consistency of the survey process within 
and across states. Such report shall in-
clude data that assesses the consistency of 
the survey process. Such report also shall 
provide a summary of the status of appeals 
process, including data that assesses the 
timeliness of the resolution of disputes.’’. 
(2) MEDICAID.—Section 1919(g)(2) of the So-
cial Security Act (42 U.S.C. 1396r(g)(2)) is amend-
ed by striking subparagraph (D) and inserting the 
following: 
‘‘(D) CONSISTENCY OF SURVEYS.— 
‘‘(i) IN GENERAL.—Each State shall 
implement programs to measure and re-
duce inconsistency in the application of 
survey results (including the results of 
both health surveys and life safety surveys) 
among surveyors. 
‘‘(ii) SECRETARY
PROVIDES
OVER-
SIGHT.—The Secretary shall take such ac-
tions as necessary to assure that there is 
consistent application, both within States 
and across States, of the survey process 
under this subsection (including the proc-
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ess for both health surveys and life safety 
surveys). 
‘‘(iii) APPEALS.—The Secretary will 
assure that there is a fair and timely ap-
peals process for surveys under this sub-
section (including both health surveys and 
life safety surveys) in which each State of-
fice and regional office provides a timely 
resolution of disputes. 
‘‘(iv) REPORT.—The Secretary shall 
report to the Congress annually, by Octo-
ber 30, on the actions taken to ensure the 
consistency of the survey process within 
and across states. Such report shall in-
clude data that assesses the consistency of 
the survey process. Such report also shall 
provide a summary of the status of appeals 
process, including data that assesses the 
timeliness of the resolution of disputes.’’. 
(e) CIRCUMSTANCES FOR SPECIAL SURVEYS OF COM-
PLIANCE.— 
(1) MEDICARE.—Section 1819(g)(3)(D) of the 
Social Security Act (42 U.S.C. 1395i–3(g)(3)(D)) is 
amended by striking subparagraph (D) and inserting 
the following: 
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(A) By inserting ‘‘(I) IN GENERAL.—’’ be-
fore ‘‘Where the Secretary has’’ and adjusting 
the indentation appropriately. 
(B) By adding at the end the following 
new subclause: 
‘‘(II) CIRCUMSTANCES FOR SPE-
CIAL SURVEYS.—The Secretary shall 
conduct a survey under subclause (I) 
of a skilled nursing facility if, with re-
spect to such facility, any of the fol-
lowing events occurs: 
‘‘(aa) A complaint is made 
by a resident or family member 
of a resident of such facility. 
‘‘(bb) The skilled nursing fa-
cility self-reports a reportable in-
cident to the State agency re-
sponsible for surveys and certifi-
cations under this subsection. 
‘‘(cc) A quarterly review of 
quality indicator data from such 
facility suggests a potential prob-
lem at such facility.’’. 
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(2) MEDICAID.—Section 1919(g)(3)(D) of the 
Social Security Act (42 U.S.C. 1396r(g)(3)(D)) is 
amended— 
(A) by inserting ‘‘(I) IN GENERAL.—’’ be-
fore ‘‘Where the Secretary has’’ and adjusting 
the indentation appropriately; and 
(B) by adding at the end the following new 
subclause: 
‘‘(II) CIRCUMSTANCES FOR SPE-
CIAL SURVEYS.—The Secretary shall 
conduct a survey under subclause (I) 
of a nursing facility if, with respect to 
such facility, any of the following 
events occurs: 
‘‘(aa) A complaint is made 
by a resident or family member 
of a resident of such facility. 
‘‘(bb) The nursing facility 
self-reports a reportable incident 
to the State agency responsible 
for surveys and certifications 
under this subsection. 
‘‘(cc) A quarterly review of 
quality indicator data from such 
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facility suggests a potential prob-
lem at such facility.’’. 
(f) NOTICE TO FACILITIES AND THE PUBLIC.— 
(1) MEDICARE.—Section 1819(g)(5) of the So-
cial Security Act (42 U.S.C. 1395i–3(g)(5)) is 
amended— 
(A) in subparagraph (A)(i), by striking 
‘‘statements of deficiencies’’ and inserting ‘‘re-
ports of surveys under subparagraph (F)’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(F) NOTICE TO FACILITY.—A written re-
port of the survey must be given to the skilled 
nursing facility within 15 calendar days fol-
lowing the date the survey team exited the facil-
ity. The report of the survey must include all 
the positive aspects of care and facility life as 
well as the aspects of care that may need im-
provement.’’. 
(2) MEDICAID.—Section 1919(g)(5) of the So-
cial Security Act (42 U.S.C. 1396r(g)(5)) is amend-
ed— 
(A) in subparagraph (A)(i), by striking 
‘‘statements of deficiencies’’ and inserting ‘‘re-
ports of surveys under subparagraph (F)’’; and 
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(B) by adding at the end the following new 
subparagraph: 
‘‘(F) NOTICE TO FACILITY.—A written re-
port of the survey must be given to the nursing 
facility within 15 calendar days following the 
date the survey team exited the facility. The re-
port of the survey must include all the positive 
aspects of care and facility life as well as the 
aspects of care that may need improvement.’’. 
(g) TREATMENT OF FUNDS COLLECTED FROM CIVIL 
MONETARY PENALTIES.— 
(1) MEDICARE.—Section 1819(h)(2)(A) of the 
Social Security Act (42 U.S.C. 1395i–3(h)(2)(A)) is 
amended by adding at the end (in the flush matter 
following clause (ii)) the following sentence: ‘‘Not-
withstanding the previous sentence, any funds col-
lected by a State as a result of the imposition of 
such a penalty (or as a result of the imposition by 
the State of a civil money penalty for activities de-
scribed 
in 
subsections 
(b)(3)(B)(ii)(I), 
(b)(3)(B)(ii)(II), or (g)(2)(A)(i)) shall be used for 
development of acuity adjusters that will provide 
more accurate information to the public, skilled 
nursing facilities, and the residents of such facilities, 
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about the quality of care that is provided by each 
such facility.’’. 
(2) MEDICAID.—Section 1919(h)(2)(A)(ii) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396r(h)(2)(A)(ii)) is amended by adding at the end 
(in the flush matter following clause (ii)) the fol-
lowing sentence: ‘‘Notwithstanding the previous sen-
tence, any funds collected by a State as a result of 
the imposition of such a penalty (or as a result of 
the imposition by the State of a civil money penalty 
for 
activities 
described 
in 
subsections 
(b)(3)(B)(ii)(I), (b)(3)(B)(ii)(II), or (g)(2)(A)(i)) 
shall be used for development of acuity adjusters 
that will provide more accurate information to the 
public, nursing facilities, and the residents of such 
facilities, about the quality of care that is provided 
by each such facility.’’. 
Æ 
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