(1) GRANT RECIPIENT REPORT.—As a condi-
tion on receipt of a grant under this section, a nurs-
ing facility shall agree to submit to the Secretary an 
annual report on the activities conducted through 
the grant, including— 
(A) a breakdown of how and when the 
grant funds were used; and 
(B) with respect to each resident at such 
facility, any difference in— 
(i) quality of care; and 
(ii) quality of life. 
(2) GAO REPORT.—Not later than June 1, 
2028, the Comptroller General of the United States 
shall submit to Congress a report on the grant pro-
gram under this section, including— 
(A) a summary of the reports under para-
graph (1); and 
(B) a summary comparing the quality of 
care and quality of life among residents who are 
in a small-house nursing facility to residents in 
traditional nursing facilities. 
(h) DAVIS-BACON COMPLIANCE.— 
(1) IN GENERAL.—All laborers and mechanics 
employed by contractors or subcontractors to per-
form construction, alteration, or repair on projects 
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funded in whole or in part by this Act shall be paid 
wages at rates not less than those prevailing on 
projects of a character similar in the locality as de-
termined by the Secretary of Labor in accordance 
with subchapter IV of chapter 31 of title 40, United 
States Code (commonly referred to as the ‘‘Davis- 
Bacon Act’’). 
(2) AUTHORITY.—With respect to the labor 
standards specified in paragraph (1), the Secretary 
of Labor shall have the authority and functions set 
forth in Reorganization Plan Numbered 14 of 1950 
(64 Stat. 1267; 5 U.S.C. App.) and section 3145 of 
title 40, United States Code. 
(i) DEFINITIONS.—In this Act: 
(1) SMALL-HOUSE
NURSING
FACILITY.—The 
term ‘‘small-house nursing facility’’ means a nursing 
facility that includes the following: 
(A) Provides each resident— 
(i) a single-occupancy room with a 
private bathroom; or 
(ii) at the request of the resident, a 
room with a private bathroom to be shared 
with the resident’s spouse, partner, or pre-
ferred roommate. 
(B) Serves not more than 12 residents— 
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(i) in a separate building for a nurs-
ing facility located in a rural area; or 
(ii) in a separate building, a separate 
floor, or a separate wing for a nursing fa-
cility located in an urban area. 
(C) Uses appropriately skilled staff to pro-
vide all personal care for residents, including 
cooking, light housekeeping, and laundry serv-
ice. 
(D) Assigns each nursing assistant for 
each work shift to not more than one nursing 
facility segment described in clauses (i) and (ii) 
of subparagraph (B). 
(E) Provides resident-centered care that 
allows maximum level of resident independence. 
(2) NURSING
FACILITY.—The term ‘‘nursing 
facility’’ has the meaning given such term under sec-
tion 1919 of the Social Security Act (42 U.S.C. 
1396r). 
(3) RURAL
AREA.—The term ‘‘rural area’’ 
means an area other than an urban area or an area 
contiguous and adjacent to an urban area. 
(4) URBAN
AREA.—The term ‘‘urban area’’ 
means a town or city that has a population of great-
er than 50,000 residents, according to the Census 
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Bureau’s most recent annual estimates of resident 
population. 
(j) APPROPRIATIONS.— 
(1) IN GENERAL.—To carry out this Act, there 
is authorized to be appropriated $30,000,000,000 
for the period of fiscal years 2024 through 2027. 
(2) MINIMUM
AMOUNTS.—Of the amounts 
available under paragraph (1), the Secretary shall 
award— 
(A) not less than 30 percent to urban 
nursing facilities; 
(B) not less than 10 percent to rural nurs-
ing facilities; and 
(C) not less than 50 percent to nursing fa-
cilities that have 85 percent or more residents 
who receive benefits under the Medicaid pro-
gram under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.). 
Æ 
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