of the Health Resources and Services Administra-
tion, in consultation with the National Health Care 
Workforce Commission, shall submit to Congress a 
report regarding the relationship between nurse 
staffing levels and nurse retention in hospitals. 
(2) UPDATED REPORT.—Not later than 5 years 
after the date of enactment of this Act, the Adminis-
trator of the Health Resources and Services Admin-
istration, in consultation with the National Health 
Care Workforce Commission, shall submit to Con-
gress an update of the report submitted under para-
graph (1). 
SEC. 3. ENFORCEMENT OF REQUIREMENTS THROUGH FED-
ERAL PROGRAMS. 
(a) MEDICARE PROGRAM.—Section 1866(a)(1) of the 
Social Security Act (42 U.S.C. 1395cc(a)(1)) is amend-
ed— 
(1) in subparagraph (X), by striking ‘‘, and’’ 
and inserting a comma; 
(2) in subparagraph (Y), by striking the period 
at the end and inserting ‘‘, and’’; and 
(3) by inserting after the subparagraph (Y) the 
following new subparagraph: 
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‘‘(Z) in the case of a hospital, to comply with 
the provisions of title XXXIV of the Public Health 
Service Act.’’. 
(b) MEDICAID PROGRAM.—Section 1902(a) of the 
Social Security Act (42 U.S.C. 1396a(a)) is amended— 
(1) by striking ‘‘and’’ at the end of paragraph 
(82); 
(2) by striking the period at the end of para-
graph (83) and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (83) the fol-
lowing new paragraph: 
‘‘(84) provide that any hospital that receives a 
payment under such plan comply with the provisions 
of title XXXIV of the Public Health Service Act (re-
lating to minimum direct care registered nurse staff-
ing requirements).’’. 
(c) HEALTH BENEFITS PROGRAM OF THE DEPART-
MENT OF VETERANS AFFAIRS.—Section 8110(a) of title 
38, United States Code, is amended by adding at the end 
the following new paragraphs: 
‘‘(7) In the case of a Department medical facil-
ity that is a hospital, the hospital shall comply with 
the provisions of title XXXIV of the Public Health 
Service Act. 
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‘‘(8) Nothing either in chapter 74 of this title 
or in section 7106 of title 5 shall preclude enforce-
ment of the provisions of title XXXIV of the Public 
Health Service Act with respect to a Department 
hospital through grievance procedures negotiated in 
accordance with chapter 71 of title 5.’’. 
(d) HEALTH BENEFITS PROGRAM OF THE DEPART-
MENT OF DEFENSE.— 
(1) IN
GENERAL.—Chapter 55 of title 10, 
United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 1110c. Staffing requirements 
‘‘In the case of a facility of the uniformed services 
that is a hospital, the hospital shall comply with the provi-
sions of title XXXIV of the Public Health Service Act.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
by inserting after the item relating to section 1110b 
the following new item: 
‘‘1110c. Staffing requirements.’’. 
(e) INDIAN HEALTH SERVICES PROGRAM.—Title 
VIII of the Indian Health Care Improvement Act (25 
U.S.C. 1671 et seq.) is amended by adding at the end 
the following new section: 
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‘‘SEC. 833. STAFFING REQUIREMENTS. 
‘‘All hospitals of the Service shall comply with the 
provisions of title XXXIV of the Public Health Service Act 
(relating to minimum direct care registered nurse staffing 
requirements).’’. 
(f) FEDERAL LABOR-MANAGEMENT RELATIONS.— 
(1) IN
GENERAL.—Section 7106 of title 5, 
United States Code, is amended by adding at the 
end the following: 
‘‘(c) Nothing in this section shall preclude enforce-
ment of the provisions of title XXXIV of the Public Health 
Service Act through grievance procedures negotiated in ac-
cordance with section 7121.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
7106(a) of title 5, United States Code, is amended 
by striking ‘‘Subject to subsection (b) of this title,’’ 
and inserting ‘‘Subject to subsections (b) and (c),’’. 
SEC. 4. NURSE WORKFORCE INITIATIVE. 
(a) SCHOLARSHIP AND STIPEND PROGRAM.—Section 
846(d) of the Public Health Service Act (42 U.S.C. 
297n(d)) is amended— 
(1) in the section heading, by inserting ‘‘AND 
STIPEND’’ after ‘‘SCHOLARSHIP’’; and 
(2) in paragraph (1), by inserting ‘‘or stipends’’ 
after ‘‘scholarships’’. 
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(b) NURSE RETENTION GRANTS.—Section 831A(b) 
of the Public Health Service Act (42 U.S.C. 296p–1(b)) 
is amended— 
(1) by striking ‘‘GRANTS FOR CAREER LADDER 
PROGRAM.—’’ and inserting ‘‘GRANTS FOR NURSE 
RETENTION.—’’; 
(2) in paragraph (2), by striking ‘‘; or’’ and in-
serting a semicolon; 
(3) in paragraph (3), by striking the period and 
inserting a semicolon; and 
(4) by adding at the end the following: 
‘‘(4) to provide additional support to nurses en-
tering the workforce by implementing nursing pre-
ceptorship projects that establish a period of prac-
tical and clinical experiences and training for nurs-
ing students, newly hired nurses, and recent grad-
uates of a direct care degree program for registered 
nurses; or 
‘‘(5) to implement mentorship projects that as-
sist new or transitional direct care registered nurses 
in adapting to the hospital setting.’’. 
Æ 
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