I 
116TH CONGRESS 
2D SESSION 
H. R. 6698 
To amend titles XVIII and XIX of the Social Security Act to improve 
the quality of care in skilled nursing facilities under the Medicare pro-
gram and nursing facilities under the Medicare program during the 
COVID–19 emergency period, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 5, 2020 
Ms. SCHAKOWSKY (for herself, Ms. MATSUI, Ms. ROYBAL-ALLARD, Mrs. DIN-
GELL, Ms. PRESSLEY, and Mr. DEUTCH) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addi-
tion to the Committee on Energy and Commerce, for a period to be sub-
sequently 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 improve the quality of care in skilled nursing facilities 
under the Medicare program and nursing facilities under 
the Medicare program during the COVID–19 emergency 
period, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Quality Care for Nurs-
ing Home Residents and Workers During COVID–19 Act 
of 2020’’. 
SEC. 2. IMPROVING QUALITY OF CARE IN SKILLED NURS-
ING FACILITIES AND NURSING FACILITIES 
DURING COVID–19 EMERGENCY PERIOD. 
(a) MEDICARE.—Section 1819 of the Social Security 
Act (42 U.S.C. 1395i–3) is amended by adding at the end 
the following new subsection: 
‘‘(k) ADDITIONAL REQUIREMENTS DURING CERTAIN 
PUBLIC HEALTH EMERGENCY.— 
‘‘(1) SKILLED NURSING FACILITIES.— 
‘‘(A) IN GENERAL.—During the portion of 
the emergency period defined in paragraph 
(1)(B) of section 1135(g) beginning on or after 
the date of the enactment of this subsection, a 
skilled nursing facility shall comply with the 
quality of care requirements described in sub-
paragraph (B), the worker safety requirements 
described in subparagraph (C), and the trans-
parency requirements described in subpara-
graph (D). 
‘‘(B) QUALITY OF CARE REQUIREMENTS.— 
The quality of care requirements described in 
this subparagraph are each of the following: 
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‘‘(i) Employ, on a full-time basis, an 
infection preventionist who— 
‘‘(I) has primary professional 
training in nursing, medical tech-
nology, microbiology, epidemiology, or 
other related field; 
‘‘(II) is qualified by education, 
training, experience or certification; 
and 
‘‘(III) has completed specialized 
training in infection prevention and 
control. 
‘‘(ii) In the case of a resident who 
elects to reside with a family member of 
such resident for any portion of the emer-
gency period described in subparagraph 
(A), guarantee the right of such resident to 
resume residency in the facility at any time 
during the 180-day period immediately fol-
lowing the end of such emergency period. 
‘‘(iii) Notwithstanding subparagraphs 
(A) and (B) of subsection (c)(2), permit a 
resident to remain in the facility and not 
discharge or transfer the resident from the 
facility unless— 
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‘‘(I) the State survey agency ap-
proves the discharge or transfer; 
‘‘(II) in the case of a transfer, 
the transfer is to a facility dedicated 
to the care of residents who have been 
diagnosed with COVID–19 if the resi-
dent 
has 
been 
diagnosed 
with 
COVID–19, or a facility dedicated to 
the care of residents who have not 
been diagnosed with COVID–19 if the 
resident has not been diagnosed with 
COVID–19; 
‘‘(III) before effecting the dis-
charge or transfer, the facility records 
the reasons in the resident’s clinical 
record; 
‘‘(IV) at least 72 hours in ad-
vance of the discharge or transfer, the 
facility provides a notice of the dis-
charge or transfer to the resident (or 
legal representative of the resident, if 
applicable), 
including 
the 
reasons 
therefor and the items described in 
clause (iii) of subsection (c)(2)(B); 
and 
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‘‘(V) the resident (or legal rep-
resentative of the resident, if applica-
ble) acknowledges receipt of the notice 
described in subclause (IV) and pro-
vides written consent to the discharge 
or transfer. 
‘‘(iv) Test (on a weekly basis) each 
resident for COVID–19, or, in the case 
that the facility does not have a sufficient 
number of testing kits for COVID–19, 
screen each resident for symptoms of 
COVID–19 and report (on a daily basis 
until the facility has a sufficient number of 
such testing kits) to the State survey agen-
cy that the facility does not have a suffi-
cient number of such testing kits and what 
steps the facility is taking to procure a suf-
ficient number of such testing kits. 
‘‘(v) Ensure there is an adequate 
number of employees to assist residents in 
communicating with family members and 
friends through phone calls, e-mail, and 
virtual communications on at least a week-
ly basis, without regard to whether a resi-
dent has been diagnosed with COVID–19. 
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‘‘(C) WORKER SAFETY REQUIREMENTS.— 
The worker safety requirements described in 
this subparagraph are each of the following: 
‘‘(i) In the case the facility is not oth-
erwise subject to the Occupational Safety 
and Health Act of 1970 (or a State occu-
pational safety and health plan that is ap-
proved under section 18(c) of such Act), 
comply with the Bloodborne Pathogens 
standard under section 1910.1030 of title 
29, Code of Federal Regulations (or a suc-
cessor regulation). 
‘‘(ii) In the case of a predicted short-
age of personal protective equipment, re-
port such predicted shortage to the State 
health department of the State in which 
the facility is located at least 24 hours in 
advance of when such predicted shortage is 
expected to occur. 
‘‘(iii) Educate each employee on the 
transmission of COVID–19. 
‘‘(iv) Notwithstanding any other pro-
vision of law, provide at least two weeks of 
paid sick leave to each employee. 
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‘‘(v) Before each employee’s shift, test 
the employee for COVID–19, or, in the 
case that the facility does not have a suffi-
cient number of testing kits for COVID– 
19, screen each employee for symptoms of 
COVID–19 and report (on a daily basis 
until the facility has a sufficient number of 
such testing kits) to the State survey agen-
cy that the facility does not have a suffi-
cient number of such testing kits and what 
steps the facility is taking to procure a suf-
ficient number of such testing kits. 
‘‘(D) TRANSPARENCY
REQUIREMENTS.— 
The transparency requirements described in 
this subparagraph are each of the following: 
‘‘(i) Report (on a daily basis) to the 
State survey agency, the Centers for Medi-
care & Medicaid Services, and the Centers 
for Disease Control and Prevention each of 
the following: 
‘‘(I) The number of confirmed 
and 
suspected 
cases 
COVID–19 
among residents and staff, including 
the age and race or ethnicity of such 
residents and staff. 
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