facility while under previous ownership 
shall no longer be published by the Sec-
retary pursuant to clause (i) after the 1- 
year period beginning on the date of such 
change of ownership. 
‘‘(F) USE OF FUNDS.—Funds collected by 
the Secretary pursuant to this subsection are 
authorized to be appropriated to implement the 
minimum nurse staffing requirements of clause 
(ii) of subsection (b)(4)(C). 
‘‘(11) NURSE
DEFINED.—In this subsection, 
the term ‘nurse’ means a registered professional 
nurse, a licensed practical nurse, and a nurse aide.’’. 
(b) MEDICAID.—Section 1919 of the Social Security 
Act (42 U.S.C. 1396r) is amended by adding at the end 
the following new subsection: 
‘‘(k) WHISTLEBLOWER
AND
RESIDENT
PROTEC-
TIONS.— 
‘‘(1) STATEMENT
REGARDING
PROFESSIONAL 
OBLIGATION AND RIGHTS.—All nurses employed by 
a nursing facility have a duty and right to act based 
on their professional judgment in accordance with 
the nursing laws and regulations of the State in 
which such facility is located, to provide nursing care 
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in the exclusive interests of the residents of the facil-
ity, and to act as the residents’ advocate. 
‘‘(2) OBJECTION TO OR REFUSAL OF WORK AS-
SIGNMENT.—A nurse may object to, or refuse to 
participate in, any activity, policy, practice, assign-
ment, or task (referred to in this subsection as a 
‘work assignment’) if— 
‘‘(A) the nurse reasonably believes such 
work assignment to be in violation of the min-
imum nurse staffing requirements of clause (ii) 
of subsection (b)(4)(C); or 
‘‘(B) the nurse reasonably believes that the 
nurse is not prepared by education, training, or 
experience to perform or comply with such work 
assignment without compromising the safety of 
a resident or jeopardizing the license of the 
nurse. 
‘‘(3) RETALIATION FOR OBJECTION TO OR RE-
FUSAL OF WORK ASSIGNMENT BARRED.— 
‘‘(A) NO DISCHARGE, DISCRIMINATION, OR 
RETALIATION.—No nursing facility may dis-
charge, retaliate, discriminate, or otherwise take 
adverse action in any manner with respect to 
any aspect of a nurse’s employment with the fa-
cility, including discharge, promotion, com-
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pensation, or terms, conditions, or privileges of 
employment, based on the nurse’s objection to, 
or refusal of, a work assignment under para-
graph (2). 
‘‘(B) NO
FILING
OF
COMPLAINT.—No 
nursing facility may file a complaint or a report 
against a nurse with a State professional dis-
ciplinary agency because of the nurse’s objec-
tion to, or refusal of, a work assignment under 
paragraph (2). 
‘‘(4) CAUSE OF ACTION.—Any nurse (or a col-
lective bargaining representative or legal representa-
tive of such nurse) against whom a nursing facility 
has taken an adverse action in violation of para-
graph (3)(A), or against whom such facility has filed 
a complaint or report in violation of paragraph 
(3)(B), may (without regard to whether a complaint 
has been filed under paragraph (5) or (10)(B)) 
bring a cause of action in an appropriate district 
court of the United States. The legal burdens of 
proof specified in section 1221(e) of title 5, United 
States Code, shall be controlling for the purposes of 
any cause of action brought under this paragraph. 
A nurse who prevails on the cause of action may be 
entitled to one or more of the following: 
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‘‘(A) Reinstatement. 
‘‘(B) Reimbursement of lost wages, com-
pensation, and benefits. 
‘‘(C) Attorneys’ fees. 
‘‘(D) Court costs. 
‘‘(E) Other damages. 
‘‘(5) COMPLAINT
TO
SECRETARY.—Any indi-
vidual may file a complaint with the Secretary 
against a nursing facility that violates a requirement 
described in paragraph (3). For any complaint filed, 
the Secretary shall— 
‘‘(A) receive and investigate the complaint; 
‘‘(B) determine whether a violation of such 
paragraph, as alleged in the complaint, has oc-
curred; and 
‘‘(C) in the case that the Secretary deter-
mines that such a violation has occurred, issue 
an order that the complaining individual may 
not suffer any adverse action prohibited by 
paragraph (3) or (7). 
‘‘(6) TOLL-FREE TELEPHONE NUMBER.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
provide for the establishment of a toll-free tele-
phone hotline to provide information regarding 
the minimum nurse staffing requirements of 
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clause (ii) of subsection (b)(4)(C) and to receive 
reports of violations of such requirements. 
‘‘(B) NOTICE TO RESIDENTS.—A nursing 
facility shall provide each resident admitted to 
the facility with the telephone number of the 
hotline described in subparagraph (A) and give 
notice to each such resident that such hotline 
may be used to report inadequate staffing or 
care. 
‘‘(7) PROTECTION FOR REPORTING.— 
‘‘(A) PROHIBITION
ON
RETALIATION
OR 
DISCRIMINATION.—A nursing facility may not 
retaliate or discriminate in any manner against 
any resident, employee, or contract employee of 
the facility, or any other individual, on the basis 
that such resident, employee, contract employee, 
or individual (individually or in conjunction 
with another individual) has, in good faith— 
‘‘(i) presented a grievance or com-
plaint; 
‘‘(ii) initiated or cooperated in any in-
vestigation or proceeding of any govern-
mental entity, regulatory agency, or private 
accreditation body; 
‘‘(iii) made a civil claim or demand; or 
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‘‘(iv) filed an action relating to the 
care, services, or conditions of the facility. 
‘‘(B) GOOD
FAITH
DEFINED.—For pur-
poses of this paragraph, an individual shall be 
deemed to be acting in good faith if the indi-
vidual reasonably believes— 
‘‘(i) the information reported or dis-
closed is true; and 
‘‘(ii) a violation of the minimum nurse 
staffing requirements of clause (ii) of sub-
section (b)(4)(C) has occurred or may 
occur. 
‘‘(8) PROHIBITION
ON
INTERFERENCE
WITH 
RIGHTS.— 
‘‘(A) EXERCISE
OF
RIGHTS.—A nursing 
facility may not— 
‘‘(i) interfere with, restrain, or deny 
the exercise, or attempt to exercise, by any 
individual of any right, procedure, or rem-
edy provided or protected under this sub-
section; or 
‘‘(ii) coerce or intimidate any indi-
vidual regarding the exercise, or attempt to 
exercise, such right. 
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‘‘(B) OPPOSITION TO UNLAWFUL POLICIES 
OR PRACTICES.—A nursing facility may not re-
taliate or discriminate against any individual 
for opposing any policy, practice, or action of 
the facility which is alleged to violate, breach, 
or fail to comply with any provision of the min-
imum nurse staffing requirements of clause (ii) 
of subsection (b)(4)(C). 
‘‘(C) PROHIBITION
ON
INTERFERENCE 
WITH PROTECTED COMMUNICATIONS.—A nurs-
ing facility may not make, adopt, or enforce any 
rule, regulation, policy, or practice which in any 
manner directly or indirectly prohibits, impedes, 
or discourages a nurse from, or intimidates, co-
erces, or induces a nurse regarding, engaging in 
free speech activities or disclosing information 
as provided under this subsection. 
‘‘(D) PROHIBITION
ON
INTERFERENCE 
WITH COLLECTIVE ACTION.—A nursing facility 
may not in any way interfere with the rights of 
nurses to organize, bargain collectively, and en-
gage in concerted activity under section 7 of the 
National Labor Relations Act (29 U.S.C. 157). 
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‘‘(9) NOTICE.—A nursing facility shall post in 
an appropriate location in each unit a conspicuous 
notice, in a form specified by the Secretary, that— 
‘‘(A) explains the rights of nurses, resi-
dents, and other individuals under this sub-
section; 
‘‘(B) includes a statement that a nurse, 
resident, or other individual may file a com-
plaint with the Secretary against the facility for 
a violation of a requirement or a prohibition of 
this subsection; and 
‘‘(C) provides instructions on how to file 
such a complaint. 
‘‘(10) ENFORCEMENT.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
enforce the requirements and prohibitions of 
this subsection in accordance with this para-
graph. 
‘‘(B) PROCEDURES
FOR
RECEIVING
AND 
INVESTIGATING
COMPLAINTS.—The Secretary 
shall establish procedures under which— 
‘‘(i) any individual may file a com-
plaint alleging that a nursing facility has 
violated a requirement or a prohibition of 
this subsection; and 
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‘‘(ii) any such complaint shall be in-
vestigated by the Secretary. 
‘‘(C) REMEDIES.—If the Secretary deter-
mines that a nursing facility has violated a re-
quirement or prohibition of this subsection, the 
Secretary— 
‘‘(i) shall require the facility to estab-
lish a corrective action plan to prevent the 
recurrence of such violation; and 
‘‘(ii) may impose civil money penalties 
as described in subparagraph (D). 
‘‘(D) CIVIL PENALTIES.— 
‘‘(i) IN GENERAL.—In addition to any 
other penalties prescribed by law, the Sec-
retary may impose civil penalties as fol-
lows: 
‘‘(I) NURSING FACILITY LIABIL-
ITY.—The Secretary may impose on a 
nursing facility found to be in viola-
tion of this subsection a civil money 
penalty of— 
‘‘(aa) 
not 
more 
than 
$25,000 for the first knowing 
violation of this subsection by 
such facility; and 
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‘‘(bb) 
not 
more 
than 
$50,000 
for 
any 
subsequent 
knowing violation of this sub-
section by such facility. 
‘‘(II) INDIVIDUAL
LIABILITY.— 
The Secretary may impose on an indi-
vidual who— 
‘‘(aa) is employed by a nurs-
ing facility; and 
‘‘(bb) is found by the Sec-
retary to have knowingly violated 
this subsection on behalf of the 
facility, 
a civil money penalty of not more 
than $20,000 for each such violation 
by the individual. 
‘‘(ii) PROCEDURES.—The provisions 
of section 1128A of the Social Security Act 
(other than subsections (a) and (b)) shall 
apply with respect to a civil money penalty 
or proceeding under this subparagraph in 
the same manner as such provisions apply 
with respect to a civil money penalty or 
proceeding under such section 1128A. 
‘‘(E) PUBLIC NOTICE OF VIOLATIONS.— 
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‘‘(i) INTERNET
WEBSITE.—The Sec-
retary shall publish on the internet website 
of the Department of Health and Human 
Services the names of nursing facilities on 
which a civil money penalty has been im-
posed under this subsection, the violation 
for which such penalty was imposed, and 
such additional information as the Sec-
retary determines appropriate. 
‘‘(ii) CHANGE OF OWNERSHIP.—With 
respect to a nursing facility that had a 
change of ownership, as determined by the 
Secretary, penalties imposed on the facility 
while under previous ownership shall no 
longer be published by the Secretary pur-
suant to clause (i) after the 1-year period 
beginning on the date of such change of 
ownership. 
‘‘(F) USE OF FUNDS.—Funds collected by 
the Secretary pursuant to this subsection are 
authorized to be appropriated to implement the 
minimum nurse staffing requirements of clause 
(ii) of subsection (b)(4)(C). 
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under State law or regulation) prior to pre-
scribing a psychotropic drug to the resident for 
a use not approved by the Food and Drug Ad-
ministration. 
‘‘(B) REQUIREMENTS.—The standardized 
protocol developed under subparagraph (A) 
shall include the following: 
‘‘(i) A requirement, with respect to a 
resident, that— 
‘‘(I) the facility, with the involve-
ment of the prescriber, inform the 
resident (or, if applicable, the resi-
dent’s designated health care agent or 
other surrogate under State law or 
regulation) of— 
‘‘(aa) possible side effects 
and risks associated with the psy-
chotropic drug, including the 
mention of any ‘black box warn-
ing’; 
‘‘(bb) treatment modalities 
that were attempted prior to the 
use of the psychotropic drug; and 
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