I 
116TH CONGRESS 
2D SESSION 
H. R. 8874 
To amend titles XVIII and XIX of the Social Security Act to provide flexi-
bility in training and competency requirements for skilled nursing facility 
and nursing facility nursing aides under the Medicare and Medicaid 
programs. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 4, 2020 
Mr. KELLER (for himself and Ms. WILD) introduced the following bill; which 
was referred to the Committee on Ways and Means, and in addition to 
the Committee on Energy and Commerce, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
to provide flexibility in training and competency require-
ments for skilled nursing facility and nursing facility 
nursing aides under the Medicare and Medicaid pro-
grams. 
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 ‘‘Nurses Certification 
And Recognition of Experience Act of 2020’’ or the 
‘‘Nurses CARE Act of 2020’’. 
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SEC. 2. PROVIDING FLEXIBILITY IN TRAINING AND COM-
PETENCY 
REQUIREMENTS 
FOR 
SKILLED 
NURSING FACILITY AND NURSING FACILITY 
NURSING AIDES UNDER THE MEDICARE AND 
MEDICAID PROGRAMS. 
(a) 
IN
GENERAL.—Sections 
1819(b)(5) 
and 
1919(b)(5) of the Social Security Act (42 U.S.C. 1395i– 
3(b)(5), 1396r(b)(5)) are each amended— 
(1) in subparagraph (A)(i)(I), by inserting ‘‘(or, 
in the case of a specified individual (as defined in 
subparagraph (H)(ii)), meets the requirement de-
scribed in subparagraph (H)(i))’’ after ‘‘subsection 
(e)(1)(A)’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(H) COVID–19 
TRAINING
AND
COM-
PETENCY REQUIREMENT FLEXIBILITY.— 
‘‘(i) IN
GENERAL.—For purposes of 
subparagraph (A)(i)(I), the requirement 
described in this clause is, with respect to 
a specified individual (as defined in clause 
(ii)), that the individual demonstrates com-
petency in work as a nursing aide 
through— 
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‘‘(I) the successful completion of 
a nursing aide examination approved 
by the State; 
‘‘(II) certification of competency 
by a site administrator of a nursing 
aide apprenticeship program approved 
by the State; or 
‘‘(III) an assessment by the facil-
ity in each of the areas and skills de-
scribed in section 583.152(b) of title 
42, Code of Federal Regulations (or a 
successor regulation). 
‘‘(ii) 
SPECIFIED
INDIVIDUAL
DE-
FINED.—For purposes of this subpara-
graph, the term ‘specified individual’ 
means an individual who, during the emer-
gency 
period 
described 
in 
section 
1135(g)(1)(B)— 
‘‘(I) completed a nursing aide 
training program and competency as-
sessment (whether online or other-
wise) approved by the State; and 
‘‘(II) completed a minimum of 80 
hours of work as a temporary nurse 
aide, in supervised practical nurse 
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aide training, in on-the-job nursing 
aide training, or in in-service nursing 
aide education, under the supervision 
of a registered nurse or a licensed 
practical nurse.’’. 
(b) 
INCLUSION
ON
REGISTRY.—Section 
1819(e)(2)(A) and 1919(e)(2)(A) of the Social Security 
Act (42 U.S.C. 1395i–3(e)(2)(A), 1396r(e)(2)(A)) are 
each amended by inserting ‘‘, or any specified individual 
(as defined in clause (ii) of subsection (b)(5)(H)(ii)) who 
meets the requirement described in clause (i) of such sub-
section’’ before the period at the end. 
(c) EDUCATIONAL
AND OUTREACH ACTIVITIES.— 
The Secretary of Health and Human Services shall under-
take outreach and educational activities for purposes of 
informing States of— 
(1) the effects of the amendments made by this 
section; and 
(2) what actions States may take with respect 
to the training and assessment of nursing aides in 
such State that will comply with the provisions of 
such amendments. 
Æ 
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