I 
110TH CONGRESS 
2D SESSION 
H. R. 5799 
To amend titles XVIII and XIX of the Social Security Act to improve 
the transparency of information on skilled nursing facilities and nursing 
facilities and to clarify and improve the targeting of the enforcement 
of requirements with respect to such facilities. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 15, 2008 
Ms. EDDIE BERNICE JOHNSON of Texas introduced the following 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 consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
to improve the transparency of information on skilled 
nursing facilities and nursing facilities and to clarify 
and improve the targeting of the enforcement of require-
ments with respect to such facilities. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Nursing Home Transparency and Improvement Act of 
2008’’. 
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(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—IMPROVING TRANSPARENCY OF INFORMATION ON 
SKILLED NURSING FACILITIES AND NURSING FACILITIES 
Sec. 101. Required disclosure of ownership and affiliated parties information. 
Sec. 102. Accountability requirements. 
Sec. 103. Nursing home compare Medicare website. 
Sec. 104. Reporting of expenditures. 
Sec. 105. Standardized complaint form. 
Sec. 106. Ensuring staffing accountability. 
TITLE II—TARGETING ENFORCEMENT 
Sec. 201. Civil money penalties. 
Sec. 202. GAO study and report on the relative financial status and perform-
ance of special focus facilities. 
Sec. 203. National independent monitor program. 
Sec. 204. GAO studies and reports on temporary management and barriers to 
purchasing facilities with a record of poor care. 
Sec. 205. Notification of facility closure. 
Sec. 206. National demonstration projects on culture change and use of infor-
mation technology in nursing homes. 
TITLE III—IMPROVING STAFF TRAINING 
Sec. 301. Dementia and abuse prevention training. 
Sec. 302. Study and report on training required for certified nurse aides and 
supervisory staff. 
TITLE 
I—IMPROVING 
TRANS-
PARENCY OF INFORMATION 
ON SKILLED NURSING FACILI-
TIES AND NURSING FACILI-
TIES 
SEC. 101. REQUIRED DISCLOSURE OF OWNERSHIP AND AF-
FILIATED PARTIES INFORMATION. 
(a) 
SKILLED
NURSING
FACILITIES.—Section 
1819(d)(1) of the Social Security Act (42 U.S.C. 1395i– 
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3(d)(1)) is amended by adding at the end the following 
new subparagraphs: 
‘‘(D) AVAILABILITY
OF
OWNERSHIP
AND 
AFFILIATED PARTIES INFORMATION.— 
‘‘(i) IN GENERAL.—Beginning on the 
date of enactment of this subparagraph, a 
skilled nursing facility must have the infor-
mation described in clause (ii) available for 
submission to the Secretary, the Inspector 
General of the Department of Health and 
Human Services, the State, the State long- 
term care ombudsman, a resident of a fa-
cility, and the legal representative of such 
a resident or other responsible party in the 
case where the Secretary, the Inspector 
General, the State, the State long-term 
care ombudsman, the resident, or the legal 
representative or responsible party re-
quests such information (and, beginning on 
the effective date of the regulations pro-
mulgated under subparagraph (E)(i), for 
reporting such information in accordance 
with such regulations). The facility shall 
certify to the Secretary and the Inspector 
General of the Department of Health and 
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Human Services, as a condition of partici-
pation and payment under the program 
under this title, that the information sub-
mitted upon such request is accurate and 
current. 
‘‘(ii) INFORMATION DESCRIBED.—The 
following information is described in this 
clause: 
‘‘(I) The identity of individuals 
with an ownership or control interest 
(as defined in section 1124(a)(3)) in 
the facility. 
‘‘(II) Information on the mem-
bers of the governing body of the 
skilled nursing facility, including the 
names, titles, and dates of service of 
such members. 
‘‘(III) Information describing the 
organizational structure of any affili-
ated or related parties, including prin-
cipal officers and directors of affili-
ated or related companies, or mem-
bers in the case of a limited liability 
company. 
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To the extent that information reported by 
a facility to the Internal Revenue Service 
on Form 990, information submitted by a 
facility to the Securities and Exchange 
Commission, or information otherwise sub-
mitted to the Secretary contains the infor-
mation described in subclauses (I), (II), 
and (III), the facility may provide such 
Form or such information submitted to 
meet the requirements of clause (i) and 
subparagraph (E)(i). 
‘‘(iii) DEFINITION OF AFFILIATED OR 
RELATED PARTIES.—In this subparagraph, 
the term ‘affiliated or related parties’ 
means companies or individuals that serve 
as operators, landlords, management com-
panies or advisors, real estate or consulting 
companies, members of a limited liability 
company, administrative services compa-
nies, lenders and companies providing fi-
nancial guarantees, captive or affiliated li-
ability insurance companies, and such 
other entities as the Secretary determines 
appropriate. 
‘‘(E) REPORTING.— 
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‘‘(i) IN GENERAL.—Not later than 2 
years after the date of enactment of this 
subparagraph, the Secretary shall promul-
gate regulations requiring skilled nursing 
facilities to report the information de-
scribed in clause (ii) of subparagraph (D) 
to the Secretary in a standardized format, 
and such other regulations as are nec-
essary to carry out such subparagraph. 
Such regulations shall ensure that the fa-
cility certifies, as a condition of participa-
tion and payment under the program 
under this title, that the information re-
ported is accurate and current. 
‘‘(ii) GUIDANCE.—The Secretary shall 
provide guidance and technical assistance 
to States on how to adopt the standardized 
format under clause (i).’’. 
(b) NURSING FACILITIES.—Section 1919(d)(1) of the 
Social Security Act (42 U.S.C. 1396r(d)(1)) is amended 
by adding at the end the following new subparagraph: 
‘‘(D) AVAILABILITY
OF
OWNERSHIP
AND 
AFFILIATED PARTIES INFORMATION.— 
‘‘(i) IN GENERAL.—Beginning on the 
date of enactment of this subparagraph, a 
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nursing facility must have the information 
described in clause (ii) available for sub-
mission to the Secretary, the Inspector 
General of the Department of Health and 
Human Services, the State, the State long- 
term care ombudsman, a resident of a fa-
cility, and the legal representative of such 
a resident or other responsible party in the 
case where the Secretary, the Inspector 
General, the State, the State long-term 
care ombudsman, the resident, or the legal 
representative or responsible party re-
quests such information (and, beginning on 
the effective date of the regulations pro-
mulgated under subparagraph (E)(i), for 
reporting such information in accordance 
with such regulations). The facility shall 
certify to the Secretary and the Inspector 
General of the Department of Health and 
Human Services, as a condition of partici-
pation and payment under the program 
under this title, that the information sub-
mitted upon such request is accurate and 
current. 
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