I 
116TH CONGRESS 
2D SESSION 
H. R. 5681 
To amend the Public Health Service Act to require hospitals to submit 
notice to the Secretary of Health and Human Services before closing 
all or certain units or departments, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 27, 2020 
Mr. BRENDAN F. BOYLE of Pennsylvania introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to require hospitals 
to submit notice to the Secretary of Health and Human 
Services before closing all or certain units or depart-
ments, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Protecting Commu-
nities from Hospital Closures Act of 2020’’. 
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SEC. 2. HOSPITAL CLOSINGS. 
(a) IN GENERAL.—Part C of title III of the Public 
Health Service Act (42 U.S.C. 248 et seq.) is amended 
by adding at the end the following: 
‘‘SEC. 327B. HOSPITAL CLOSINGS. 
‘‘(a) NOTICE REQUIREMENT.— 
‘‘(1) REQUIREMENT.—A hospital shall provide 
written notice to the Secretary of a determination— 
‘‘(A) to close all or most of its units or de-
partments (in this section referred to as a ‘gen-
eral hospital closing’); or 
‘‘(B) to close an emergency treatment unit 
or department, a labor and delivery unit or de-
partment, or any other type of unit or depart-
ment that the Secretary determines, by regula-
tion, might significantly impact the health and 
welfare of an affected community such that ad-
vanced notice and planning is warranted (in 
this section referred to as a ‘significant impact 
unit closing’). 
‘‘(2) TIMING.—A hospital shall give notice re-
quired by paragraph (1)— 
‘‘(A) upon making a determination to close 
described in such paragraph; and 
‘‘(B) in no event less than 180 days from 
the anticipated date of the closing. 
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‘‘(b) PROHIBITION AGAINST CLOSING EXCEPT PUR-
SUANT TO CLOSURE PLAN.— 
‘‘(1) PROHIBITION.—A hospital shall not close 
any unit or department as part of a general hospital 
closing or a significant impact unit closing except 
pursuant to a written closure plan that has been ap-
proved by the Secretary with respect to such unit or 
department. 
‘‘(2) APPROVAL
STANDARD.—The Secretary 
shall approve a closure plan with respect to the clos-
ing of a unit or department only if the Secretary de-
termines that the closure plan adequately address-
es— 
‘‘(A) continuity of patient care; and 
‘‘(B) the health and safety needs of the 
community served by the unit or department. 
‘‘(3) MODIFICATION.—The Secretary may con-
dition approval under paragraph (2) on the agree-
ment by the hospital to modify the closure plan to 
include such conditions as the Secretary determines 
to be necessary meet the approval standard of para-
graph (2). 
‘‘(4) NOTIFICATION TO CONGRESS.—The Sec-
retary shall promptly provide written notice to the 
Congress upon receiving, approving, rejecting, or re-
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quiring a modification to a closure plan under this 
section. 
‘‘(c) CLOSURE PLANS.— 
‘‘(1) INITIAL CLOSURE PLAN.—A hospital seek-
ing to carry out a general hospital closing or a sig-
nificant impact unit closing shall submit to the Sec-
retary— 
‘‘(A) not later than 120 days before the 
anticipated date of the closing, an initial closure 
plan; and 
‘‘(B) not less than every 2 weeks there-
after, through the completion of the proposed 
closing, updates on the progress of the hospital 
in— 
‘‘(i) finalizing the closure plan; and 
‘‘(ii) implementing the closing. 
‘‘(2) MEETINGS, 
DISCUSSIONS, 
AND
DOCU-
MENTS.—Upon receipt of a closure plan from a hos-
pital, the Secretary may, for the purpose of evalu-
ating the proposed plan and overseeing the imple-
mentation of the plan, require— 
‘‘(A) attendance at meetings, and involve-
ment in discussions, by executive staff and ad-
ministrators of the hospital; and 
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‘‘(B) provision by the hospital to the Sec-
retary of relevant information and documents. 
‘‘(3) CONTENTS OF CLOSURE PLAN.—A closure 
plan under this section shall address the following: 
‘‘(A) The reasons for the closing. 
‘‘(B) Any plans for the closing of all major 
departments and units of the hospital, including 
with respect to— 
‘‘(i) continuity of patient care in each 
department and unit; and 
‘‘(ii) the transfer of patients to other 
facilities. 
‘‘(C) Plans with respect to specialized pro-
grams or groups of patients particularly vulner-
able to interruptions in medical care, such as 
cancer chemotherapy or prenatal care. 
‘‘(D) Any plans for the closure of an emer-
gency department, including diversion to other 
hospital emergency departments and the inter-
face with emergency medical services. 
‘‘(E) Written agreements with other health 
care providers to accept responsibility for con-
tinuing the care of patients receiving ongoing 
care at the hospital. 
‘‘(F) Plans for— 
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‘‘(i) how all medical records (including 
paper and electronic records) will be main-
tained throughout and after the closing; 
and 
‘‘(ii) how those medical records will be 
made available to former patients and the 
physicians who provide care for such pa-
tients. 
‘‘(G) Plans for the maintenance, transfer, 
and disposal of pharmaceuticals, chemicals, haz-
ardous substances, and other similar materials 
located at the unit or department subject to the 
closing. 
‘‘(H) The anticipated timeline for closing 
the units or departments subject to the closing. 
‘‘(I) A communications and engagement 
plan with respect to the affected community, in-
cluding plans for a public meeting to be held in 
the affected community. 
‘‘(J) Changes in the hospital’s governing 
body, administration, and medical staff leader-
ship as the closure is implemented. 
‘‘(K) A plan regarding the hospital’s ef-
forts to assist affected workers and students 
with— 
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‘‘(i) finding suitable employment and 
educational opportunities; and 
‘‘(ii) continuation of insurance. 
‘‘(L) Plans to address the effects on bar-
gaining for represented employees. 
‘‘(M) An assurance that existing agree-
ments between the hospital and its employees, 
and agreements subject to collective bargaining 
with an organization that represents hospital 
employees, will be honored. 
‘‘(N) Plans with respect to maintaining on-
going hospital security. 
‘‘(O) Plans for supervising compliance 
with, and updates of, the closure plan. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed as creating obligations for the Fed-
eral Government to relieve, discharge, perform, indemnify, 
or assume liability for any obligation or responsibility of 
a hospital or any of its officers, directors, or affiliates. 
‘‘(e) VIOLATIONS.— 
‘‘(1) DETERMINATION OF VIOLATION.—If the 
Secretary determines that a hospital has violated or 
is violating any provision of this section, the Sec-
retary may institute an action in a Federal court of 
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