142
National Association of Attorneys General (NAAG) 
or other similarly situated entity. 
SEC. 208. SUPPORTING FEDERAL CASES INVOLVING ELDER 
JUSTICE. 
(a) SUPPORT AND ASSISTANCE.—
(1) IN GENERAL.—The Attorney General shall 
support cases relating to elder justice. 
(2) ADDITIONAL STAFF.—The Attorney General 
shall have additional Federal prosecutors and make 
funding available to Federal prosecutors to hire 
nurse-investigators or other experts needed to iden-
tify, assist with, or pursue cases relating to elder 
justice. 
(3) RESOURCE GROUP.—The Attorney General 
may fund through the Executive Office of United 
States Attorneys for a Resource Group to assist 
prosecutors throughout the Nation in pursuing fail-
ure of care and other cases relating to elder justice 
matters. 
(b) OFFICE OF INSPECTOR GENERAL.—The Office of 
Inspector General of the Department of Health and 
Human Services shall hire nurse investigators and other 
experts to investigate and pursue failure of care allega-
tions.
143
SEC. 209. COMMUNITY POLICING. 
(a) GRANT AUTHORIZED.—The Attorney General, 
after consultation with the Secretary of the Department 
of Health and Human Services, shall establish a grant 
program to develop community policing and other law en-
forcement efforts to make communities safer for elders liv-
ing in all settings. 
(b) SPECIAL ELDER UNITS.—The Attorney General, 
after consultation with the Secretary of Health and 
Human Services, shall establish a grant program to sup-
port—
(1) special elder units and officers; 
(2) in rural areas with fewer law enforcement 
personnel, a specially trained elder officer; 
(3) programs, including the Alzheimer Associa-
tion’s ‘‘Safe Return Program’’ or other similar pro-
gram; and 
(4) training, technical assistance, policy devel-
opment, multidisciplinary coordination, and other 
support and programs relating to elder justice. 
SEC. 210. SUPPORTING LAW ENFORCEMENT IN ELDER JUS-
TICE MATTERS. 
The Attorney General shall, after consultation with 
the Secretary of Health and Human Services, award 
grants to provide training, technical assistance, multidisci-
plinary coordination, policy development, and other types
144
of support to police, sheriffs, detectives, public safety offi-
cers, corrections personnel, and other front line law en-
forcement responders who handle elder justice-related 
matters, to fund specially designated elder justice posi-
tions or units, designed to support front line law enforce-
ment in elder justice matters. 
SEC. 211. EVALUATIONS. 
(a) GRANTS.—
(1) IN GENERAL.—In making a grant under a 
provision of this title (other than this section), the 
granting authority shall—
(A) require the recipient of the grant to—
(i) reserve a portion of the funds 
made available through the grant; and 
(ii) use the reserved funds to conduct 
an evaluation of the other activities carried 
out through the grant; or 
(B)(i) reserve a portion of the funds avail-
able for the grant; and
(ii) use the reserved funds to provide as-
sistance to an eligible entity to conduct an eval-
uation of the activities carried out through the 
grant. 
(2) USE OF FUNDS.—A recipient of a grant de-
scribed in paragraph (1)(A), or assistance described
145
in paragraph (1)(B)(ii), shall use the funds made 
available through the grant, or the assistance, re-
spectively, to conduct a validated evaluation of the 
effectiveness of the activities described in subpara-
graph (A) or (B), respectively, of paragraph (1). 
(3) APPLICATIONS.—
(A) SUBMISSION.—
(i) GRANTS
FOR
PROJECTS
CON-
TAINING EVALUATIONS.—To be eligible to 
receive a grant for which the granting au-
thority requires the reservation described 
in paragraph (1)(A)(i), an entity shall in-
clude a proposal for the evaluation in the 
application submitted for the grant. 
(ii) ASSISTANCE FOR EVALUATIONS.—
To be eligible to receive assistance under 
paragraph (1)(B)(ii), an entity shall sub-
mit an application to the granting author-
ity at such time, in such manner, and con-
taining such information as the granting 
authority may require, including a proposal 
for the evaluation. 
(B) REVIEW
AND
ASSISTANCE.—An em-
ployee of the Department of Justice, after con-
sultation with an employee of the Department
146
of Health and Human Services and a non-
governmental member of the advisory board es-
tablished under section 2214 of the Social Secu-
rity Act, with expertise in evaluation method-
ology shall review each proposal described in 
clause (i) or (ii) of subparagraph (A), and de-
termine whether the methodology described in 
the proposal is adequate to gather meaningful 
information. If the reviewers determine that the 
methodology is inadequate, they shall rec-
ommend that the granting authority deny the 
application for the grant described in subpara-
graph (A)(i), or the assistance described in sub-
paragraph (B)(ii), as appropriate, or make rec-
ommendations for how the application should 
be amended. If the granting authority denies 
the application on the basis of the proposal, the 
granting authority shall inform the applicant 
why the application was denied, and offer as-
sistance to the applicant in modifying the pro-
posal. 
(b) OTHER GRANTS.—The granting authority shall 
make grants to appropriate entities to conduct validated 
evaluations of activities, to reduce elder abuse, neglect, 
and exploitation, that are not funded under this title.
147
(c) CONDITION OF PARTICIPATION.—As a condition 
of participation in any grant under this title, individuals, 
facilities, and other entities shall agree to be subject to 
the provisions of section 571 of title 18, United States 
Code, as added by this Act. 
SEC. 212. AUTHORIZATION OF APPROPRIATIONS. 
There are authorized to be appropriated such sums 
as are necessary for fiscal years 2004 through 2010 to 
carry out this title. 
SEC. 213. CAUSE OF ACTION FOR ELDER ABUSE AND NE-
GLECT. 
(a) IN GENERAL.—Part I of title 18, United States 
Code, is amended by adding after chapter 27 the fol-
lowing:
‘‘CHAPTER 28—ELDER ABUSE AND 
NEGLECT
‘‘Sec. 
‘‘571. Harm to residents of nursing facilities.
‘‘§ 571. Harm to residents of nursing facilities 
‘‘(a) DEFINITIONS.—In this section:
‘‘(1) ENTITY.—The term ‘entity’ means—
‘‘(A) any nursing facility (including facili-
ties that do not exclusively provide nursing 
care); 
‘‘(B) any entity that manages a nursing 
facility; or
149
‘‘(2) PENALTY
FOR
INDIVIDUAL.—Any indi-
vidual who violates paragraph (1) shall be—
‘‘(A) imprisoned for not more than 20 
years and, if death results, shall be imprisoned 
for any term of years or for life; and 
‘‘(B) fined in accordance with section 
3571. 
‘‘(3) OTHER PENALTY.—Any entity or person, 
other than an individual, that violates paragraph (1) 
shall be fined not more than $3,000,000 per nursing 
facility involved.’’. 
(b) HEALTH CARE OFFENSE.—Section 24(a)(1) of 
title 18, United States Code, is amended by inserting 
‘‘571,’’ before ‘‘669,’’. 
(c) TECHNICAL AND CONFORMING AMENDMENT.—
The table of chapters for part I of title 18, United States 
Code, is amended by inserting after the item relating to 
chapter 27 the following:
‘‘28. Elder Abuse and Neglect ........................................................
571’’.
SEC. 214. CIVIL ACTIONS FOR ELDER ABUSE AND NEGLECT. 
(a) DEFINITIONS.—In this section: 
(1) ENTITY.—
(A) IN
GENERAL.—The term ‘‘entity’’ 
means—
150
(i) any nursing facility (including fa-
cilities that do not exclusively provide nurs-
ing care); 
(ii) any entity that manages a nursing 
facility; or 
(iii) any entity that owns, directly or 
indirectly, a controlling interest or a 50 
percent or greater interest in 1 or more 
nursing facilities. 
(B) ADDITIONAL
ENTITIES.—The term 
shall include States, localities, and political sub-
divisions thereof. 
(2) NEGLECT.—The term ‘‘neglect’’ means the 
failure of a caregiver (as defined in section 2201 of 
the Social Security Act, as added by this Act) to 
provide the goods or services that are necessary to 
avoid physical harm, disability, mental anguish, or 
mental illness. 
(3) NURSING
FACILITY.—The term ‘‘nursing 
facility’’ means both a nursing facility (as defined in 
section 1919(a) of the Social Security Act (42 
U.S.C. 1396r(a))) and a skilled nursing facility as 
defined in section 1819(a) of the Social Security 
Act.
151
(4) PERSON.—The term ‘‘person’’ has the same 
meaning as in section 921(a)(1) of title 18, United 
States Code. 
(5) OTHER
TERMS.—The 
terms 
‘‘abuse’’, 
‘‘State’’, and ‘‘serious bodily injury’’ shall have the 
meanings given those terms in section 2201 of the 
Social Security Act. 
(b) CIVIL ACTIONS BROUGHT BY THE ATTORNEY 
GENERAL.—
(1) IN GENERAL.—The Attorney General may 
bring an action under this subsection against any 
person or entity that knowingly, or in reckless dis-
regard for the safety of human life, acts or fails to 
act, if such act or omission results in serious bodily 
injury to 1 or more residents of a nursing facility 
and in abuse or neglect of an additional 2 or more 
residents of the same nursing facility. 
(2) CIVIL PENALTY.—A person or entity that 
acts or fails to act as described in paragraph (1) 
shall be liable to the United States for a civil penalty 
of—
(A) in the case of an individual (other than 
an owner, operator, officer, or manager of such 
a nursing facility, such as a nurse or a certified
152
nurse’s aide) up to $50,000 for each violation 
of this subsection; 
(B) in the case of an individual who is an 
owner, operator, officer, or manager of such a 
nursing facility, up to $500,000 for each viola-
tion of this subsection; 
(C) in the case of a violation of this sub-
section involving a single nursing facility, that 
facility, or its management company, up to 
$3,000,000 for that facility for such violation; 
and 
(D) in the case of a violation of this sub-
section at 2 or more nursing facilities with com-
mon ownership or under common management, 
up to $6,000,000 for each entity that owns 
such facilities where there were such violations. 
The amount shall be set by the district court, de-
pending on the number of residents who suffered 
abuse or neglect, the severity of the injury to resi-
dents relating to abuse or neglect, and the number 
of resident deaths relating to abuse or neglect at the 
facilities in violation of this subsection.
(3) OTHER APPROPRIATE RELIEF.—If the At-
torney General has reason to believe that a person 
or entity is engaging in or is about to engage in an
153
act or omission that results in or has the potential 
for resulting in serious bodily injury to 1 or more 
residents of a nursing facility and in abuse or ne-
glect of an additional 2 or more residents of the 
same nursing facility, the Attorney General may pe-
tition an appropriate United States district court for 
appropriate equitable and declaratory relief to elimi-
nate the circumstances giving rise to the actual or 
potential harm. 
(4) PROCEDURES.—
(A) IN GENERAL.—A subpoena requiring 
the attendance of a witness at a trial or hearing 
conducted under this subsection may be served 
at any place in the United States. 
(B) 
LIMITATION.—An 
action 
brought 
under paragraph (1) may not be brought more 
than 6 years after the date on which the viola-
tion of this subsection occurred, except that the 
time for filing is tolled during the period when 
the right of action was not known and reason-
ably could not have been known by an official 
of the United States charged with responsibility 
to act in the circumstances. 
(C) STANDARD
OF
PROOF.—The United 
States shall be required to prove all actions