288 
long-term care hospital and satellite facility 
beds, for purposes of the Medicare program 
under title XVIII of the Social Security Act. The 
moratorium shall terminate at the end of the 4- 
year period beginning on the date of the enact-
ment of this Act. 
(B) EXCEPTIONS.— 
(i) IN
GENERAL.—The moratorium 
under subparagraph (A) shall not apply as 
follows: 
(I) To a long-term care hospital, 
satellite facility, or additional beds 
under development as of the date of the 
enactment of this Act. 
(II) To an existing long-term care 
hospital that requests to increase its 
number of long-term care hospital beds, 
if the Secretary determines there is a 
need at the long-term care hospital for 
additional beds to accommodate— 
(aa) infectious disease issues 
for isolation of patients; 
(bb) bedside dialysis services; 
(cc) single-sex accommoda-
tion issues; 
VerDate Aug 31 2005 
02:09 Aug 02, 2007
Jkt 059200
PO 00000
Frm 00288
Fmt 6652
Sfmt 6203
E:\BILLS\H3162.RH
H3162
bajohnson on PROD1PC69 with BILLS
289 
(dd) behavioral issues; or 
(ee) 
any 
requirements 
of 
State or local law. 
(III) To an existing long-term 
care hospital that requests an increase 
in beds because of the closure of a long- 
term care hospital or significant de-
crease in the number of long-term care 
hospital beds, in a State where there is 
only one other long-term care hospital. 
There shall be no administrative or judicial 
review from a decision of the Secretary 
under this subparagraph. 
(ii) 
‘‘UNDER
DEVELOPMENT’’ 
DE-
FINED.—For purposes of clause (i)(I), a 
long-term care hospital or satellite facility 
is considered to be ‘‘under development’’ as 
of a date if any of the following have oc-
curred on or before such date : 
(I) The hospital or a related party 
has a binding written agreement with 
an outside, unrelated party for the con-
struction, reconstruction, lease, rental, 
or financing of the long-term care hos-
pital and the hospital has expended, 
VerDate Aug 31 2005 
02:09 Aug 02, 2007
Jkt 059200
PO 00000
Frm 00289
Fmt 6652
Sfmt 6203
E:\BILLS\H3162.RH
H3162
bajohnson on PROD1PC69 with BILLS
290 
before the date of the enactment of this 
Act, at least 10 percent of the esti-
mated cost of the project (or, if less, 
$2,500,000). 
(II) Actual construction, renova-
tion or demolition for the long-term 
care hospital has begun and the hos-
pital has expended, before the date of 
the enactment of this Act, at least 10 
percent of the estimated cost of the 
project (or, if less, $2,500,000). 
(III) A certificate of need has been 
approved in a State where one is re-
quired or other necessary approvals 
from appropriate State agencies have 
been received for the operation of the 
hospital. 
(IV) The hospital documents that, 
within 3 months after the date of the 
enactment of this Act, it is within a 6- 
month long-term care hospital dem-
onstration period required by section 
412.23(e)(1)–(3) of title 42, Code of 
Federal Regulations, to demonstrate 
VerDate Aug 31 2005 
02:09 Aug 02, 2007
Jkt 059200
PO 00000
Frm 00290
Fmt 6652
Sfmt 6203
E:\BILLS\H3162.RH
H3162
bajohnson on PROD1PC69 with BILLS
291 
that it has a greater than 25 day aver-
age length of stay. 
(5) NO APPLICATION OF 25 PERCENT PATIENT 
THRESHOLD
PAYMENT
ADJUSTMENT
TO
FREE-
STANDING AND GRANDFATHERED LTCHS.—The Sec-
retary shall not apply, during the 5-year period be-
ginning on the date of the enactment of this Act, sec-
tion 412.536 of title 42, Code of Federal Regulations, 
or any similar provision, to freestanding long-term 
care hospitals and the Secretary shall not apply such 
section or section 412.534 of title 42, Code of Federal 
Regulations, or any similar provisions, to a long-term 
care hospital identified by section 4417(a) of the Bal-
anced Budget Act of 1997 (Public Law 105–33). A 
long-term care hospital identified by such section 
4417(a) shall be deemed to be a freestanding long- 
term care hospital for the purpose of this section. Sec-
tion 412.536 of title 42, Code of Federal Regulations, 
shall be void and of no effect. 
(6) 
PAYMENT
FOR
HOSPITALS-WITHIN-HOS-
PITALS.— 
(A) IN GENERAL.—Payments to an applica-
ble long-term care hospital or satellite facility 
which is located in a rural area or which is co- 
located with an urban single or MSA dominant 
VerDate Aug 31 2005 
02:09 Aug 02, 2007
Jkt 059200
PO 00000
Frm 00291
Fmt 6652
Sfmt 6203
E:\BILLS\H3162.RH
H3162
bajohnson on PROD1PC69 with BILLS