(3) REPORTING
OF
CRIMES
AND
ENSURING 
SAFETY OF RESIDENTS WHEN FEDERALLY FUNDED 
LONG-TERM
CARE
FACILITIES
CLOSE.—Part A of 
title XI of the Social Security Act (42 U.S.C. 1301 
et seq.) is amended by adding at the end the fol-
lowing new sections: 
‘‘REPORTING TO LAW ENFORCEMENT OF CRIMES OCCUR-
RING IN FEDERALLY FUNDED LONG-TERM CARE FA-
CILITIES 
‘‘SEC. 1150A. (a) DETERMINATION AND NOTIFICA-
TION.— 
‘‘(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 re-
ceived at least $10,000 in such Federal funds during 
the preceding year, such owner or operator shall an-
nually 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 in-
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dividual who is an owner, operator, employee, man-
ager, 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 en-
forcement entities for the political subdivision in 
which the facility is located any reasonable 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 sus-
picion— 
‘‘(A) result in serious bodily injury, the in-
dividual 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 individual shall report the suspicion not 
later than 24 hours after forming the suspicion. 
‘‘(c) PENALTIES.— 
‘‘(1) IN GENERAL.—If a covered individual vio-
lates subsection (b)— 
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‘‘(A) the covered individual shall be subject 
to a civil money penalty of not more than 
$200,000; or 
‘‘(B) the Secretary shall classify the cov-
ered individual as an excluded individual, for a 
period of not more than 3 years. 
‘‘(2) INCREASED
HARM.—If a covered indi-
vidual violates subsection (b) and the violation exac-
erbates the harm to the victim of the crime or re-
sults in harm to another individual— 
‘‘(A) the covered individual shall be subject 
to a civil money penalty of not more than 
$300,000; and 
‘‘(B) the Secretary shall classify the cov-
ered individual as an excluded individual, for a 
period of not more than 3 years. 
‘‘(3) EXCLUDED INDIVIDUAL.—During any pe-
riod 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 pro-
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viders with underserved populations in deter-
mining any penalty to be imposed under this 
subsection. 
‘‘(B) UNDERSERVED
POPULATION
DE-
FINED.—In this paragraph, the term ‘under-
served population’ means the population of an 
area designated by the Secretary as an area 
with a shortage of elder justice programs or a 
population group designated by the Secretary 
as having a shortage of such programs. Such 
areas or groups designated by the Secretary 
may include— 
‘‘(i) areas or groups that are geo-
graphically isolated (such as isolated in a 
rural area); 
‘‘(ii) racial and ethnic minority popu-
lations; 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 employ-
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ment-related benefit to an employee, or in any 
other manner discriminate against an employee 
in the terms and conditions of employment be-
cause 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 disciplinary 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 state-
ment that an employee may file a complaint with the 
Secretary against a long-term care facility that vio-
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lates the provisions of this subsection and informa-
tion with respect to the manner of filing such a com-
plaint. 
‘‘(e) PROCEDURE.—The provisions of section 1128A 
(other than subsections (a) and (b) and the second sen-
tence of subsection (f)) shall apply to a civil money penalty 
under this section in the same manner as such provisions 
apply to a penalty or proceeding under section 1128A(a). 
‘‘(f) DEFINITIONS.—In this section, the terms ‘elder 
justice’, ‘long-term care facility’, and ‘law enforcement’ 
have the meanings given those terms in section 2011. 
‘‘ENSURING SAFETY OF RESIDENTS WHEN FEDERALLY 
FUNDED LONG-TERM CARE FACILITIES CLOSE 
‘‘SEC. 1150B. (a) IN GENERAL.— 
‘‘(1) NOTIFICATION OF FACILITY CLOSURE.— 
Subject to paragraph (2), if the owner or operator 
determines under section 1150A(a)(1) that a long- 
term care facility received at least $10,000 in Fed-
eral funds under this Act during the preceding year, 
the owner or operator of the facility shall— 
‘‘(A) submit to the Secretary and the ap-
propriate State regulatory agency written notifi-
cation of an impending closure not later than 
the date that is 60 days prior to the date of 
such closure; 
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‘‘(B) include in the notice a plan for the 
transfer and adequate relocation of the resi-
dents of the facility prior to closure, including 
assurances that the residents will be transferred 
to the most appropriate facility in terms of 
quality, services, and location; and 
‘‘(C) not later than 10 days after the facil-
ity closure, submit to the Secretary and the ap-
propriate State agency information identifying 
where residents of the closed facility were trans-
ferred and on what date. 
‘‘(2) EXCEPTION WHERE THE SECRETARY HAS 
ISSUED A TERMINATION NOTICE.—In the case of a 
long-term care facility described in paragraph (1) for 
which the Secretary has issued a termination notice 
for the facility to close by not later than 15 days 
after the issuance of such notice, the Secretary shall 
establish requirements for the notification, transfer, 
and adequate relocation of residents within an ap-
propriate timeframe. 
‘‘(b) SANCTIONS.—Any person owning or operating 
a long-term care facility that fails to comply with the re-
quirements of subsection (a) shall be subject to— 
‘‘(1) a civil monetary penalty of up to 
$1,000,000; 
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‘‘(2) exclusion from participation in the pro-
grams under this Act (in accordance with the proce-
dures of section 1128); and 
‘‘(3) any other applicable civil monetary pen-
alties and assessments. 
‘‘(c) PROCEDURE.—The provisions of section 1128A 
(other than subsections (a) and (b) and the second sen-
tence of subsection (f)) shall apply to a civil money penalty 
or assessment under this section in the same manner as 
such provisions apply to a penalty or proceeding under 
section 1128A(a). 
‘‘(d) DEFINITION.—In this section, the term ‘long- 
term care facility’ has the meaning given that term in sec-
tion 2011.’’. 
(c) NATIONAL NURSE AIDE REGISTRY.— 
(1) DEFINITION OF NURSE AIDE.—In this sub-
section, the term ‘‘nurse aide’’ has the meaning 
given that term in sections 1819(b)(5)(F) and 
1919(b)(5)(F) of the Social Security Act (42 U.S.C. 
1395i–3(b)(5)(F), 1396r(b)(5)(F)). 
(2) STUDY AND REPORT.— 
(A) IN GENERAL.—The Secretary, in con-
sultation with appropriate government agencies 
and private sector organizations, shall conduct 
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a study on establishing a national nurse aide 
registry. 
(B) AREAS EVALUATED.—The study con-
ducted under this subsection shall include an 
evaluation of— 
(i) who should be included in the reg-
istry; 
(ii) how such a registry would comply 
with Federal and State privacy laws and 
regulations; 
(iii) how data would be collected for 
the registry; 
(iv) what entities and individuals 
would have access to the data collected; 
(v) how the registry would provide ap-
propriate information regarding violations 
of Federal and State law by individuals in-
cluded in the registry; 
(vi) how the functions of a national 
nurse aide registry would be coordinated 
with the pilot program for national and 
State background checks on direct patient 
access employees of long-term care facili-
ties or providers established under section 
307 of the Medicare Prescription Drug, 
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Improvement, and Modernization Act of 
2003 (Public Law 108–173); and 
(vii) how the information included in 
State nurse aide registries developed and 
maintained under sections 1819(e)(2) and 
1919(e)(2) of the Social Security Act (42 
U.S.C. 
1395i–3(e)(2), 
1396r(e)(2)(2)) 
would be provided as part of a national 
nurse aide registry. 
(C) CONSIDERATIONS.—In conducting the 
study and preparing the report required under 
this subsection, the Secretary shall take into 
consideration the findings and conclusions of 
relevant reports and other relevant resources, 
including the following: 
(i) The Department of Health and 
Human Services Office of Inspector Gen-
eral Report, Nurse Aide Registries: State 
Compliance 
and 
Practices 
(February 
2005). 
(ii) The General Accounting Office 
(now known as the Government Account-
ability Office) Report, Nursing Homes: 
More Can Be Done to Protect Residents 
from Abuse (March 2002). 
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(iii) The Department of Health and 
Human Services Office of the Inspector 
General Report, Nurse Aide Registries: 
Long-Term Care Facility Compliance and 
Practices (July 2005). 
(iv) The Department of Health and 
Human Services Health Resources and 
Services Administration Report, Nursing 
Aides, Home Health Aides, and Related 
Health Care Occupations—National and 
Local Workforce Shortages and Associated 
Data Needs (2004) (in particular with re-
spect to chapter 7 and appendix F). 
(v) The 2001 Report to CMS from 
the School of Rural Public Health, Texas 
A&M University, Preventing Abuse and 
Neglect in Nursing Homes: The Role of 
Nurse Aide Registries. 
(vi) Information included in State 
nurse aide registries developed and main-
tained under sections 1819(e)(2) and 
1919(e)(2) of the Social Security Act (42 
U.S.C. 1395i–3(e)(2), 1396r(e)(2)(2)). 
(D) REPORT.—Not later than 18 months 
after the date of enactment of this Act, the Sec-
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(1) TITLE XX.—Title XX of the Social Security 
Act (42 U.S.C. 1397 et seq.), as amended by section 
102(a), is amended— 
(A) in the heading of section 2001, by 
striking ‘‘TITLE’’ and inserting ‘‘PART’’; and 
(B) in part A, by striking ‘‘this title’’ each 
place it appears and inserting ‘‘this part’’. 
(2) TITLE IV.—Title IV of the Social Security 
Act (42 U.S.C. 601 et seq.) is amended— 
(A) in section 404(d)— 
(i) in paragraph (1)(A), by striking 
‘‘Title’’ and inserting ‘‘Part A of title’’; 
(ii) in paragraphs (2)(A) and (3)(B), 
by inserting ‘‘part A of’’ before ‘‘title XX’’ 
each place it appears; 
(iii) in the heading of paragraph (2), 
by inserting ‘‘PART A OF’’ before ‘‘TITLE 
XX’’; and 
(iv) in the heading of paragraph 
(3)(B), by inserting ‘‘PART A OF’’ before 
‘‘TITLE XX’’; and 
(B) 
in 
sections 
422(b), 
471(a)(4), 
472(h)(1), and 473(b)(2), by inserting ‘‘part A 
of’’ before ‘‘title XX’’ each place it appears. 
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(3) TITLE XI.—Title XI of the Social Security 
Act (42 U.S.C. 1301 et seq.) is amended— 
(A) in section 1128(h)(3)— 
(i) by inserting ‘‘part A of’’ before 
‘‘title XX’’; and 
(ii) by striking ‘‘such title’’ and in-
serting ‘‘such part’’; and 
(B) in section 1128A(i)(1), by inserting 
‘‘part A of’’ before ‘‘title XX’’. 
TITLE II—DEPARTMENT OF 
JUSTICE 
SEC. 201. ANALYSIS, REPORT, AND RECOMMENDATIONS RE-
LATED TO ELDER JUSTICE PROGRAMS. 
(a) IN GENERAL.—The Attorney General, in con-
sultation with the Secretary of Health and Human Serv-
ices, shall carry out the following: 
(1) STUDY.—Conduct a study of laws and prac-
tices relating to elder abuse, neglect, and exploi-
tation, which shall include— 
(A) a comprehensive description of State 
laws and practices relating to elder abuse, ne-
glect, and exploitation; 
(B) a comprehensive analysis of the effec-
tiveness of such State laws and practices; and 
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(C) an examination of State laws and prac-
tices relating to specific elder abuse, neglect, 
and exploitation issues, including— 
(i) the definition of— 
(I) ‘‘elder’’; 
(II) ‘‘abuse’’; 
(III) ‘‘neglect’’; 
(IV) ‘‘exploitation’’; and 
(V) such related terms the Attor-
ney General determines to be appro-
priate; 
(ii) mandatory reporting laws, with re-
spect to— 
(I) who is a mandated reporter; 
(II) to whom must they report 
and within what time frame; and 
(III) any consequences for not 
reporting; 
(iii) 
evidentiary, 
procedural, 
sen-
tencing, choice of remedies, and data re-
tention issues relating to pursuing cases 
relating to elder abuse, neglect, and exploi-
tation; 
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(iv) laws requiring reporting of all 
nursing home deaths to the county coroner 
or to some other individual or entity; 
(v) fiduciary laws, including guardian-
ship and power of attorney laws; 
(vi) laws that permit or encourage 
banks and bank employees to prevent and 
report suspected elder abuse, neglect, and 
exploitation; 
(vii) laws relating to fraud and related 
activities in connection with mail, tele-
marketing, or the Internet; 
(viii) laws that may impede research 
on elder abuse, neglect, and exploitation; 
(ix) practices relating to the enforce-
ment of laws relating to elder abuse, ne-
glect, and exploitation; and 
(x) practices relating to other aspects 
of elder justice. 
(2) DEVELOPMENT OF PLAN.—Develop objec-
tives, priorities, policies, and a long-term plan for 
elder justice programs and activities relating to— 
(A) prevention and detection of elder 
abuse, neglect, and exploitation; 
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(B) intervention and treatment for victims 
of elder abuse, neglect, and exploitation; 
(C) training, evaluation, and research re-
lated to elder justice programs and activities; 
and 
(D) improvement of the elder justice sys-
tem in the United States. 
(3) REPORT.—Not later than 2 years after the 
date of enactment of this Act, submit to the Chair-
man and Ranking Member of the Special Committee 
on Aging of the Senate, the Speaker and minority 
leader of the House of Representatives, and the Sec-
retary of Health and Human Services, and make 
available to the States, a report that contains— 
(A) the findings of the study conducted 
under paragraph (1); 
(B) a description of the objectives, prior-
ities, policies, and a long-term plan developed 
under paragraph (2); and 
(C) a list, description, and analysis of the 
best practices used by States to develop, imple-
ment, maintain, and improve elder justice sys-
tems, based on such findings. 
(b) GAO RECOMMENDATIONS.—Not later than 18 
months after the date of enactment of this Act, the Comp-
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troller General shall review existing Federal programs and 
initiatives in the Federal criminal justice system relevant 
to elder justice and shall submit to Congress— 
(1) a report on such programs and initiatives; 
and 
(2) any recommendations the Comptroller Gen-
eral determines are appropriate to improve elder jus-
tice in the United States. 
(c) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$6,000,000 for each of the fiscal years 2010 through 
2016. 
SEC. 202. VICTIM ADVOCACY GRANTS. 
(a) GRANTS AUTHORIZED.—The Attorney General, 
after consultation with the Secretary of Health and 
Human Services, may award grants to eligible entities to 
study the special needs of victims of elder abuse, neglect, 
and exploitation. 
(b) AUTHORIZED ACTIVITIES.—Funds awarded pur-
suant to subsection (a) shall be used for pilot programs 
that— 
(1) develop programs for and provide training 
to health care, social, and protective services pro-
viders, 
law 
enforcement, 
fiduciaries 
(including 
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