H. R. 3590—674 
‘‘(A) IN GENERAL.—The Secretary shall make grants 
to eligible entities to enable the entities to provide training 
and technical assistance. 
‘‘(B) AUTHORIZED ACTIVITIES.—An eligible entity that 
receives a grant under subparagraph (A) shall use funds 
made available through the grant to provide training and 
technical assistance regarding management practices using 
methods that are demonstrated to promote retention of 
individuals who provide direct care, such as— 
‘‘(i) the establishment of standard human resource 
policies that reward high performance, including poli-
cies that provide for improved wages and benefits on 
the basis of job reviews; 
‘‘(ii) 
the 
establishment 
of 
motivational 
and 
thoughtful work organization practices; 
‘‘(iii) the creation of a workplace culture that 
respects and values caregivers and their needs; 
‘‘(iv) the promotion of a workplace culture that 
respects the rights of residents of an eligible entity 
or individuals receiving community-based long-term 
care from an eligible entity and results in improved 
care for the residents or the individuals; and 
‘‘(v) the establishment of other programs that pro-
mote the provision of high quality care, such as a 
continuing education program that provides additional 
hours of training, including on-the-job training, for 
employees who are certified nurse aides. 
‘‘(C) APPLICATION.—To be eligible to receive a grant 
under this paragraph, an eligible entity shall submit an 
application to the Secretary at such time, in such manner, 
and containing such information as the Secretary may 
require (which may include evidence of consultation with 
the State in which the eligible entity is located with respect 
to carrying out activities funded under the grant). 
‘‘(D) AUTHORITY TO LIMIT NUMBER OF APPLICANTS.— 
Nothing in this paragraph shall be construed as prohibiting 
the Secretary from limiting the number of applicants for 
a grant under this paragraph. 
‘‘(4) ACCOUNTABILITY
MEASURES.—The Secretary shall 
develop accountability measures to ensure that the activities 
conducted using funds made available under this subsection 
benefit individuals who provide direct care and increase the 
stability of the long-term care workforce. 
‘‘(5) DEFINITIONS.—In this subsection: 
‘‘(A) COMMUNITY-BASED LONG-TERM CARE.—The term 
‘community-based long-term care’ has the meaning given 
such term by the Secretary. 
‘‘(B) ELIGIBLE ENTITY.—The term ‘eligible entity’ means 
the following: 
‘‘(i) A long-term care facility. 
‘‘(ii) A community-based long-term care entity (as 
defined by the Secretary). 
‘‘(b) CERTIFIED EHR TECHNOLOGY GRANT PROGRAM.— 
‘‘(1) GRANTS AUTHORIZED.—The Secretary is authorized to 
make grants to long-term care facilities for the purpose of 
assisting such entities in offsetting the costs related to pur-
chasing, leasing, developing, and implementing certified EHR
H. R. 3590—675 
technology (as defined in section 1848(o)(4)) designed to improve 
patient safety and reduce adverse events and health care com-
plications resulting from medication errors. 
‘‘(2) USE OF GRANT FUNDS.—Funds provided under grants 
under this subsection may be used for any of the following: 
‘‘(A) Purchasing, leasing, and installing computer soft-
ware and hardware, including handheld computer tech-
nologies. 
‘‘(B) Making improvements to existing computer soft-
ware and hardware. 
‘‘(C) Making upgrades and other improvements to 
existing computer software and hardware to enable e-pre-
scribing. 
‘‘(D) Providing education and training to eligible long- 
term care facility staff on the use of such technology to 
implement the electronic transmission of prescription and 
patient information. 
‘‘(3) APPLICATION.— 
‘‘(A) IN GENERAL.—To be eligible to receive a grant 
under this subsection, a long-term care facility shall submit 
an application to the Secretary at such time, in such 
manner, and containing such information as the Secretary 
may require (which may include evidence of consultation 
with the State in which the long-term care facility is located 
with respect to carrying out activities funded under the 
grant). 
‘‘(B) AUTHORITY TO LIMIT NUMBER OF APPLICANTS.— 
Nothing in this subsection shall be construed as prohibiting 
the Secretary from limiting the number of applicants for 
a grant under this subsection. 
‘‘(4) PARTICIPATION IN STATE HEALTH EXCHANGES.—A long- 
term care facility that receives a grant under this subsection 
shall, where available, participate in activities conducted by 
a State or a qualified State-designated entity (as defined in 
section 3013(f) of the Public Health Service Act) under a grant 
under section 3013 of the Public Health Service Act to coordi-
nate care and for other purposes determined appropriate by 
the Secretary. 
‘‘(5) ACCOUNTABILITY
MEASURES.—The Secretary shall 
develop accountability measures to ensure that the activities 
conducted using funds made available under this subsection 
help improve patient safety and reduce adverse events and 
health care complications resulting from medication errors. 
‘‘(c) ADOPTION OF STANDARDS FOR TRANSACTIONS INVOLVING 
CLINICAL DATA BY LONG-TERM CARE FACILITIES.— 
‘‘(1) STANDARDS AND COMPATIBILITY.—The Secretary shall 
adopt electronic standards for the exchange of clinical data 
by long-term care facilities, including, where available, stand-
ards for messaging and nomenclature. Standards adopted by 
the Secretary under the preceding sentence shall be compatible 
with standards established under part C of title XI, standards 
established under subsections (b)(2)(B)(i) and (e)(4) of section 
1860D–4, standards adopted under section 3004 of the Public 
Health Service Act, and general health information technology 
standards. 
‘‘(2) ELECTRONIC SUBMISSION OF DATA TO THE SECRETARY.—
H. R. 3590—676 
‘‘(A) IN GENERAL.—Not later than 10 years after the 
date of enactment of the Elder Justice Act of 2009, the 
Secretary shall have procedures in place to accept the 
optional electronic submission of clinical data by long-term 
care facilities pursuant to the standards adopted under 
paragraph (1). 
‘‘(B) RULE
OF
CONSTRUCTION.—Nothing in this sub-
section shall be construed to require a long-term care 
facility to submit clinical data electronically to the Sec-
retary. 
‘‘(3) REGULATIONS.—The Secretary shall promulgate regula-
tions to carry out this subsection. Such regulations shall require 
a State, as a condition of the receipt of funds under this 
part, to conduct such data collection and reporting as the Sec-
retary determines are necessary to satisfy the requirements 
of this subsection. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 
to be appropriated to carry out this section— 
‘‘(1) for fiscal year 2011, $20,000,000; 
‘‘(2) for fiscal year 2012, $17,500,000; and 
‘‘(3) for each of fiscal years 2013 and 2014, $15,000,000. 
‘‘SEC. 2042. ADULT PROTECTIVE SERVICES FUNCTIONS AND GRANT 
PROGRAMS. 
‘‘(a) SECRETARIAL RESPONSIBILITIES.— 
‘‘(1) IN
GENERAL.—The Secretary shall ensure that the 
Department of Health and Human Services— 
‘‘(A) provides funding authorized by this part to State 
and local adult protective services offices that investigate 
reports of the abuse, neglect, and exploitation of elders; 
‘‘(B) collects and disseminates data annually relating 
to the abuse, exploitation, and neglect of elders in coordina-
tion with the Department of Justice; 
‘‘(C) develops and disseminates information on best 
practices regarding, and provides training on, carrying out 
adult protective services; 
‘‘(D) conducts research related to the provision of adult 
protective services; and 
‘‘(E) provides technical assistance to States and other 
entities that provide or fund the provision of adult protec-
tive services, including through grants made under sub-
sections (b) and (c). 
‘‘(2) 
AUTHORIZATION
OF
APPROPRIATIONS.—There 
are 
authorized to be appropriated to carry out this subsection, 
$3,000,000 for fiscal year 2011 and $4,000,000 for each of 
fiscal years 2012 through 2014. 
‘‘(b) GRANTS TO ENHANCE THE PROVISION OF ADULT PROTECTIVE 
SERVICES.— 
‘‘(1) ESTABLISHMENT.—There is established an adult protec-
tive services grant program under which the Secretary shall 
annually award grants to States in the amounts calculated 
under paragraph (2) for the purposes of enhancing adult protec-
tive services provided by States and local units of government. 
‘‘(2) AMOUNT OF PAYMENT.— 
‘‘(A) IN GENERAL.—Subject to the availability of appro-
priations and subparagraphs (B) and (C), the amount paid 
to a State for a fiscal year under the program under this
H. R. 3590—677 
subsection shall equal the amount appropriated for that 
year to carry out this subsection multiplied by the percent-
age of the total number of elders who reside in the United 
States who reside in that State. 
‘‘(B) GUARANTEED MINIMUM PAYMENT AMOUNT.— 
‘‘(i) 50 STATES.—Subject to clause (ii), if the amount 
determined under subparagraph (A) for a State for 
a fiscal year is less than 0.75 percent of the amount 
appropriated for such year, the Secretary shall increase 
such determined amount so that the total amount paid 
under this subsection to the State for the year is equal 
to 0.75 percent of the amount so appropriated. 
‘‘(ii) TERRITORIES.—In the case of a State other 
than 1 of the 50 States, clause (i) shall be applied 
as if each reference to ‘0.75’ were a reference to ‘0.1’. 
‘‘(C) PRO RATA REDUCTIONS.—The Secretary shall make 
such pro rata reductions to the amounts described in 
subparagraph (A) as are necessary to comply with the 
requirements of subparagraph (B). 
‘‘(3) AUTHORIZED ACTIVITIES.— 
‘‘(A) ADULT PROTECTIVE SERVICES.—Funds made avail-
able pursuant to this subsection may only be used by 
States and local units of government to provide adult 
protective services and may not be used for any other 
purpose. 
‘‘(B) USE
BY
AGENCY.—Each State receiving funds 
pursuant to this subsection shall provide such funds to 
the agency or unit of State government having legal respon-
sibility for providing adult protective services within the 
State. 
‘‘(C) SUPPLEMENT NOT SUPPLANT.—Each State or local 
unit of government shall use funds made available pursu-
ant to this subsection to supplement and not supplant 
other Federal, State, and local public funds expended to 
provide adult protective services in the State. 
‘‘(4) STATE
REPORTS.—Each State receiving funds under 
this subsection shall submit to the Secretary, at such time 
and in such manner as the Secretary may require, a report 
on the number of elders served by the grants awarded under 
this subsection. 
‘‘(5) 
AUTHORIZATION
OF
APPROPRIATIONS.—There 
are 
authorized to be appropriated to carry out this subsection, 
$100,000,000 for each of fiscal years 2011 through 2014. 
‘‘(c) STATE DEMONSTRATION PROGRAMS.— 
‘‘(1) ESTABLISHMENT.—The Secretary shall award grants 
to States for the purposes of conducting demonstration pro-
grams in accordance with paragraph (2). 
‘‘(2) DEMONSTRATION
PROGRAMS.—Funds made available 
pursuant to this subsection may be used by States and local 
units of government to conduct demonstration programs that 
test— 
‘‘(A) training modules developed for the purpose of 
detecting or preventing elder abuse; 
‘‘(B) methods to detect or prevent financial exploitation 
of elders; 
‘‘(C) methods to detect elder abuse;
H. R. 3590—678 
‘‘(D) whether training on elder abuse forensics 
enhances the detection of elder abuse by employees of 
the State or local unit of government; or 
‘‘(E) other matters relating to the detection or preven-
tion of elder abuse. 
‘‘(3) APPLICATION.—To be eligible to receive a grant under 
this subsection, a State shall submit an application to the 
Secretary at such time, in such manner, and containing such 
information as the Secretary may require. 
‘‘(4) STATE REPORTS.—Each State that receives funds under 
this subsection shall submit to the Secretary a report at such 
time, in such manner, and containing such information as 
the Secretary may require on the results of the demonstration 
program conducted by the State using funds made available 
under this subsection. 
‘‘(5) 
AUTHORIZATION
OF
APPROPRIATIONS.—There 
are 
authorized to be appropriated to carry out this subsection, 
$25,000,000 for each of fiscal years 2011 through 2014. 
‘‘SEC. 2043. LONG-TERM CARE OMBUDSMAN PROGRAM GRANTS AND 
TRAINING. 
‘‘(a) GRANTS TO SUPPORT THE LONG-TERM CARE OMBUDSMAN 
PROGRAM.— 
‘‘(1) IN
GENERAL.—The Secretary shall make grants to 
eligible entities with relevant expertise and experience in abuse 
and neglect in long-term care facilities or long-term care 
ombudsman programs and responsibilities, for the purpose of— 
‘‘(A) improving the capacity of State long-term care 
ombudsman programs to respond to and resolve complaints 
about abuse and neglect; 
‘‘(B) conducting pilot programs with State long-term 
care ombudsman offices or local ombudsman entities; and 
‘‘(C) providing support for such State long-term care 
ombudsman programs and such pilot programs (such as 
through the establishment of a national long-term care 
ombudsman resource center). 
‘‘(2) 
AUTHORIZATION
OF
APPROPRIATIONS.—There 
are 
authorized to be appropriated to carry out this subsection— 
‘‘(A) for fiscal year 2011, $5,000,000; 
‘‘(B) for fiscal year 2012, $7,500,000; and 
‘‘(C) for each of fiscal years 2013 and 2014, $10,000,000. 
‘‘(b) OMBUDSMAN TRAINING PROGRAMS.— 
‘‘(1) IN GENERAL.—The Secretary shall establish programs 
to provide and improve ombudsman training with respect to 
elder abuse, neglect, and exploitation for national organizations 
and State long-term care ombudsman programs. 
‘‘(2) 
AUTHORIZATION
OF
APPROPRIATIONS.—There 
are 
authorized to be appropriated to carry out this subsection, 
for each of fiscal years 2011 through 2014, $10,000,000. 
‘‘SEC. 2044. PROVISION OF INFORMATION REGARDING, AND EVALUA-
TIONS OF, ELDER JUSTICE PROGRAMS. 
‘‘(a) PROVISION OF INFORMATION.—To be eligible to receive a 
grant under this part, an applicant shall agree— 
‘‘(1) except as provided in paragraph (2), to provide the 
eligible entity conducting an evaluation under subsection (b) 
of the activities funded through the grant with such information
H. R. 3590—680 
‘‘(1) compiling, summarizing, and analyzing the information 
contained in the State reports submitted under subsections 
(b)(4) and (c)(4) of section 2042; and 
‘‘(2) containing such recommendations for legislative or 
administrative action as the Secretary determines to be appro-
priate. 
‘‘SEC. 2046. RULE OF CONSTRUCTION. 
‘‘Nothing in this subtitle shall be construed as— 
‘‘(1) limiting any cause of action or other relief related 
to obligations under this subtitle that is available under the 
law of any State, or political subdivision thereof; or 
‘‘(2) creating a private cause of action for a violation of 
this subtitle.’’. 
(2) OPTION
FOR
STATE
PLAN
UNDER
PROGRAM
FOR
TEM-
PORARY ASSISTANCE FOR NEEDY FAMILIES.— 
(A) IN
GENERAL.—Section 402(a)(1)(B) of the Social 
Security Act (42 U.S.C. 602(a)(1)(B)) is amended by adding 
at the end the following new clause: 
‘‘(v) The document shall indicate whether the State 
intends to assist individuals to train for, seek, and 
maintain employment— 
‘‘(I) providing direct care in a long-term care 
facility (as such terms are defined under section 
2011); or 
‘‘(II) in other occupations related to elder care 
determined appropriate by the State for which the 
State identifies an unmet need for service per-
sonnel, 
and, if so, shall include an overview of such assist-
ance.’’. 
(B) EFFECTIVE
DATE.—The amendment made by 
subparagraph (A) shall take effect on January 1, 2011. 
(b) PROTECTING RESIDENTS OF LONG-TERM CARE FACILITIES.— 
(1) NATIONAL TRAINING INSTITUTE FOR SURVEYORS.— 
(A) IN GENERAL.—The Secretary of Health and Human 
Services shall enter into a contract with an entity for 
the purpose of establishing and operating a National 
Training Institute for Federal and State surveyors. Such 
Institute shall provide and improve the training of sur-
veyors with respect to investigating allegations of abuse, 
neglect, and misappropriation of property in programs and 
long-term care facilities that receive payments under title 
XVIII or XIX of the Social Security Act. 
(B) ACTIVITIES CARRIED OUT BY THE INSTITUTE.—The 
contract entered into under subparagraph (A) shall require 
the Institute established and operated under such contract 
to carry out the following activities: 
(i) Assess the extent to which State agencies use 
specialized surveyors for the investigation of reported 
allegations of abuse, neglect, and misappropriation of 
property in such programs and long-term care facilities. 
(ii) Evaluate how the competencies of surveyors 
may be improved to more effectively investigate 
reported allegations of such abuse, neglect, and mis-
appropriation of property, and provide feedback to Fed-
eral and State agencies on the evaluations conducted.
H. R. 3590—681 
(iii) Provide a national program of training, tools, 
and technical assistance to Federal and State surveyors 
on investigating reports of such abuse, neglect, and 
misappropriation of property. 
(iv) Develop and disseminate information on best 
practices for the investigation of such abuse, neglect, 
and misappropriation of property. 
(v) Assess the performance of State complaint 
intake systems, in order to ensure that the intake 
of complaints occurs 24 hours per day, 7 days a week 
(including holidays). 
(vi) To the extent approved by the Secretary of 
Health and Human Services, provide a national 24 
hours per day, 7 days a week (including holidays), 
back-up system to State complaint intake systems in 
order to ensure optimum national responsiveness to 
complaints of such abuse, neglect, and misappropria-
tion of property. 
(vii) Analyze and report annually on the following: 
(I) The total number and sources of complaints 
of such abuse, neglect, and misappropriation of 
property. 
(II) The extent to which such complaints are 
referred to law enforcement agencies. 
(III) General results of Federal and State 
investigations of such complaints. 
(viii) Conduct a national study of the cost to State 
agencies of conducting complaint investigations of 
skilled nursing facilities and nursing facilities under 
sections 1819 and 1919, respectively, of the Social Secu-
rity Act (42 U.S.C. 1395i–3; 1396r), and making rec-
ommendations to the Secretary of Health and Human 
Services with respect to options to increase the effi-
ciency and cost-effectiveness of such investigations. 
(C) AUTHORIZATION.—There are authorized to be appro-
priated to carry out this paragraph, for the period of fiscal 
years 2011 through 2014, $12,000,000. 
(2) GRANTS TO STATE SURVEY AGENCIES.— 
(A) IN GENERAL.—The Secretary of Health and Human 
Services shall make grants to State agencies that perform 
surveys of skilled nursing facilities or nursing facilities 
under sections 1819 or 1919, respectively, of the Social 
Security Act (42 U.S.C. 1395i–3; 1395r). 
(B) USE OF FUNDS.—A grant awarded under subpara-
graph (A) shall be used for the purpose of designing and 
implementing complaint investigations systems that— 
(i) promptly prioritize complaints in order to 
ensure a rapid response to the most serious and urgent 
complaints; 
(ii) respond to complaints with optimum effective-
ness and timeliness; and 
(iii) optimize the collaboration between local 
authorities, consumers, and providers, including— 
(I) such State agency; 
(II) the State Long-Term Care Ombudsman; 
(III) local law enforcement agencies; 
(IV) advocacy and consumer organizations;
H. R. 3590—682 
(V) State aging units; 
(VI) Area Agencies on Aging; and 
(VII) other appropriate entities. 
(C) AUTHORIZATION.—There are authorized to be appro-
priated to carry out this paragraph, for each of fiscal years 
2011 through 2014, $5,000,000. 
(3) REPORTING
OF
CRIMES
IN
FEDERALLY
FUNDED
LONG- 
TERM CARE FACILITIES.—Part A of title XI of the Social Security 
Act (42 U.S.C. 1301 et seq.), as amended by section 6005, 
is amended by inserting after section 1150A the following new 
section: 
‘‘REPORTING TO LAW ENFORCEMENT OF CRIMES OCCURRING IN 
FEDERALLY FUNDED LONG-TERM CARE FACILITIES 
‘‘SEC. 1150B. (a) DETERMINATION AND NOTIFICATION.— 
‘‘(1) DETERMINATION.—The owner or operator of each long- 
term care facility that receives Federal funds under this Act 
shall annually determine whether the facility received at least 
$10,000 in such Federal funds during the preceding year. 
‘‘(2) NOTIFICATION.—If the owner or operator determines 
under paragraph (1) that the facility received at least $10,000 
in such Federal funds during the preceding year, such owner 
or operator shall annually notify each covered individual (as 
defined in paragraph (3)) of that individual’s obligation to 
comply with the reporting requirements described in subsection 
(b). 
‘‘(3) COVERED INDIVIDUAL DEFINED.—In this section, the 
term ‘covered individual’ means each individual who is an 
owner, operator, employee, manager, agent, or contractor of 
a long-term care facility that is the subject of a determination 
described in paragraph (1). 
‘‘(b) REPORTING REQUIREMENTS.— 
‘‘(1) IN GENERAL.—Each covered individual shall report to 
the Secretary and 1 or more law enforcement entities for the 
political subdivision in which the facility is located any reason-
able suspicion of a crime (as defined by the law of the applicable 
political subdivision) against any individual who is a resident 
of, or is receiving care from, the facility. 
‘‘(2) TIMING.—If the events that cause the suspicion— 
‘‘(A) result in serious bodily injury, the individual shall 
report the suspicion immediately, but not later than 2 
hours after forming the suspicion; and 
‘‘(B) do not result in serious bodily injury, the indi-
vidual shall report the suspicion not later than 24 hours 
after forming the suspicion. 
‘‘(c) PENALTIES.— 
‘‘(1) IN
GENERAL.—If a covered individual violates sub-
section (b)— 
‘‘(A) the covered individual shall be subject to a civil 
money penalty of not more than $200,000; and 
‘‘(B) the Secretary may make a determination in the 
same proceeding to exclude the covered individual from 
participation in any Federal health care program (as 
defined in section 1128B(f)). 
‘‘(2) INCREASED HARM.—If a covered individual violates sub-
section (b) and the violation exacerbates the harm to the victim 
of the crime or results in harm to another individual—
H. R. 3590—683 
‘‘(A) the covered individual shall be subject to a civil 
money penalty of not more than $300,000; and 
‘‘(B) the Secretary may make a determination in the 
same proceeding to exclude the covered individual from 
participation in any Federal health care program (as 
defined in section 1128B(f)). 
‘‘(3) EXCLUDED INDIVIDUAL.—During any period for which 
a covered individual is classified as an excluded individual 
under paragraph (1)(B) or (2)(B), a long-term care facility that 
employs such individual shall be ineligible to receive Federal 
funds under this Act. 
‘‘(4) EXTENUATING CIRCUMSTANCES.— 
‘‘(A) IN GENERAL.—The Secretary may take into account 
the financial burden on providers with underserved popu-
lations in determining any penalty to be imposed under 
this subsection. 
‘‘(B) UNDERSERVED
POPULATION
DEFINED.—In this 
paragraph, the term ‘underserved population’ means the 
population of an area designated by the Secretary as an 
area with a shortage of elder justice programs or a popu-
lation group designated by the Secretary as having a short-
age of such programs. Such areas or groups designated 
by the Secretary may include— 
‘‘(i) areas or groups that are geographically isolated 
(such as isolated in a rural area); 
‘‘(ii) racial and ethnic minority populations; and 
‘‘(iii) populations underserved because of special 
needs (such as language barriers, disabilities, alien 
status, or age). 
‘‘(d) ADDITIONAL PENALTIES FOR RETALIATION.— 
‘‘(1) IN GENERAL.—A long-term care facility may not— 
‘‘(A) discharge, demote, suspend, threaten, harass, or 
deny a promotion or other employment-related benefit to 
an employee, or in any other manner discriminate against 
an employee in the terms and conditions of employment 
because of lawful acts done by the employee; or 
‘‘(B) file a complaint or a report against a nurse or 
other employee with the appropriate State professional dis-
ciplinary agency because of lawful acts done by the nurse 
or employee, 
for making a report, causing a report to be made, or for taking 
steps in furtherance of making a report pursuant to subsection 
(b)(1). 
‘‘(2) PENALTIES
FOR
RETALIATION.—If a long-term care 
facility violates subparagraph (A) or (B) of paragraph (1) the 
facility shall be subject to a civil money penalty of not more 
than $200,000 or the Secretary may classify the entity as 
an excluded entity for a period of 2 years pursuant to section 
1128(b), or both. 
‘‘(3) REQUIREMENT TO POST NOTICE.—Each long-term care 
facility shall post conspicuously in an appropriate location a 
sign (in a form specified by the Secretary) specifying the rights 
of employees under this section. Such sign shall include a 
statement that an employee may file a complaint with the 
Secretary against a long-term care facility that violates the 
provisions of this subsection and information with respect to 
the manner of filing such a complaint.