SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Emergency Support for Nursing Homes and Elder Jus-
tice Reform Act of 2020’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Definitions. 
Sec. 3. Providing resources for personal protective equipment and testing. 
Sec. 4. Promoting transparency about COVID–19-related cases and fatalities 
and staffing levels in long-term care facilities. 
Sec. 5. Establishing strike teams. 
Sec. 6. Promoting identification and reporting of potential abuse or neglect in 
long-term care facilities. 
Sec. 7. Promoting quality of life of long-term care facility residents through 
televisitation. 
Sec. 8. Upgrading nursing home compare and the Five-Star rating system. 
Sec. 9. Enhancing Federal oversight of nursing homes participating in Medi-
care or Medicaid. 
Sec. 10. Continuing funding for programs to prevent and prosecute elder abuse 
and neglect. 
Sec. 11. Increasing resources to investigate abuse or neglect and extend services 
to victims. 
Sec. 12. Protecting Americans with dementia. 
Sec. 13. Reducing racial and ethnic disparities in long-term care facilities. 
Sec. 14. Establishing reciprocity with Drug Enforcement Administration to ad-
dress improper prescribing of controlled substances. 
SEC. 2. DEFINITIONS. 
In this Act: 
(1) COVID–19 PUBLIC
HEALTH
EMERGENCY 
PERIOD.—The term ‘‘COVID–19 public health emer-
gency period’’ means the period beginning on the 
first day of the emergency period defined in para-
graph (1)(B) of section 1135(g) of the Social Secu-
rity Act (42 U.S.C. 1320b-5(g)) and ending on the 
last day of the calendar quarter in which the last 
day of such emergency period occurs. 
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(2) INDIAN TRIBE.—The term ‘‘Indian tribe’’ 
has the meaning given that term in section 4 of the 
Indian Self-Determination and Education Assistance 
Act (25 U.S.C. 5304). 
(3) LONG-TERM
CARE
FACILITY.—The term 
‘‘long-term care facility’’ has the meaning given that 
term in section 2011(15) of the Social Security Act 
(42 U.S.C. 1397j(15)). 
(4) NURSING
FACILITY.—The term ‘‘nursing 
facility’’ has the meaning given that term in section 
1919(a) of the Social Security Act (42 U.S.C. 
1396r(a)). 
(5) 
PARTICIPATING
PROVIDER.—The 
term 
‘‘participating provider’’ means a skilled nursing fa-
cility or a nursing facility that has been assigned a 
national provider identifier number by the Secretary 
and has executed an agreement to participate in the 
Medicare program established under title XVIII of 
the Social Security Act (42 U.S.C. 1395 et seq.) or 
the Medicaid program established under title XIX of 
such Act (42 U.S.C. 1396 et seq.). 
(6) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(7) SKILLED
NURSING
FACILITY.—The term 
‘‘skilled nursing facility’’ has the meaning given that 
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term in section 1819(a) of the Social Security Act 
(42 U.S.C. 1395i–3(a)). 
(8) STATE.—Except as otherwise provided, the 
term ‘‘State’’ has the meaning given such term for 
purposes of title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.). 
(9) TRIBAL ORGANIZATION.—The term ‘‘tribal 
organization’’ has the meaning given that term in 
section 4 of the Indian Self-Determination and Edu-
cation Assistance Act (25 U.S.C. 5304). 
(10) OTHER TERMS.—Each other term has the 
meaning given the term for purposes of subtitle B 
of title XX of the Social Security Act (42 U.S.C. 
1397j et seq.). 
SEC. 3. PROVIDING RESOURCES FOR PERSONAL PROTEC-
TIVE EQUIPMENT AND TESTING. 
(a) IN GENERAL.—A portion of any payments re-
ceived or funds made available on or after July 1, 2020, 
for responding to the public health or fiscal impacts re-
lated to the Coronavirus Disease (COVID–19) under Fed-
eral legislation enacted on or after that date which pri-
marily makes appropriations for the coronavirus response 
and related activities, shall be used for the purposes de-
scribed in subsection (b), notwithstanding the original 
purpose for which the amounts were appropriated to make 
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such payments or funds available, or any other provision 
of law restricting the use of such payments or funds. 
(b) PURPOSES DESCRIBED.—The purposes described 
in this subsection are the following: 
(1) To establish and maintain a supply of per-
sonal protective equipment at a level that is suffi-
cient, as determined by the Centers for Disease Con-
trol and Prevention, in collaboration with the Sec-
retary and the Administrator of the Federal Emer-
gency Management Agency, to provide for the safety 
of— 
(A) personnel employed by participating 
providers and long-term care facilities, includ-
ing licensed assisted living or residential care 
facilities, during the COVID–19 public health 
emergency period; and 
(B) State survey agency personnel who 
conduct audits or investigations of participating 
providers and long-term care facilities, includ-
ing licensed assisted living or residential care 
facilities, during the COVID–19 public health 
emergency period. 
(2) To provide regular COVID–19 testing for 
personnel and residents of participating providers 
and long-term care facilities, including licensed as-
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sisted living or residential care facilities, (at no cost 
to such personnel and residents) at a level that is 
sufficient, based on the needs of the locality and its 
circumstances, as determined by the Director of the 
Centers for Disease Control and Prevention, in col-
laboration with the Secretary and the Administrator 
of the Federal Emergency Management Agency, to 
provide for the safety of such personnel and resi-
dents. A State shall provide such testing during the 
90-day period that begins on the date on which the 
Secretary, after consultation with the Director of the 
Centers for Disease Control and Prevention, deter-
mines the State is able to conduct such testing at 
such level and notifies the State of the date on 
which the testing period is to start. 
(c) STANDARDS AND GUIDANCE.—Not later than 30 
days after the date of enactment of this Act, the Director 
of the Centers for Disease Control and Prevention, in col-
laboration with the Secretary and the Administrator of the 
Federal Emergency Management Agency, shall issue de-
tailed guidance to States on compliance with the require-
ments of this section as it relates to participating pro-
viders and long-term care facilities, including licensed as-
sisted living or residential care facilities. 
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SEC. 4. PROMOTING TRANSPARENCY ABOUT COVID–19-RE-
LATED CASES AND FATALITIES AND STAFF-
ING LEVELS IN LONG-TERM CARE FACILI-
TIES. 
(a) COLLECTION
AND REPORTING
OF STAFFING 
DATA
BY PARTICIPATING PROVIDERS.—The Secretary 
shall develop a plan for ensuring that participating pro-
viders shall resume compliance with the requirement, 
under section 1128I(g) of the Social Security Act (42 
U.S.C. 1320a–7j(g)), to electronically submit direct care 
staffing information based on payroll and other auditable 
data (including measures to ensure that the submitted 
data includes direct care staffing information for the en-
tire duration of the emergency period). 
(b) COLLECTION
AND REPORTING
OF DATA RE-
LATED
TO COVID–19 BY PARTICIPATING PROVIDERS 
AND LONG-TERM CARE FACILITIES.— 
(1) IN GENERAL.— 
(A) REPORTING OF COVID–19 CASES AND 
FATALITIES BY PARTICIPATING PROVIDERS AND 
LONG-TERM CARE FACILITIES.—The Secretary 
shall ensure that participating providers and 
long-term care facilities report all suspected and 
confirmed cases of COVID–19 among personnel 
and residents of the provider or facility, all 
COVID–19-related fatalities among personnel 
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and residents of the provider or facility, and all 
fatalities among personnel and residents of the 
provider or facility, whether related to COVID– 
19 or unrelated to COVID–19, for the period 
beginning on January 1, 2020, to the Sec-
retary. 
(B) TIMING
AND
MANNER
OF
REPORT-
ING.—Such data shall be reported to the Sec-
retary by participating providers and long-term 
care facilities in a format and manner that is 
consistent with any data that the Secretary has 
directed participating providers to furnish to 
the Centers for Disease Control and Prevention 
on or after May 8, 2020, and, beginning on the 
date that is 15 days after the date of enactment 
of this Act, shall be collected and reported to 
the Secretary by participating providers and 
long-term care facilities on a daily basis. 
(C) PUBLICATION
OF
DATA.—Not later 
than 15 days after the date of enactment of 
this Act, the Secretary shall make the data col-
lected under this paragraph publicly available 
and shall update such data on a daily basis. 
(2) COLLECTION
AND
REPORTING
OF
DEMO-
GRAPHIC DATA.—The Secretary shall post the fol-
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lowing information with respect to participating pro-
viders and long-term care facilities on the official 
internet website of the Federal Government for 
Medicare beneficiaries (commonly referred to as the 
‘‘Nursing Home Compare’’ Medicare website) (or a 
successor website) aggregated by State: 
(A) The age, gender, race, ethnicity, dis-
ability, and preferred language of the residents 
of participating providers with suspected or 
confirmed COVID–19 infections. 
(B) With respect to residents of partici-
pating providers and long-term care facilities 
who died on or after January 1, 2020, the age, 
gender, race, ethnicity, disability, and preferred 
language of— 
(i) all of such residents; and 
(ii) all of such residents whose deaths 
are related to COVID–19. 
(3) CONFIDENTIALITY.—Any information re-
ported under this subsection that is made available 
to the public shall be made so available in a manner 
that protects the identity of residents of partici-
pating providers and long-term care facilities. 
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SEC. 5. ESTABLISHING STRIKE TEAMS. 
(a) IN GENERAL.—A portion of any payments re-
ceived or funds made available on or after July 1, 2020, 
for responding to the public health or fiscal impacts re-
lated to the Coronavirus Disease (COVID–19) under Fed-
eral legislation enacted on or after that date which pri-
marily makes appropriations for the coronavirus response 
and related activities, shall be used to establish and sup-
port the operation of statewide or regional strike teams 
that meet the requirements of subsection (b) to respond 
to COVID–19-related crises in participating providers, 
notwithstanding the original purpose for which the 
amounts were appropriated to make such payments or 
funds available, or any other provision of law restricting 
the use of such payments or funds. 
(b) STRIKE TEAM REQUIREMENTS.—The require-
ments of this section with respect to a strike team of a 
State are the following: 
(1) Strike teams may include assessment, test-
ing, and clinical teams, and the State shall establish 
a mission for each such team by written directive, 
which may include performing medical examinations, 
conducting COVID–19 testing, and assisting partici-
pating providers with the implementation of quar-
antine, isolation, or disinfection procedures. 
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(2) Each strike team shall be comprised of indi-
viduals who have relevant skills, qualifications, and 
experience to serve as members of 1 or more of the 
assessment, testing, and clinical teams described in 
paragraph (1), such as employees of the State or 
any of its political subdivisions, members of the mili-
tia on State activity duty, members of COVID–19 
response teams sent to the State by the Secretary, 
or other individuals designated by the State agency 
with primary responsibility for promoting resident 
and employee safety in participating providers. 
(3) Strike teams and members of such teams 
shall be subject to the State’s oversight and direc-
tion and team members shall receive a State-issued 
letter of authorization describing— 
(A) the individual’s designation to serve on 
1 or more teams under an emergency proclama-
tion; 
(B) the mission of the team; 
(C) the authority of the individual to per-
form the team mission on the State’s behalf; 
(D) the individual’s authority to access 
places, persons, and materials necessary for the 
team member’s performance of the team’s mis-
sion; and 
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(E) the requirement that team members 
maintain the confidentiality of patient informa-
tion shared with such individuals by the facility. 
(4) The State may, at any time, disband any 
strike team and rescind the letter of authorization 
for any team member. 
(5) A team and team member may not use the 
letter of authorization described in paragraph (3) for 
any purpose except in connection with the team’s 
mission of acting in good faith to promote resident 
and employee safety in participating providers in 
which COVID–19 is confirmed to be present. 
(6) The State shall establish protocols and pro-
cedures for requesting the assistance of a strike 
team established under this section and any other 
procedures deemed necessary for the team’s oper-
ation. 
(7) If a strike team finds consistent quality of 
care deficiencies with respect to a participating pro-
vider and such deficiencies immediately jeopardize 
the health or safety of residents of the participating 
provider, the team shall, within 18 hours of making 
such finding, alert the State survey agency (which 
may take immediate enforcement action to remove 
the jeopardy and correct the deficiencies through the 
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remedies specified in section 1819(h)(2)(B)(iii) or 
1919(h)(2)(A)(iii) of the Social Security Act (42 
U.S.C. 1395i–3(h)(2)(B)(iii), 1396r(h)(2)(A)(iii)), 
the long-term care ombudsman of the State, and the 
Medicaid fraud control unit of such State). 
SEC. 6. PROMOTING IDENTIFICATION AND REPORTING OF 
POTENTIAL ABUSE OR NEGLECT IN LONG- 
TERM CARE FACILITIES. 
(a) USE OF CLAIMS DATA TO IDENTIFY INSTANCES 
OF POTENTIAL ABUSE OR NEGLECT IN FACILITIES.— 
Section 1128I of the Social Security Act (42 U.S.C. 
1320a–7j) is amended by adding at the end the following 
new subsection: 
‘‘(i) USE OF CLAIMS DATA TO IDENTIFY INSTANCES 
OF POTENTIAL ABUSE OR NEGLECT.— 
‘‘(1) COMPILATION OF CODES.—Not later than 
1 year after the date of the enactment of this sub-
section, the Secretary, in collaboration with the In-
spector General of the Department of Health and 
Human Services, shall— 
‘‘(A) compile a comprehensive list of diag-
nosis codes that may indicate potential physical 
or sexual abuse or neglect of the elderly; and 
‘‘(B) develop a plan for reliance on data 
from claims under titles XVIII and XIX that 
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contain 1 or more of those codes, for the pur-
pose of identifying instances of potential phys-
ical or sexual abuse or neglect in facilities re-
ceiving reimbursement under such titles. 
‘‘(2) AVAILABILITY TO STATES.—Not later than 
2 years after the date of the enactment of this sub-
section, the Secretary shall make such claims data 
available to State survey agencies to help verify com-
pliance with Federal and State mandatory reporting 
laws.’’. 
(b) REQUIRED TRAINING ON SIGNS AND SYMPTOMS 
OF POTENTIAL ABUSE OR NEGLECT.—Section 1128I of 
the Social Security Act (42 U.S.C. 1320a–7j), as amended 
by subsection (a), is amended by adding at the end the 
following new subsection: 
‘‘(j) REQUIRED TRAINING ON SIGNS AND SYMPTOM 
OF POTENTIAL ABUSE
OR NEGLECT.—Beginning not 
later than 1 year after the date of the enactment of this 
subsection, a facility shall ensure that any staff of the fa-
cility who provide direct care (as defined in section 2011) 
to residents of the facility receive training on the signs 
and symptoms of potential abuse or neglect of the elder-
ly.’’. 
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(c) EVALUATION AND REPORT ON PROTOCOLS TO 
ENCOURAGE PROMPT REPORTING OF SUSPECTED INCI-
DENTS OF POTENTIAL ABUSE OR NEGLECT.— 
(1) EVALUATION
AND
IMPLEMENTATION
OF 
PROTOCOLS.—The Secretary, in collaboration with 
the Attorney General, shall evaluate the effectiveness 
of current protocols and, if warranted, recommend 
and implement improvements in those protocols, to 
encourage prompt reporting of suspected incidents of 
potential abuse or neglect to the appropriate law en-
forcement officials or adult protective services office, 
by State and Federal surveyors of Medicare and 
Medicaid covered entities. 
(2) REPORT.—Not later than 180 days after 
the completion of the evaluation under paragraph 
(1), the Secretary shall submit to Congress a report 
containing the results of such evaluation, together 
with recommendations for improvements, including 
such legislation and administrative action as the 
Secretary determines appropriate. 
(d) ISSUANCE
OF GUIDANCE TO DETER SOCIAL 
MEDIA ABUSE IN FACILITIES.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this Act, the Secretary 
shall— 
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(A) update guidance, and, as necessary, 
issue new guidance to clarify for State survey 
and certification agencies the requirements ap-
plicable to facilities (as defined in section 483.5 
of title 42, Code of Federal Regulations (or any 
successor regulations)) under part 483 of title 
42, Code of Federal Regulations (or any suc-
cessor regulations), to protect resident privacy 
and prohibit mental abuse or exploitation, spe-
cifically as it relates to exploitative photo-
graphs, audio and video recordings, and posting 
or sharing of such photographs or recordings on 
social media networks or through multimedia 
messages; and 
(B) establish procedures to ensure that 
violations of the safety and privacy require-
ments applicable to facilities (as so defined) 
under part 483 of title 42, Code of Federal 
Regulations (or any successor regulations), 
which prohibit misuse of photographs, audio 
and video recordings, and the inappropriate 
posting or sharing of such photographs or re-
cordings on social media networks or through 
multimedia messages, are reported by State 
survey agencies to law enforcement agencies, 
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adult protective service agencies, and other rel-
evant agencies and that such violations are re-
corded and tracked in the Automated Survey 
Processing Environment (‘‘ASPEN’’) and the 
ASPEN Complaints/Incident Tracking System 
(‘‘ACTS’’). 
(2) 
CLARIFICATION.—The 
guidance 
issued 
under paragraph (1) shall clarify that enforcement 
penalties do not apply to the posting or sharing of 
such photographs or recordings that occurred solely 
for the purpose of documenting and promptly report-
ing, to the appropriate authorities, a case of abuse 
in a facility. 
SEC. 7. PROMOTING QUALITY OF LIFE OF LONG-TERM 
CARE FACILITY RESIDENTS THROUGH TELE-
VISITATION. 
(a) PROMOTING TELEVISITATION FOR RESIDENTS.— 
(1) IN
GENERAL.—Sections 1819(c)(3) and 
1919(c)(3) of the Social Security Act (42 U.S.C. 
1395i–3(c)(3), 1396r(c)(3)) are each amended— 
(A) in subparagraph (D), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (E), by striking the 
period and inserting ‘‘; and’’; and 
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(C) by adding at the end the following new 
subparagraph: 
‘‘(F) provide for access to telecommuni-
cations devices and use of the internet, includ-
ing assistance from facility staff in the use of 
such technology, if necessary or requested by 
the resident or a family member, to support 
telecommunication, including but not limited to 
audio, 
visual, 
text 
communication, 
video-
conference, and two-way audio/video options, by 
residents of such facility with family members 
and other individuals.’’. 
(2) ACCESS DURING COVID–19 PUBLIC HEALTH 
EMERGENCY PERIOD.— 
(A) IN GENERAL.—Not later than 30 days 
after the date of enactment of this Act, the Sec-
retary shall take steps necessary to ensure that 
the residents of each participating provider and 
licensed assisted living or residential care facil-
ity have access to telecommunications devices 
and use of the internet (to the extent prac-
ticable), including assistance from facility staff 
in the use of such technology, if necessary or 
requested by the resident or a family member, 
to support telecommunication, including but not 
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limited to audio, visual, text communication, 
videoconference and two-way audio/video op-
tions, by residents of such provider or facility 
with family members and other individuals. 
(B) 
REQUIREMENTS.—In 
taking 
such 
steps, the Secretary shall address— 
(i) notification to residents, family 
members, and other individuals of access 
to televisation described in subparagraph 
(A); 
(ii) how such a provider or facility will 
ensure or enable installation and access to 
a device purchased by, or for the use or 
benefit of, individual residents; and 
(iii) operational issues and steps to 
avoid unnecessary barriers to the timely 
deployment of such televisitation. 
(b) FUNDING.—A participating provider may use a 
portion of any emergency funding that the provider re-
ceives (prior to and after the date of enactment of this 
Act) from the Secretary related to the COVID–19 public 
health emergency period to purchase any technology, in-
cluding telecommunications devices and internet service, 
or any other items or services as necessary to implement 
the televisitation described in the provisions of, and 
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amendments made by, subsection (a), notwithstanding any 
other provision of law restricting the use of such funding. 
SEC. 8. UPGRADING NURSING HOME COMPARE AND THE 
FIVE-STAR RATING SYSTEM. 
(a) COMPREHENSIVE REVIEW OF FIVE-STAR QUAL-
ITY RATING SYSTEM.—Sections 1819 and 1919 of the So-
cial Security Act (42 U.S.C. 1395i–3, 1396r) are each 
amended— 
(1) by redesignating subsection (j) as sub-
section (k); and 
(2) by inserting after subsection (i) the fol-
lowing new subsection: 
‘‘(j) COMPREHENSIVE REVIEW AND MODIFICATION 
OF FIVE-STAR QUALITY RATING SYSTEM.— 
‘‘(1) IN GENERAL.—The Secretary shall con-
duct a comprehensive review of the system main-
tained by the Secretary to measure and publicly re-
port the quality of skilled nursing facilities and nurs-
ing facilities (commonly referred to as the ‘Five-Star 
Quality Rating System’). 
‘‘(2) TIMING.—The Secretary shall conduct 
such review not later than 1 year after the end of 
the COVID–19 public health emergency period and 
shall implement modifications to the Five-Star Qual-
ity Rating System (or its successor system) not later 
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than 180 days after the release of the report that is 
required under paragraph (4). 
‘‘(3) REQUIREMENTS.—The review of the sys-
tem under this subsection shall include an evaluation 
of the relative weight accorded to each of the fol-
lowing: 
‘‘(A) The adequacy of the facility’s proce-
dures for preventing and reporting infection. 
‘‘(B) The adequacy of the facility’s proce-
dures for preventing and reporting incidents of 
abuse, neglect, mistreatment, or exploitation of 
residents of the facility. 
‘‘(C) Deficiencies identified in the facility’s 
most recent standard survey and the extent to 
which the facility corrected such deficiencies 
since the date of the most recent survey. 
‘‘(D) The number, type, severity, and out-
come of substantiated complaints. 
‘‘(E) The number of adjudicated instances 
of criminal violations by a facility or the em-
ployees of a facility. 
‘‘(F) The number of civil monetary pen-
alties levied against the facility, employees, con-
tractors, and other agents of the facility. 
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‘‘(G) Selected quality measures (such as 
the percentages of long-stay residents who expe-
rience pressure ulcers, are physically restrained, 
experience falls with major injury, or received 
antipsychotic medication). 
‘‘(H) Whether a facility is connected to an 
assisted living facility and whether such facili-
ties should be rated separately from facilities 
that are standalone skilled nursing facilities or 
nursing facilities. 
‘‘(I) Other items determined appropriate 
by the Secretary. 
‘‘(4) REPORT.—Not later than 180 days after 
the completion of the review under paragraph (1), 
the Secretary shall submit to the Committee on Fi-
nance of the Senate and the Committee on Ways 
and Means of the House of Representatives a final 
report that includes such findings and recommenda-
tions as the Secretary considers appropriate based 
on the review, including recommended actions to be 
taken to implement the specific recommendations in 
such report. 
‘‘(5) CONSULTATION.—In conducting such re-
view and implementing modifications of the system, 
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the Secretary shall consult with each of the fol-
lowing: 
‘‘(A) State long-term care ombudsman pro-
grams. 
‘‘(B) Adult protective services agencies. 
‘‘(C) Consumer advocacy and other non-
profit organizations whose mission is to pro-
mote the health, safety, and well being of older 
Americans. 
‘‘(D) Provider stakeholder groups. 
‘‘(E) Statewide provider agencies and ad-
vocacy groups with relevant expertise. 
‘‘(F) Any other representatives of pro-
grams or groups the Secretary determines ap-
propriate. 
‘‘(6) COVID–19 PUBLIC HEALTH EMERGENCY 
PERIOD.—In this subsection, the term ‘COVID–19 
public health emergency period’ means the period 
beginning on the first day of the emergency period 
defined in paragraph (1)(B) of section 1135(g) and 
ending on the last day of the calendar quarter in 
which the last day of such emergency period oc-
curs.’’. 
(b) TRANSPARENCY.—The Secretary shall publicly 
report data, at least quarterly, regarding each State’s en-
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forcement actions with respect to deficiencies or statutory 
violations that have been reported to the Centers for Medi-
care & Medicaid Services, corrective actions, if any, that 
were recommended to resolve such deficiencies or statu-
tory violations, and the status of implementation of each 
such recommended corrective action by the participating 
provider involved. 
(c) FUNDING.—The Secretary shall transfer to the 
Centers for Medicare & Medicaid Services Program Man-
agement Account, from the Federal Hospital Insurance 
Trust Fund established under section 1817 of the Social 
Security Act (42 U.S.C. 1395i) a one-time allocation of 
$20,000,000, to be used to carry out sections 1819(j) and 
1919(j) of the Social Security Act (42 U.S.C. 1395i–3, 
1396r) (as added by subsection (a)) and subsection (b). 
The amount shall be available on the date of the enact-
ment of this Act and shall remain available until expended. 
SEC. 9. ENHANCING FEDERAL OVERSIGHT OF NURSING 
HOMES PARTICIPATING IN MEDICARE OR 
MEDICAID. 
(a) IDENTIFICATION OF FACILITIES INCLUDED IN, 
OR CANDIDATES FOR, THE SPECIAL FOCUS FACILITY 
PROGRAM.—Not later than 60 days after the date of en-
actment of this Act, the Secretary shall publish the fol-
lowing lists on the official internet website of the Federal 
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Government for Medicare beneficiaries (commonly re-
ferred to as the ‘‘Nursing Home Compare’’ Medicare 
website) (or a successor website): 
(1) A list of all participating providers that are 
included in the special focus facility program con-
ducted under sections 1819(f)(8) and 1919(f)(10) of 
the Social Security Act (42 U.S.C. 1395i–3(f)(8), 
1396r(f)(10)). 
(2) A list of all participating providers that 
have been identified as candidates for such program, 
based on the most recent survey of the facility. 
(b) REGULARLY PUBLISHED UPDATES.—The Sec-
retary shall publish periodic updates of the lists published 
under subsection (a) no less often than once every 30 days. 
(c) DATA COLLECTION.—To the extent that the Sec-
retary maintains a system to collect certification defi-
ciencies and licensure violations relating to participating 
providers (such as the Automated Survey Processing Envi-
ronment ‘‘ASPEN’’ or a successor system), the Secretary 
shall develop methods to separately track reports of con-
firmed incidents of abuse or neglect in such providers on 
survey forms through such system. 
(d) GUIDANCE ON THE MEANING OF TERMS.—Not 
later than 18 months after the date of enactment of this 
Act, the Secretary, after consultation with staff of partici-
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pating providers and other long-term care facilities that 
receive provider payments under the Medicare or Medicaid 
programs, shall issue guidance for such participating pro-
viders and other long-term care facilities to clarify the 
meaning of certain terms, such as ‘‘suspicious’’, ‘‘injuries 
of unknown source’’, and ‘‘mistreatment’’, when used in 
the statutory and regulatory requirements for such pro-
viders relating to reporting and tracking incidents of 
abuse, sexual abuse, neglect, mistreatment, or exploitation 
of residents of such providers by facility staff, including 
on social media. 
SEC. 10. CONTINUING FUNDING FOR PROGRAMS TO PRE-
VENT AND PROSECUTE ELDER ABUSE AND 
NEGLECT. 
(a) LONG-TERM
CARE
OMBUDSMAN
PROGRAM 
GRANTS AND TRAINING.—Section 2043 of the Social Se-
curity Act (42 U.S.C. 1397m–2) is amended— 
(1) in subsection (a)(2)— 
(A) in subparagraph (B), by striking 
‘‘and’’ after the semicolon; 
(B) in subparagraph (C), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(D) for each of fiscal years 2020 through 
2023, $12,000,000.’’; and 
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(2) in subsection (b)(2), by inserting before the 
period the following: ‘‘, and for each of fiscal years 
2020 through 2023, $12,000,000’’. 
(b) ELDER ABUSE, NEGLECT, AND EXPLOITATION 
FORENSIC CENTERS.—Section 2031(f) of the Social Secu-
rity Act (42 U.S.C. 1397l(f)) is amended— 
(1) in paragraph (2), by striking ‘‘and’’ after 
the semicolon; 
(2) in paragraph (3), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(4) for each of fiscal years 2020 through 
2023, $10,000,000.’’. 
(c) ELDER JUSTICE COORDINATING COUNCIL.— 
(1) MEMBERSHIP.—Section 2021(b)(1) of the 
Social Security Act (42 U.S.C. 1397k(b)(1)) is 
amended— 
(A) by redesignating subparagraph (C) as 
subparagraph (D); and 
(B) by inserting after subparagraph (B), 
the following: 
‘‘(C) The Administrator of the Federal 
Emergency Management Agency.’’. 
(2) DUTIES.—Section 2021(f)(1) of such Act 
(42 U.S.C. 1397k(f)(1)) is amended by inserting 
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‘‘the Federal Emergency Management Agency,’’ 
after ‘‘Justice,’’. 
(d) ADULT PROTECTIVE SERVICES FUNCTIONS AND 
GRANT PROGRAMS.—Section 2042 of the Social Security 
Act (42 U.S.C. 1397m–1) is amended— 
(1) 
in 
subsection 
(a)(2), 
by 
striking 
‘‘$3,000,000’’ and all that follows through the pe-
riod and inserting ‘‘$5,000,000 for each of fiscal 
years 2020 through 2023.’’; 
(2) 
in 
subsection 
(b)(5), 
by 
striking 
‘‘$100,000,000’’ and all that follows through the pe-
riod and inserting ‘‘$120,000,000 for each of fiscal 
years 2020 through 2023.’’; and 
(3) 
in 
subsection 
(c)(6), 
by 
striking 
‘‘$25,000,000’’ and all that follows through the pe-
riod and inserting ‘‘$30,000,000 for each of fiscal 
years 2020 through 2023.’’. 
(e) TECHNICAL AMENDMENT.—Section 2011(12)(A) 
of the Social Security Act (42 U.S.C. 1397j(12)(A)) is 
amended by striking ‘‘450b’’ and inserting ‘‘5304’’. 
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SEC. 11. INCREASING RESOURCES TO INVESTIGATE ABUSE 
OR NEGLECT AND EXTEND SERVICES TO VIC-
TIMS. 
(a) FUNDING FOR ADULT PROTECTIVE SERVICES 
DURING
THE
COVID–19 PUBLIC
HEALTH
EMER-
GENCY.— 
(1) IN GENERAL.—A total of $60,000,000 of 
the amounts appropriated to make payments or 
funds available on or after July 1, 2020, for re-
sponding to the public health or fiscal impacts re-
lated to the Coronavirus Disease (COVID–19) under 
Federal legislation enacted on or after that date 
which primarily makes appropriations for the 
coronavirus response and related activities, shall be 
transferred and made available to the Secretary to 
make direct payments under this subsection to the 
agency of each State with primary responsibility for 
adult protective services and to tribally operated 
adult protective services agencies, notwithstanding 
the original purpose for which the amounts were ap-
propriated to make such payments or funds avail-
able, or any other provision of law restricting the 
use of such payments or funds. 
(2) PAYMENTS.— 
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(A) IN GENERAL.—From the funds trans-
ferred and made available under paragraph (1), 
the Secretary shall— 
(i) reserve 3 percent of such funds for 
making payments to tribally operated adult 
protective services agencies in such man-
ner, and based on such information, as the 
Secretary shall specify; and 
(ii) make allotments to States from 
the remainder of such funds (after the ap-
plication of clause (i)), in the same manner 
as amounts are allotted to States for fiscal 
year 2020 under section 2003(b) of the 
Social Security Act (42 U.S.C. 1397b(b)). 
(B) DIRECT
PAYMENTS.—The Secretary 
shall make direct payment from the amounts 
reserved under subparagraph (A) to tribally op-
erated adult protective services agencies and 
from the amounts allotted under that subpara-
graph to the agency of each State with primary 
responsibility for adult protective services. 
(3) OTHER REQUIREMENTS.— 
(A) NO
MATCH.—No cash or in-kind 
matching requirement shall apply to the pay-
ments made under this subsection. 
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(B) DEADLINE.—The Secretary shall make 
the payments required under this subsection 
not later than 60 days after the date on which 
funds are transferred and made available under 
paragraph (1). 
(C) USE OF FUNDS.—Each agency that re-
ceives funds from a payment made under this 
subsection shall use the funds to provide adult 
protective services during the COVID–19 public 
health emergency period. 
(D) PROHIBITION.—No funds from a pay-
ment made under this subsection shall be used 
to satisfy any requirement of a federally funded 
program relating to State or local matching 
funds or in-kind contributions. 
(4) DEFINITIONS.—In this subsection: 
(A) ADULT PROTECTIVE SERVICES.—The 
term ‘‘adult protective services’’ has the mean-
ing given that term in section 2011(2) of the 
Social Security Act (42 U.S.C. 1397j(2)). 
(B) INDIAN COUNTRY.—The term ‘‘Indian 
country’’ has the meaning given that term in 
section 1151 of title 18, United States Code. 
(C) STATE.—The term ‘‘State’’ has the 
meaning given that term in section 1101(a)(1) 
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of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1301(a)(1)) for purposes of title XX of such 
Act. 
(D) TRIBALLY OPERATED ADULT PROTEC-
TIVE
SERVICES
AGENCY.—The term ‘‘tribally 
operated adult protective services agency’’ 
means an agency of the recognized governing 
body of any Indian or Alaska Native Tribe, 
band, Nation, pueblo, village, community, com-
ponent band, or component reservation, individ-
ually identified (including parenthetically) in 
the list published most recently as of the date 
of enactment of this Act pursuant to section 
104 of the Federally Recognized Indian Tribe 
List Act of 1994 (25 U.S.C. 5131) whose pri-
mary purpose is to protect any vulnerable adult 
who is the victim of an alleged or substantiated 
incident of abuse, neglect, or exploitation in In-
dian Country. 
(b) AUTHORITY FOR TRANSFERS FROM THE CRIME 
VICTIMS FUND.—Section 1402(d)(3) of the Victims of 
Crime Act of 1984 (34 U.S.C. 20101(d)(3)) is amended 
by adding at the end the following: 
‘‘(C)(i) 
Notwithstanding 
subparagraph 
(B), the Director may use not more than 3 per-
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cent of the amount to be distributed from the 
Fund under this paragraph in a particular fis-
cal year to provide and improve services for vic-
tims of elder abuse, neglect, or exploitation by 
a department or agency of the Federal Govern-
ment other than the Department of Justice.’’. 
SEC. 12. PROTECTING AMERICANS WITH DEMENTIA. 
(a) ALZHEIMER’S DISEASE BEST PRACTICES AND 
REPORTING.— 
(1) ADDRESSING
ALZHEIMER’S
DISEASE
IN 
BEST PRACTICES.— 
(A) IN GENERAL.—Section 101(b) of the 
Elder Abuse Prevention and Prosecution Act 
(34 U.S.C. 21711(b)) is amended— 
(i) by redesignating subparagraphs 
(A), (B), and (C) of paragraph (2) as 
clauses (i), (ii), and (iii), respectively, and 
adjusting the margin accordingly; 
(ii) by redesignating paragraphs (1), 
(2), and (3) as subparagraphs (A), (B), 
and (C), respectively, and adjusting the 
margin accordingly; 
(iii) by striking ‘‘Not later than’’ and 
inserting the following: 
‘‘(1) IN GENERAL.—Not later than’’; 
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(iv) in paragraph (1)(B), as so redes-
ignated— 
(I) in clause (ii), by inserting ‘‘, 
including witnesses who have Alz-
heimer’s disease and related demen-
tias’’ after ‘‘other legal issues’’; and 
(II) in clause (iii), by striking 
‘‘elder abuse cases,’’ and inserting 
‘‘elder abuse cases (including victims 
and witnesses who have Alzheimer’s 
disease and related dementias),’’; and 
(v) by adding at the end the following: 
‘‘(2) TRAINING MATERIALS.— 
‘‘(A) IN GENERAL.—In creating or com-
piling replication guides and training materials 
under paragraph (1)(B), the Elder Justice Co-
ordinator shall consult with the Secretary of 
Health and Human Services, State, local, and 
Tribal adult protective services, aging, social, 
and human services agencies, Federal, State, 
local, and Tribal law enforcement agencies, and 
nationally recognized nonprofit associations 
with relevant expertise, as appropriate. 
‘‘(B) UPDATING.—The Elder Justice Coor-
dinator shall— 
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‘‘(i) review the best practices identi-
fied and replication guides and training 
materials created or compiled under para-
graph (1)(B) to determine if the replica-
tion guides or training materials require 
updating; and 
‘‘(ii) perform any necessary updating 
of the replication guides or training mate-
rials.’’. 
(B) 
APPLICABILITY.—The 
amendments 
made by subparagraph (A) shall— 
(i) take effect on the date of enact-
ment of this Act; and 
(ii) apply on and after the date that 
is 1 year after the date of enactment of 
this Act. 
(2) REPORT ON OUTREACH.— 
(A) IN
GENERAL.—Section 101(c)(2) of 
the Elder Abuse Prevention and Prosecution 
Act (34 U.S.C. 21711(c)(2)) is amended— 
(i) by redesignating subparagraphs 
(A) through (D) as clauses (i) through 
(iv), respectively, and adjusting the margin 
accordingly; 
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(ii) by striking ‘‘a report detailing’’ 
and inserting the following: ‘‘a report— 
‘‘(A) detailing’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(B) with respect to the report by the At-
torney General, including a link to the publicly 
available best practices identified under sub-
section (b)(1)(B) and the replication guides and 
training materials created or compiled under 
such subsection.’’. 
(B) 
APPLICABILITY.—The 
amendments 
made by subparagraph (A) shall apply with re-
spect to the report under section 101(c)(2) of 
the Elder Abuse Prevention and Prosecution 
Act (34 U.S.C. 21711(c)(2)) submitted during 
the second year beginning after the date of en-
actment of this Act, and each year thereafter. 
(b) PROMOTING ACCOUNTABILITY
OF COURT-AP-
POINTED GUARDIANS.—Section 2042(c) of the Social Se-
curity Act (42 U.S.C. 1397m–1(c)) is amended— 
(1) in paragraph (1), by striking ‘‘paragraph 
(2)(E)’’ and inserting ‘‘subparagraphs (E), (F), (G), 
and (H) of paragraph (2)’’; 
(2) in paragraph (2)— 
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(A) in the matter preceding subparagraph 
(A)— 
(i) by striking ‘‘Funds’’ and inserting 
‘‘Subject to paragraph (7), funds’’; and 
(ii) by striking ‘‘subparagraph (E)’’ 
and inserting ‘‘subparagraphs (E), (F), 
(G), and (H)’’; 
(B) in subparagraph (E), by striking ‘‘or’’ 
at the end; 
(C) by redesignating subparagraph (F) as 
subparagraph (I); and 
(D) by inserting after subparagraph (E) 
the following new paragraphs: 
‘‘(F) methods to assess State guardianship 
statistics such as the creation of State data-
bases to collect information about the number 
and characteristics of guardianship arrange-
ments, guardians, and individuals subject to 
guardianship; 
‘‘(G) the use of trained court visitors to 
improve court administration of guardianship 
arrangements, including the appointment and 
oversight of guardians; 
‘‘(H) methods for collecting, storing, and 
making available to the appropriate individuals, 
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organizations, and entities information on pro-
spective, current, and previously appointed 
guardians, which may include— 
‘‘(i) contact and identifying informa-
tion; 
‘‘(ii) information relating to back-
ground check investigations; 
‘‘(iii) court decisions regarding peti-
tions for appointment as a guardian, in-
cluding the rationale for such decisions; 
and 
‘‘(iv) information relating to the cause 
for removal of the guardian or termination 
of the guardianship arrangement; or’’; 
(3) in paragraph (4), by striking ‘‘paragraph 
(2)(E)’’ and inserting ‘‘subparagraphs (E), (F), (G), 
and (H) of paragraph (2)’’; 
(4) in paragraph (5), by striking ‘‘paragraph 
(2)(E)’’ each place it appears and inserting ‘‘sub-
paragraphs (E), (F), (G), and (H) of paragraph 
(2)’’; and 
(5) by adding at the end the following new 
paragraph: 
‘‘(7) ENSURING
DEMONSTRATION
PROGRAM 
FUNDING FOR THE HIGHEST COURTS OF STATES.— 
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The Secretary shall ensure that up to 5 percent of 
the total of any funds made available to carry out 
this subsection in a fiscal year (beginning with fiscal 
year 2020) is awarded under grants to the highest 
courts of States for purposes of conducting dem-
onstration programs described in subparagraphs 
(E), (F), (G), and (H) of paragraph (2).’’. 
SEC. 13. REDUCING RACIAL AND ETHNIC DISPARITIES IN 
LONG-TERM CARE FACILITIES. 
(a) TASK FORCE.—The Secretary shall establish a 
task force, to be known as the ‘‘Ethnic and Racial Dispari-
ties in Long-Term Care Facilities Task Force’’ (referred 
to in this section as the ‘‘task force’’), to gather data on 
racial and ethnic disparities in long-term care facilities 
and provide recommendations to Federal, State, local, and 
Tribal policymakers on ways to reduce such disparities. 
(b) MEMBERSHIP.—The task force shall be composed 
of the Secretary, the Surgeon General, other Federal, 
State, and local government officials, and individuals ap-
pointed by the Secretary with firsthand knowledge of, or 
expertise relating to, disparities in access to quality care 
for residents of long-term care facilities who are members 
of racial or ethnic minority groups. In appointing such in-
dividuals, the Secretary shall ensure the individuals ap-
pointed provide ample representation with respect to the 
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demographics of residents and caregivers of such facilities, 
particularly with respect to residents and caregivers of 
such facilities who are members of racial or ethnic minor-
ity groups. 
(c) ADMINISTRATION.— 
(1) CHAIRPERSON.—The Secretary shall serve 
as the chairperson of the task force. The Surgeon 
General shall serve as the vice chairperson. 
(2) STAFF.—The task force shall have 2 full- 
time staff members. 
(3) MEETINGS.—The task force shall convene 
at least monthly, with the first meeting to occur 
within 60 days after the enactment of this Act. 
(d) REPORTING AND RECOMMENDATIONS.— 
(1) MONTHLY
REPORTS.—Not later than 45 
days after the 1st meeting of the task force, and 
monthly thereafter, the task force shall submit to 
Congress and the Federal Emergency Management 
Agency a report that includes— 
(A) recommended methodologies for im-
proving Federal data collection on resident out-
comes in long term care facilities with dis-
proportionately high rates of admission of indi-
viduals who are members of racial or ethnic mi-
nority groups; 
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(B) the identification of long-term care fa-
cilities evidencing racial or ethnic disparities in 
psychotropic drug usage, infection prevention 
and control deficiencies, hospitalization rates, 
infectious disease rates, injury rates, abuse 
rates, neglect rates, fatality rates, and any ad-
ditional areas, as determined by the task force 
based on available public health data (or, if no 
such data are available, on the basis of such 
other publicly available data or information as 
the task force may determine); 
(C) the identification of factors, including 
Federal and State policies, that have contrib-
uted to racial or ethnic health disparities in 
resident outcomes in long term care facilities, 
and actions Congress (and if appropriate, other 
entities) can take to address these factors; and 
(D) recommendations for best practices to 
promote improvements in long-term care facili-
ties evidencing racial or ethnic disparities in 
psychotropic drug usage, infection prevention 
and control deficiencies, hospitalization rates, 
infectious disease rates, injury rates, abuse and 
neglect rates, fatality rates, or any additional 
areas determined by the task force. 
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(2) CONSULTATION WITH INDIAN TRIBES.—In 
submitting reports and recommendations under this 
subsection, the task force shall consult with Indian 
Tribes and Tribal organizations. 
(3) SUNSET.—The task force shall terminate on 
December 31, 2021. 
SEC. 14. ESTABLISHING RECIPROCITY WITH DRUG EN-
FORCEMENT ADMINISTRATION TO ADDRESS 
IMPROPER PRESCRIBING OF CONTROLLED 
SUBSTANCES. 
(a) NOTIFICATION OF THE ATTORNEY GENERAL BY 
THE SECRETARY OF HEALTH AND HUMAN SERVICES IN 
CASES
OF IMPROPER PRESCRIBING
OF CONTROLLED 
SUBSTANCES.— 
(1) IN GENERAL.—Section 1866(j) of the Social 
Security Act (42 U.S.C. 1395cc(j)) is amended by 
adding at the end the following new paragraph: 
‘‘(10) NOTIFICATION
OF
ATTORNEY
GEN-
ERAL.— 
‘‘(A) IN
GENERAL.—If the Secretary 
makes a determination described in subpara-
graph (B) with respect to improper prescribing 
of a controlled substance (as defined in section 
102(6) of the Controlled Substances Act), the 
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Secretary shall notify the Attorney General in 
accordance with subparagraph (C). 
‘‘(B) DETERMINATION BY SECRETARY.—A 
determination described in this subparagraph is 
a 
determination 
by 
the 
Secretary 
under 
which— 
‘‘(i) the enrollment of a provider of 
services or supplier under this title is re-
voked, based in whole or in part on a find-
ing 
by 
the 
Secretary 
under 
section 
424.535(a)(14) of title 42, Code of Federal 
Regulations (or any successor regulation), 
as applied to improper prescribing of con-
trolled substances; or 
‘‘(ii) a provider of services or supplier 
is placed on the preclusion list as defined 
under sections 422.2 and 423.100 of such 
title 42 (or any successor regulation), 
based in whole or in part on a finding by 
the Secretary that such provider or sup-
plier has engaged in conduct, in connection 
with prescribing of controlled substances, 
that would be considered improper pre-
scribing 
under 
such 
section 
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