I 
110TH CONGRESS 
1ST SESSION H. R. 1476 
To amend titles XVIII and XIX of the Social Security Act to expand the 
nursing home patients’ bill of rights to include the right to receive 
care from a credible caregiver by requiring background checks on direct 
access employees and the right to a safe environment during an emer-
gency or natural disaster by requiring nursing long-term care facilities 
to establish disaster emergency and evacuation plans. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 12, 2007 
Ms. GINNY BROWN-WAITE of Florida (for herself, Mr. KIRK, Mr. FEENEY, 
Mr. BOUSTANY, Mr. SHAYS, Mrs. BIGGERT, Mrs. MILLER of Michigan, 
Mr. PORTER, Mr. GINGREY, Mr. CHABOT, Mr. GILCHREST, Mr. BART-
LETT of Maryland, Mr. UPTON, and Mr. ROSKAM) introduced the fol-
lowing bill; which was referred to the Committee on Ways and Means, 
and in addition to the Committee on Energy and Commerce, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation 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 expand the nursing home patients’ bill of rights to 
include the right to receive care from a credible caregiver 
by requiring background checks on direct access employ-
ees and the right to a safe environment during an emer-
gency or natural disaster by requiring nursing long-term 
care facilities to establish disaster emergency and evacu-
ation plans. 
VerDate Aug 31 2005 
19:47 Mar 16, 2007
Jkt 059200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6652
E:\BILLS\H1476.IH
H1476
ycherry on PROD1PC64 with BILLS
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 ‘‘Senior Safety and Dig-
nity Act of 2007’’. 
SEC. 2. SECURING RIGHT TO RECEIVE CARE FROM A CRED-
IBLE CAREGIVER BY REQUIRING PERFORM-
ANCE OF BACKGROUND CHECKS ON DIRECT 
ACCESS EMPLOYEES OF LONG-TERM CARE 
FACILITIES OR PROVIDERS. 
(a) ADDITION TO NURSING HOME PATIENTS’ BILL 
OF RIGHTS OF RIGHT TO RECEIVE CARE FROM A CRED-
IBLE
CAREGIVER.—Sections 
1819(c)(1)(A) 
and 
1919(c)(1)(A) of the Social Security Act (42 U.S.C. 
1395i–3(c)(1)(A), 1396r(c)(1)(A)) are each amended— 
(1) by redesignating clause (xi) as clause (xiii); 
and 
(2) by inserting after clause (x) the following 
new clause: 
‘‘(xi) RECEIPT OF CARE FROM CRED-
IBLE
CAREGIVER.—The right to receive 
care from a credible caregiver.’’. 
(b) SCREENING OF SKILLED NURSING FACILITY AND 
NURSING FACILITY EMPLOYEE APPLICANTS.— 
VerDate Aug 31 2005 
19:47 Mar 16, 2007
Jkt 059200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H1476.IH
H1476
ycherry on PROD1PC64 with BILLS
(1) MEDICARE PROGRAM.—Section 1819(b) of 
the Social Security Act (42 U.S.C. 1395i–3(b)) is 
amended by adding at the end the following: 
‘‘(9) SCREENING OF SKILLED NURSING FACIL-
ITY WORKERS.— 
‘‘(A) BACKGROUND
CHECKS
ON
APPLI-
CANTS.—Before hiring a skilled nursing facility 
worker, a skilled nursing facility shall conduct 
a background check on the employee in accord-
ance with such procedures as the Secretary 
shall establish. 
‘‘(B) PROHIBITION ON HIRING OF ABUSIVE 
WORKERS.— 
‘‘(I) IN GENERAL.—Subject to clause 
(ii), a skilled nursing facility may not 
knowingly employ any skilled nursing facil-
ity worker who has any disqualifying infor-
mation 
(as 
defined 
in 
subparagraph 
(F)(ii)). 
‘‘(ii) PROVISIONAL EMPLOYMENT.—A 
skilled nursing facility may provide for a 
provisional period of employment for a 
skilled nursing facility worker pending 
completion of the background check re-
quired under subparagraph (A). Such facil-
VerDate Aug 31 2005 
19:47 Mar 16, 2007
Jkt 059200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H1476.IH
H1476
ycherry on PROD1PC64 with BILLS
ity shall maintain direct supervision of the 
covered individual during the worker’s pro-
visional period of employment. 
‘‘(C) PROCEDURES.—The procedures es-
tablished by the Secretary under subparagraph 
(A) shall— 
‘‘(I) provide a process by which a 
skilled nursing facility worker may appeal 
or dispute the accuracy of the information 
obtained in a background check conducted 
under this paragraph; 
‘‘(ii) take into account the needs of 
skilled nursing facilities that serve a low 
volume of patients (as determined by the 
Secretary) with respect to providing super-
vision for provisional employees who are 
awaiting the results of a background check 
conducted under this paragraph; and 
‘‘(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 
skilled nursing facility that, in denying employ-
VerDate Aug 31 2005 
19:47 Mar 16, 2007
Jkt 059200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H1476.IH
H1476
ycherry on PROD1PC64 with BILLS