ment for an applicant, reasonably relies upon 
information about such applicant provided by 
the criminal background check shall not be lia-
ble in any action brought by such applicant 
based on the employment determination result-
ing from the information. 
‘‘(E) CIVIL PENALTY.— 
‘‘(I) IN GENERAL.—A skilled nursing 
facility that violates the provisions of this 
paragraph shall be subject to a civil pen-
alty in an amount not to exceed— 
‘‘(I) for the first such violation, 
$2,000; and 
‘‘(II) for the second and each 
subsequent violation within any 5-year 
period, $5,000. 
‘‘(ii) KNOWING RETENTION OF WORK-
ER.—In addition to any civil penalty under 
clause (I), a skilled nursing facility that 
knowingly continues to employ a skilled 
nursing facility worker in violation of sub-
paragraph (A) or (B) shall be subject to a 
civil penalty in an amount not to exceed 
$5,000 for the first such violation, and 
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$10,000 for the second and each subse-
quent violation within any 5-year period. 
‘‘(F) DEFINITIONS.—In this paragraph: 
‘‘(I) CONVICTION
FOR
A
RELEVANT 
CRIME.—The term ‘conviction for a rel-
evant crime’ means any Federal or State 
criminal conviction for— 
‘‘(I) any offense described in sec-
tion 1128(a); and 
‘‘(II) such other types of offenses 
as the Secretary may specify in regu-
lations. 
‘‘(ii) DISQUALIFYING INFORMATION.— 
The term ‘disqualifying information’ means 
information about a conviction for a rel-
evant crime or a finding of patient or resi-
dent abuse. 
‘‘(iii) SKILLED
NURSING
FACILITY 
WORKER.—The term ‘skilled nursing facil-
ity worker’ means any individual that has 
direct access to a patient of a skilled nurs-
ing facility under an employment or other 
contract, or both, with such facility. Such 
term includes individuals who are licensed 
or certified by the State to provide long- 
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term care services, and nonlicensed individ-
uals providing such services, as defined by 
the Secretary, including nurse assistants, 
nurse aides, home health aides, and per-
sonal care workers and attendants.’’. 
(2) MEDICAID PROGRAM.—Section 1919(b) of 
the Social Security Act (42 U.S.C. 1396r(b)) is 
amended by adding at the end the following new 
paragraph: 
‘‘(9) SCREENING OF NURSING FACILITY WORK-
ERS.— 
‘‘(A) BACKGROUND
CHECKS
ON
APPLI-
CANTS.—Before hiring a nursing facility work-
er, a nursing facility shall conduct a back-
ground check on the employee in accordance 
with such procedures as the Secretary shall es-
tablish. 
‘‘(B) PROHIBITION ON HIRING OF ABUSIVE 
WORKERS.— 
‘‘(I) IN GENERAL.—Subject to clause 
(ii), a nursing facility may not knowingly 
employ any nursing facility worker who 
has any disqualifying information (as de-
fined in subparagraph (F)(ii)). 
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‘‘(ii) PROVISIONAL EMPLOYMENT.—A 
nursing facility may provide for a provi-
sional period of employment for a nursing 
facility worker pending completion of the 
background check required under subpara-
graph (A). Such facility shall maintain di-
rect supervision of the covered individual 
during the worker’s provisional period of 
employment. 
‘‘(C) PROCEDURES.—The procedures es-
tablished by the Secretary under subparagraph 
(A) shall— 
‘‘(I) provide a process by which a 
nursing facility worker may appeal or dis-
pute the accuracy of the information ob-
tained in a background check conducted 
under this paragraph; 
‘‘(ii) take into account the needs of 
nursing facilities that serve a low volume 
of patients (as determined by the Sec-
retary) with respect to providing super-
vision for provisional employees who are 
awaiting the results of a background check 
conducted under this paragraph; and 
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‘‘(iii) provide for the reimbursement 
of nursing facilities for 100 percent of the 
costs incurred by such facilities in com-
plying with the requirements of this sec-
tion. 
‘‘(D) 
IMMUNITY
FROM
LIABILITY.—A 
nursing facility that, in denying employment for 
an applicant, reasonably relies upon information 
about such applicant provided by the criminal 
background check shall not be liable in any ac-
tion brought by such applicant based on the 
employment determination resulting from the 
information. 
‘‘(E) CIVIL PENALTY.— 
‘‘(I) IN GENERAL.—A nursing facility 
that violates the provisions of this para-
graph shall be subject to a civil penalty in 
an amount not to exceed— 
‘‘(I) for the first such violation, 
$2,000; and 
‘‘(II) for the second and each 
subsequent violation within any 5-year 
period, $5,000. 
‘‘(ii) KNOWING RETENTION OF WORK-
ER.—In addition to any civil penalty under 
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clause (I), a nursing facility that know-
ingly continues to employ a nursing facility 
worker in violation of subparagraph (A) or 
(B) shall be subject to a civil penalty in an 
amount not to exceed $5,000 for the first 
such violation, and $10,000 for the second 
and each subsequent violation within any 
5-year period. 
‘‘(F) DEFINITIONS.—In this paragraph: 
‘‘(I) CONVICTION
FOR
A
RELEVANT 
CRIME.—The term ‘conviction for a rel-
evant crime’ means any Federal or State 
criminal conviction for— 
‘‘(I) any offense described in sec-
tion 1128(a); and 
‘‘(II) such other types of offenses 
as the Secretary may specify in regu-
lations. 
‘‘(ii) DISQUALIFYING INFORMATION.— 
The term ‘disqualifying information’ means 
information about a conviction for a rel-
evant crime or a finding of patient or resi-
dent abuse. 
‘‘(iii) NURSING FACILITY WORKER.— 
The term ‘nursing facility worker’ means 
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any individual that has direct access to a 
patient of a nursing facility under an em-
ployment or other contract, or both, with 
such facility. Such term includes individ-
uals who are licensed or certified by the 
State to provide long-term care services, 
and nonlicensed individuals providing such 
services, as defined by the Secretary, in-
cluding nurse assistants, nurse aides, home 
health aides, and personal care workers 
and attendants.’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection and subsection (a) shall take ef-
fect on the date that is 1 year after the date on 
which the evaluation is completed under subsection 
(d)(1). 
(c) APPLICATION TO OTHER LONG-TERM CARE FA-
CILITIES OR PROVIDERS.— 
(1) MEDICARE.—Part E of title XVIII of the 
Social Security Act (42 U.S.C. 1395x et seq.) is 
amended by adding at the end the following: 
‘‘APPLICATION OF SKILLED NURSING FACILITY PREVEN-
TIVE ABUSE PROVISIONS TO LONG-TERM CARE FA-
CILITIES AND PROVIDERS 
‘‘SEC. 1898. (a) IN GENERAL.—The provisions of 
section 1819(b)(9) shall apply to a long-term care facility 
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or provider (as defined in subsection (b)) in the same man-
ner as such provisions apply to a skilled nursing facility. 
‘‘(b) LONG-TERM CARE FACILITY OR PROVIDER.— 
In this section, the term ‘long-term care facility or pro-
vider’ means the following facilities or providers which re-
ceive payment for services under this title or title XIX: 
‘‘(1) A home health agency. 
‘‘(2) A provider of hospice care. 
‘‘(3) A long-term care hospital. 
‘‘(4) A provider of personal care services. 
‘‘(5) A residential care provider that arranges 
for, or directly provides, long-term care services. 
‘‘(6) An intermediate care facility for the men-
tally retarded (as defined in section 1905(d)).’’. 
(2) MEDICAID.—Section 1902(a) of the Social 
Security Act (42 U.S.C. 1396a) is amended— 
(A) in paragraph (69), by striking ‘‘and’’ 
at the end; 
(B) in paragraph (70), by striking the pe-
riod and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (70) the 
following: 
‘‘(71) provide that the provisions of section 
1919(b)(9) apply to a long-term care facility or pro-
vider (as defined in section 1898(b)) in the same 
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