I 
116TH CONGRESS 
1ST SESSION H. R. 3558 
To direct the Secretary of Health and Human Services to conduct a study 
on the state of hospital infrastructure in the United States, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 27, 2019 
Mr. ENGEL (for himself and Mr. KING of New York) introduced the following 
bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To direct the Secretary of Health and Human Services to 
conduct a study on the state of hospital infrastructure 
in the United States, and for other purposes. 
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 ‘‘21st Century Hospitals 
Act’’. 
SEC. 2. HHS STUDY ON HOSPITAL INFRASTRUCTURE. 
(a) STUDY.—The Secretary of Health and Human 
Services, in consultation with State departments of health 
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and other public health entities, shall conduct a study on 
the state of hospital infrastructure in the United States. 
(b) TOPICS.—The study under subsection (a) shall 
include the following: 
(1) An assessment of barriers to accessing cap-
ital for infrastructure at hospitals serving vulnerable 
populations, such as hospitals described in section 
1886(d)(5)(F)(i) of the Social Security Act (42 
U.S.C. 1395ww(d)(5)(F)(i), relating to dispropor-
tionate share payments), sole community hospitals 
(as defined in section 1886(d)(5)(D)(iii) of such Act 
(42 U.S.C. 1395ww(d)(5)(F)(i)), critical access hos-
pitals (as defined in section 1861(mm)(1) of such 
Act (42 U.S.C. 1395x(mm)(1)), and public hospitals, 
including— 
(A) recommendations for addressing such 
barriers, which may include recommendations 
for grants or low-cost borrowing vehicles; 
(B) analysis of the impact of such barriers 
on managing infrastructure at such hospitals, 
including with respect to life-safety issues and 
emergency preparedness; and 
(C) identification of public funds that are 
available for— 
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(i) bringing such hospitals into com-
pliance with applicable laws; and 
(ii) ensuring that such hospitals and 
the communities they serve are appro-
priately prepared for responding to emer-
gencies including public health emer-
gencies. 
(2) An assessment of the state of health infor-
mation technology at hospitals in the United States, 
including— 
(A) the state of electronic medical records 
and the dependence of hospitals and health sys-
tems on technology that is outdated or de-
bunked; and 
(B) barriers associated with updating 
health information technology, including with 
respect to hardware, software, administrative 
burden, staff training, and associated costs. 
(c) REPORT.—Not later than 1 year after the date 
of enactment of this Act, the Secretary of Health and 
Human Services shall complete the study under this sec-
tion and submit a report on the results of such study to 
the Committee on Energy and Commerce of the House 
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