I
107TH CONGRESS
1ST SESSION
H. R. 1804
To require Medicare providers to disclose publicly staffing and performance
in order to promote improved consumer information and choice.
IN THE HOUSE OF REPRESENTATIVES
MAY 10, 2001
Mr. HINCHEY introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned
A BILL
To require Medicare providers to disclose publicly staffing
and performance in order to promote improved consumer
information and choice.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Patient Safety Act of
2001’’.
SEC. 2. PUBLIC DISCLOSURE OF STAFFING AND OUTCOMES
DATA.
(a) DISCLOSURE OF STAFFING AND OUTCOMES.—
Any provider under the medicare program shall, as a con-
dition of continued participation in such program, make
publicly available information regarding nurse staffing
and patient outcomes as specified by the Secretary. Such
information shall include at least the following:
(1) The number of registered nurses providing
direct care. This information shall be expressed both
in raw numbers, in terms of total hours of nursing
care per patient (including adjustment for case mix
and acuity), and as a percentage of nursing staff,
and shall be broken down in terms of the total nurs-
ing staff, each unit, and each shift.
(2) The number of licensed practical nurses or
licensed vocational nurses providing direct care. This
information shall be expressed both in raw numbers,
in terms of total hours of nursing care per patient
(including adjustment for case mix and acuity), and
as a percentage of nursing staff, and shall be broken
down in terms of the total nursing staff, each unit,
and each shift.
(3) Numbers of unlicensed personnel utilized to
provide direct patient care. This information shall be
expressed both in raw numbers and as a percentage
of nursing staff and shall be broken down in terms
of the total nursing staff, each unit, and each shift.
(4) The average number of patients per reg-
istered nurse providing direct patient care. This in-
formation shall be broken down in terms of the total
nursing staff, each unit, and each shift.
(5) Risk-adjusted patient mortality rate (in raw
numbers and by diagnosis or diagnostic-related
group).
(6) Incidence of adverse patient care incidents,
including as such incidents at least medication er-
rors, patient injury, pressure ulcers, nosocomial in-
fections, and nosocomial urinary tract infections.
(7) Methods used for determining and adjusting
staffing levels and patient care needs and the pro-
vider’s compliance with these methods.
(b) DISCLOSURE OF COMPLAINTS.—Data regarding
complaints filed with the State agency, the Health Care
Financing Administration, or an accrediting agency, com-
pliance with the standards of which have been deemed to
demonstrate compliance with conditions of participation
under the medicare program, and data regarding inves-
tigations and findings as a result of those complaints and
the findings of scheduled inspection visits, shall be made
publicly available.
(c) INFORMATION ON DATA.—All data made publicly
available under this section shall indicate the source and
currency of the data provided.
(d) WAIVER FOR SMALL PROVIDERS.—The Secretary
may waive or reduce reporting requirements under this
section in the case of a small provider (as defined by the
Secretary) for whom the imposition of the requirements
would be unduly burdensome.
(e) DEFINITIONS.—For purposes of this section:
(1) LICENSED PRACTICAL NURSE OR LICENSED
VOCATIONAL NURSE.—The term ‘‘licensed practical
nurse or licensed vocational nurse’’ means an indi-
vidual who is entitled under State law or regulation
to practice as a licensed practical nurse or a licensed
vocational nurse.
(2) MADE
PUBLICLY
AVAILABLE.—The term
‘‘made publicly available’’ means, with respect to in-
formation of a provider, information that is—
(A) provided to the Secretary and to any
State agency responsible for licensing or accred-
iting the provider;
(B) provided to any State agency which
approves or oversees health care services deliv-
ered by the provider directly or through an in-
suring entity or corporation; and
(C) provided to any member of the public
which requests such information directly from
the provider.
(3) MEDICARE PROGRAM.—The term ‘‘medicare
program’’ means the programs under title XVIII of
the Social Security Act.
(4) PROVIDER.—The term ‘‘provider’’ means an
entity that is—
(A) a psychiatric hospital described in sec-
tion 1861(f) of the Social Security Act (42
U.S.C. 1395x(f));
(B) a provider of services described in sec-
tion 1861(u) of such Act (42 U.S.C. 1395x(u));
(C) a rural health clinic described in sec-
tion 1861(aa)(2) of such Act (42 U.S.C.
1395x(aa)(2));
(D) an ambulatory surgical center de-
scribed in section 1832(a)(2)(F)(i) of such Act
(42 U.S.C. 1395k(a)(2)(F)(i)); or
(E) a renal dialysis facility described in
section 1881(b)(1)(A) of such Act (42 U.S.C.
1395rr(b)(1)(A)).
(5) REGISTERED
NURSE.—The term ‘‘reg-
istered nurse’’ means an individual who is entitled
under State law or regulation to practice as a reg-
istered nurse.
(6) SECRETARY.—The term ‘‘Secretary’’ means
the Secretary of Health and Human Services.
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