shall comply with the requirements of section 2(a) of
the Elderly and Disabled Protection Act of 1998
with respect to any direct care employee it em-
ploys.’’.
(2) HOME
HEALTH
AGENCIES
AND
HOSPICE
PROGRAMS.—
(A) MEDICARE PROGRAM.—
(i) HOME
HEALTH
AGENCIES.—Sec-
tion 1891(a) of such Act (42 U.S.C.
1395bbb(a)) is amended by adding at the
end the following:
‘‘(7) The agency complies with the requirements
of section 2(a) of the Elderly and Disabled Protec-
tion Act of 1998 with respect to any direct care em-
ployee it employs.’’.
(ii) 
HOSPICE
PROGRAMS.—Section
1861(dd)(2)(G) of such Act (42 U.S.C.
1395x(dd)(2)(G)) is amended by inserting
before the period at the end the following:
‘‘, including compliance with the require-
ments of section 2(a) of the Elderly and
Disabled Protection Act of 1998 with re-
spect to any direct care employee it em-
ploys’’.
(B) 
MEDICAID
PROGRAM.—Section
1902(a)(57) 
of 
such 
Act 
(42 
U.S.C.
1396a(a)(57)) is amended—
(i) by inserting ‘‘(A)’’ after ‘‘(57)’’;
and
(ii) by adding at the end the follow-
ing:
‘‘(B) provide that each provider of home health
care or personal care services and each hospice pro-
gram receiving funds under the plan shall comply
with the requirements of section 2(a) of the Elderly
and Disabled Protection Act of 1998 with respect to
any direct care employee it employs;’’.
(d) EFFECTIVE DATES.—The requirements of sub-
section (a) shall apply with respect to a covered facility—
(1) beginning as of such date (specified by the
Secretary and not later than 60 days after the date
the Secretary has established the national registry
coordination system under section 3(b)), with re-
spect to the hiring of individuals as a direct care em-
ployee by the facility on and after such date; and
(2) as of 1 year after the date described in
paragraph (1), with respect to individuals first em-
ployed as such an employee before the date de-
scribed in such paragraph.
SEC. 3. EXPANDED ROLE OF STATE DIRECT CARE EM-
PLOYEE REGISTRIES; NATIONAL REGISTRY
COORDINATION SYSTEM; PROCEDURES FOR
BACKGROUND CHECKS.
(a) EXPANDED ROLE OF REGISTRY.—
(1) IN GENERAL.—Each State shall expand its
direct care employee registry established under sec-
tions 1819(e)(2) and 1919(e)(2) of the Social Secu-
rity Act to carry out the following functions:
(A) RECEIPT OF REQUESTS.—The registry
shall provide for the receipt of requests for
background checks described in section 2(a)(1).
(B) 
CONDUCT
OF
BACKGROUND
CHECKS.—Upon receipt of such a request with
respect to an individual, the registry, in coordi-
nation with the national registry coordination
system established by the Secretary under sub-
section (b) and in accordance with this section,
shall provide for the performance of (or the col-
lection of information concerning) a background
check (including a criminal background check
and an abusive work history background check)
requested under section 2(a) and for the sub-
mittal of a background check report (as defined
in paragraph (2)) on such check to the request-
ing facility.
(C) PROVISION OF INFORMATION TO NA-
TIONAL
REGISTRY
COORDINATION
SYSTEM.—
The registry shall provide for the reporting to
the national registry coordination system of—
(i) a criminal background check sum-
mary (as defined in paragraph (3)) on any
individual on whom it obtains a criminal
background check under subsection (c)(3);
and
(ii) the identity of any individual for
whom the registry has documented find-
ings of patient abuse and such additional
information as the State registry involved
may disclose concerning such findings.
(2) BACKGROUND CHECK REPORT DEFINED.—
For purposes of this section, the term ‘‘background
check report’’ means, with respect to a background
check concerning an individual, a statement contain-
ing the following:
(A) Whether the individual has been con-
victed of a disqualifying crime.
(B) Whether there are documented find-
ings of patient abuse by the individual in a
State direct care employee registry and, if so,
such additional information as the State reg-
istry involved may disclose concerning such
findings.
Such report shall not include information from the
criminal background check other than the informa-
tion described in subparagraph (A).
(3) CRIMINAL BACKGROUND CHECK SUMMARY
DEFINED.—For purposes of this section, the term
‘‘criminal background check summary’’ means, with
respect to a criminal background check concerning
an individual, the following information:
(A) The identity of the individual.
(B) The date of the criminal background
check.
(C) Whether the check revealed that—
(i) the individual had not been con-
victed of any crime,
(ii) the individual has been convicted
of a national disqualifying crime, or
(iii) the individual has been convicted
of a crime that is not a national disqualify-
ing crime.
(4) CONFORMING
MEDICARE
AND
MEDICAID
AMENDMENTS.—Sections 1819(e)(2) and 1919(e)(2)
of the Social Security Act (42 U.S.C. 1395i–3(e)(2),
1396r(e)(2)) are each amended—
(A) in subparagraph (C), by striking ‘‘A
State’’ and inserting ‘‘Subject to section 3(e) of
the Elderly and Disabled Protection Act of
1998, a State’’, and
(B) by adding at the end the following new
subparagraph:
‘‘(D) EXPANDED
FUNCTIONS.—Effective
not later than 90 days after the date of the es-
tablishment of the national registry coordina-
tion system under section 3(b) of the Elderly
and Disabled Protection Act of 1998, the State
shall—
‘‘(i) modify the operations of its reg-
istry so it performs the functions required
under section 3(a) of such Act; and
‘‘(ii) provide for the specification of a
State agency that is separate from the reg-
istry and that will be responsible for the
performance of criminal background checks
under such section.’’.
(b) NATIONAL REGISTRY COORDINATION SYSTEM.—
(1) ESTABLISHMENT.—The Secretary shall es-
tablish methods by which State direct care registries
can pool and share information regarding individuals
concerning criminal background check summaries
and the existence of documented findings of patient
abuse.
(2) DEADLINE FOR ESTABLISHING SYSTEM.—
The Secretary shall provide for the establishment of
the national registry coordination system by not
later than 1 year after the date of the enactment of
this Act.
(3) CONSULTATION
WITH
FBI
ON
CRIMINAL
BACKGROUND
CHECKS.—In carrying out this Act
with respect to criminal background checks, the Sec-
retary shall consult with the Director of the Federal
Bureau of Investigation.
(c) PROCEDURES
FOR
CRIMINAL
BACKGROUND
CHECKS.—A registry shall carry out its responsibilities
under subsection (a)(1)(B), in relation to a criminal back-
ground check with respect to an individual, in a manner
consistent with the following:
(1) DETERMINATION
OF
WHETHER
RECENT
CRIMINAL
BACKGROUND
CHECK
DONE.—The reg-
istry shall determine whether the registry (or,
through the national registry coordination system,
the direct care employee registry of another State)
has obtained a criminal background check on the in-
dividual within the previous year.
(2) USE OF PREVIOUS BACKGROUND CHECK.—
If there has been such a check done within such pe-
riod, if the check revealed that—
(A) the individual had not been convicted
of any crime, the registry need not request a
new criminal background check and may as-
sume that the individual has not been convicted
of any disqualifying crime;
(B) the individual has been convicted of a
national or state disqualifying crime, the reg-
istry need not request a new criminal back-
ground check and shall treat the individual as
having been convicted of a disqualifying crime;
or
(C) the individual has been convicted of a
crime that is not a national or state disqualify-
ing crime and the State has disqualifying
crimes that are other than national disqualify-
ing crimes, the registry shall request a criminal
background check as provided under paragraph
(3).
(3) 
REQUESTING
STATE
CRIMINAL
BACK-
GROUND
CHECK
AGENCY
TO
OBTAIN
CRIMINAL
BACKGROUND CHECK.—If there has not been such a
check done within such period or in the case de-
scribed in paragraph (2)(C), the registry shall re-
quest the State criminal background check agency of
the State—
(A) to perform a criminal background
check on the individual;
(B) to determine, on the basis of such
check, whether the individual—
(i) has not been convicted of any
crime;
(ii) has been convicted of a national
disqualifying crime; or
(iii) has been convicted of a crime
that is a State disqualifying crime; and
(C) to submit to the registry a criminal
background check summary on the individual.
(4) APPLICATION
OF
CERTAIN
PROCEDURES
FOR CRIMINAL BACKGROUND CHECKS.—Under regu-
lations of the Secretary, the following provisions in
section 3 of the National Child Protection Act of
1993 (Public Law 103–209) shall apply to criminal
background checks required of a direct care em-
ployee with respect to a covered facility to be per-
formed under this Act in the same manner as they
apply to providers with respect to qualified entities:
(A) Subsection (a)(2) (relating to access to
records and timeliness of response).
(B) Subsection (b) (relating to guidelines
on background checks), other than paragraph
(1)(B), except that denial of unsupervised ac-
cess under paragraph (1)(E) shall be treated
for purposes of this section as a denial of unsu-
pervised access to patients in covered facilities
and determinations under paragraph (4) shall
be made only with respect to crimes relating to
patient abuse.
(C) Subsection (c) (relating to authority of
Attorney General).
(D) Subsection (d) (relating to limitation
on liability).
(d) PROCEDURES
FOR ABUSIVE WORK HISTORY
BACKGROUND CHECKS.—A registry shall carry out its re-
sponsibilities under subsection (a)(1)(B), in relation to