1580 
‘CERTF’) under section 9511 of the Internal Revenue 
Code of 1986 shall be available, without the need for fur-
ther appropriations and without fiscal year limitation, to 
the Secretary to carry out this section. 
‘‘(h) CONSTRUCTION.—Nothing in this section shall 
be construed to permit the Commission or the Center to 
mandate coverage, reimbursement, or other policies for 
any public or private payer.’’. 
(b) 
COMPARATIVE
EFFECTIVENESS
RESEARCH 
TRUST FUND; FINANCING FOR THE TRUST FUND.—For 
provision establishing a Comparative Effectiveness Re-
search Trust Fund and financing such Trust Fund, see 
section 1802. 
Subtitle B—Nursing Home 
Transparency 
PART 1—IMPROVING TRANSPARENCY OF INFOR-
MATION ON SKILLED NURSING FACILITIES 
AND NURSING FACILITIES 
SEC. 1411. REQUIRED DISCLOSURE OF OWNERSHIP AND 
ADDITIONAL DISCLOSABLE PARTIES INFOR-
MATION. 
(a) IN GENERAL.—Section 1124 of the Social Secu-
rity Act (42 U.S.C. 1320a–3) is amended by adding at 
the end the following new subsection: 
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‘‘(c) REQUIRED DISCLOSURE OF OWNERSHIP AND 
ADDITIONAL DISCLOSABLE PARTIES INFORMATION.— 
‘‘(1) DISCLOSURE.—A facility (as defined in 
paragraph (7)(B)) shall have the information de-
scribed in paragraph (3) available— 
‘‘(A) during the period beginning on the 
date of the enactment of this subsection and 
ending on the date such information is made 
available to the public under section 1411(b) of 
the America’s Affordable Health Choices Act of 
2009, for submission to the Secretary, the In-
spector General of the Department of Health 
and Human Services, the State in which the fa-
cility is located, and the State long-term care 
ombudsman in the case where the Secretary, 
the Inspector General, the State, or the State 
long-term care ombudsman requests such infor-
mation; and 
‘‘(B) beginning on the effective date of the 
final regulations promulgated under paragraph 
(4)(A), for reporting such information in ac-
cordance with such final regulations. 
Nothing in subparagraph (A) shall be construed as 
authorizing a facility to dispose of or delete informa-
tion described in such subparagraph after the effec-
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tive date of the final regulations promulgated under 
paragraph (4)(A). 
‘‘(2) PUBLIC AVAILABILITY OF INFORMATION.— 
During the period described in paragraph (1)(A), a 
facility shall— 
‘‘(A) make the information described in 
paragraph (3) available to the public upon re-
quest and update such information as may be 
necessary to reflect changes in such informa-
tion; and 
‘‘(B) post a notice of the availability of 
such information in the lobby of the facility in 
a prominent manner. 
‘‘(3) INFORMATION DESCRIBED.— 
‘‘(A) IN GENERAL.—The following infor-
mation is described in this paragraph: 
‘‘(i) The information described in sub-
sections (a) and (b), subject to subpara-
graph (C). 
‘‘(ii) The identity of and information 
on— 
‘‘(I) each member of the gov-
erning body of the facility, including 
the name, title, and period of service 
of each such member; 
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‘‘(II) each person or entity who is 
an officer, director, member, partner, 
trustee, or managing employee of the 
facility, including the name, title, and 
date of start of service of each such 
person or entity; and 
‘‘(III) each person or entity who 
is an additional disclosable party of 
the facility. 
‘‘(iii) The organizational structure of 
each person and entity described in sub-
clauses (II) and (III) of clause (ii) and a 
description of the relationship of each such 
person or entity to the facility and to one 
another. 
‘‘(B) SPECIAL RULE WHERE INFORMATION 
IS
ALREADY
REPORTED
OR
SUBMITTED.—To 
the extent that information reported by a facil-
ity to the Internal Revenue Service on Form 
990, information submitted by a facility to the 
Securities and Exchange Commission, or infor-
mation otherwise submitted to the Secretary or 
any other Federal agency contains the informa-
tion described in clauses (i), (ii), or (iii) of sub-
paragraph (A), the Secretary may allow, to the 
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extent practicable, such Form or such informa-
tion to meet the requirements of paragraph (1) 
and to be submitted in a manner specified by 
the Secretary. 
‘‘(C) SPECIAL
RULE.—In applying sub-
paragraph (A)(i)— 
‘‘(i) with respect to subsections (a) 
and (b), ‘ownership or control interest’ 
shall include direct or indirect interests, in-
cluding such interests in intermediate enti-
ties; and 
‘‘(ii) subsection (a)(3)(A)(ii) shall in-
clude the owner of a whole or part interest 
in any mortgage, deed of trust, note, or 
other obligation secured, in whole or in 
part, by the entity or any of the property 
or assets thereof, if the interest is equal to 
or exceeds 5 percent of the total property 
or assets of the entirety. 
‘‘(4) REPORTING.— 
‘‘(A) IN
GENERAL.—Not later than the 
date that is 2 years after the date of the enact-
ment of this subsection, the Secretary shall pro-
mulgate regulations requiring, effective on the 
date that is 90 days after the date on which 
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such final regulations are published in the Fed-
eral Register, a facility to report the informa-
tion described in paragraph (3) to the Secretary 
in a standardized format, and such other regu-
lations as are necessary to carry out this sub-
section. Such final regulations shall ensure that 
the facility certifies, as a condition of participa-
tion and payment under the program under 
title XVIII or XIX, that the information re-
ported by the facility in accordance with such 
final regulations is accurate and current. 
‘‘(B) GUIDANCE.—The Secretary shall pro-
vide guidance and technical assistance to States 
on how to adopt the standardized format under 
subparagraph (A). 
‘‘(5) NO EFFECT ON EXISTING REPORTING RE-
QUIREMENTS.—Nothing in this subsection shall re-
duce, diminish, or alter any reporting requirement 
for a facility that is in effect as of the date of the 
enactment of this subsection. 
‘‘(6) DEFINITIONS.—In this subsection: 
‘‘(A) ADDITIONAL DISCLOSABLE PARTY.— 
The term ‘additional disclosable party’ means, 
with respect to a facility, any person or entity 
who— 
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ership interest in the limited partnership 
which is equal to or exceeds 10 percent; 
‘‘(v) a trust, the trustees of the trust; 
‘‘(vi) an individual, contact informa-
tion for the individual; and 
‘‘(vii) any other person or entity, such 
information as the Secretary determines 
appropriate.’’. 
(b) PUBLIC AVAILABILITY OF INFORMATION.— 
(1) IN GENERAL.—Not later than the date that 
is 1 year after the date on which the final regula-
tions promulgated under section 1124(c)(4)(A) of 
the Social Security Act, as added by subsection (a), 
are published in the Federal Register, the informa-
tion reported in accordance with such final regula-
tions shall be made available to the public in accord-
ance with procedures established by the Secretary. 
(2) DEFINITIONS.—In this subsection: 
(A) NURSING FACILITY.—The term ‘‘nurs-
ing facility’’ has the meaning given such term 
in section 1919(a) of the Social Security Act 
(42 U.S.C. 1396r(a)). 
(B) SECRETARY.—The term ‘‘Secretary’’ 
means the Secretary of Health and Human 
Services. 
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(C) SKILLED
NURSING
FACILITY.—The 
term ‘‘skilled nursing facility’’ has the meaning 
given such term in section 1819(a) of the Social 
Security Act (42 U.S.C. 1395i–3(a)). 
(c) CONFORMING AMENDMENTS.— 
(1) SKILLED
NURSING
FACILITIES.—Section 
1819(d)(1) of the Social Security Act (42 U.S.C. 
1395i–3(d)(1)) is amended by striking subparagraph 
(B) and redesignating subparagraph (C) as subpara-
graph (B). 
(2) NURSING FACILITIES.—Section 1919(d)(1) 
of the Social Security Act (42 U.S.C. 1396r(d)(1)) 
is amended by striking subparagraph (B) and redes-
ignating subparagraph (C) as subparagraph (B). 
SEC. 1412. ACCOUNTABILITY REQUIREMENTS. 
(a) EFFECTIVE COMPLIANCE
AND ETHICS PRO-
GRAMS.— 
(1) SKILLED
NURSING
FACILITIES.—Section 
1819(d)(1) of the Social Security Act (42 U.S.C. 
1395i–3(d)(1)), as amended by section 1411(c)(1), 
is amended by adding at the end the following new 
subparagraph: 
‘‘(C) COMPLIANCE
AND
ETHICS
PRO-
GRAMS.— 
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‘‘(i) REQUIREMENT.—On or after the 
date that is 36 months after the date of 
the enactment of this subparagraph, a 
skilled nursing facility shall, with respect 
to the entity that operates the facility (in 
this subparagraph referred to as the ‘oper-
ating organization’ or ‘organization’), have 
in operation a compliance and ethics pro-
gram that is effective in preventing and de-
tecting criminal, civil, and administrative 
violations under this Act and in promoting 
quality of care consistent with regulations 
developed under clause (ii). 
‘‘(ii) 
DEVELOPMENT
OF
REGULA-
TIONS.— 
‘‘(I) IN
GENERAL.—Not later 
than the date that is 2 years after 
such date of the enactment, the Sec-
retary, in consultation with the In-
spector General of the Department of 
Health and Human Services, shall 
promulgate regulations for an effec-
tive compliance and ethics program 
for operating organizations, which 
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may include a model compliance pro-
gram. 
‘‘(II) 
DESIGN
OF
REGULA-
TIONS.—Such regulations with respect 
to specific elements or formality of a 
program may vary with the size of the 
organization, such that larger organi-
zations should have a more formal 
and rigorous program and include es-
tablished written policies defining the 
standards and procedures to be fol-
lowed by its employees. Such require-
ments shall specifically apply to the 
corporate level management of multi- 
unit nursing home chains. 
‘‘(III) EVALUATION.—Not later 
than 3 years after the date of promul-
gation 
of 
regulations 
under 
this 
clause, the Secretary shall complete 
an evaluation of the compliance and 
ethics programs required to be estab-
lished under this subparagraph. Such 
evaluation shall determine if such pro-
grams led to changes in deficiency ci-
tations, changes in quality perform-
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ance, or changes in other metrics of 
resident quality of care. The Secretary 
shall submit to Congress a report on 
such evaluation and shall include in 
such report such recommendations re-
garding changes in the requirements 
for such programs as the Secretary 
determines appropriate. 
‘‘(iii) REQUIREMENTS
FOR
COMPLI-
ANCE
AND
ETHICS
PROGRAMS.—In this 
subparagraph, the term ‘compliance and 
ethics program’ means, with respect to a 
skilled nursing facility, a program of the 
operating organization that— 
‘‘(I) has been reasonably de-
signed, implemented, and enforced so 
that it generally will be effective in 
preventing and detecting criminal, 
civil, and administrative violations 
under this Act and in promoting qual-
ity of care; and 
‘‘(II) includes at least the re-
quired components specified in clause 
(iv). 
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‘‘(iv) REQUIRED
COMPONENTS
OF 
PROGRAM.—The required components of a 
compliance and ethics program of an orga-
nization are the following: 
‘‘(I) The organization must have 
established compliance standards and 
procedures to be followed by its em-
ployees, contractors, and other agents 
that are reasonably capable of reduc-
ing the prospect of criminal, civil, and 
administrative violations under this 
Act. 
‘‘(II) Specific individuals within 
high-level personnel of the organiza-
tion must have been assigned overall 
responsibility to oversee compliance 
with such standards and procedures 
and have sufficient resources and au-
thority to assure such compliance. 
‘‘(III) The organization must 
have used due care not to delegate 
substantial discretionary authority to 
individuals whom the organization 
knew, or should have known through 
the exercise of due diligence, had a 
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