‘‘(f) REPORT.—Not later than 2 years after the date 
of enactment of this section, the Secretary shall submit 
a report to Congress on—
‘‘(1) the number of requests for searches and 
exchanges of records made under this section; 
‘‘(2) the disposition of such requests; and 
‘‘(3) the cost of responding to such requests.’’
‘‘(g) LIMITATION ON PREEMPTION OF STATE LAW.—
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
the requirements under this section and section 
1134A shall not preempt existing State laws that 
are in effect on the date of the enactment of this 
section. 
‘‘(2) 
NATIONAL
FLOOR.—Notwithstanding 
paragraph (1), States shall work with the Attorney 
General to avoid duplicative requirements under this 
section and section 1134A.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to any individual applying for em-
ployment or hired for such employment by any long-term 
care provider on or after the date which is the later of—
(1) 6 months after the date of the enactment 
of this Act; or 
(2) upon implementation by the State of the re-
quirements under this Act.
SEC. 3. EXPANSION OF STATE REGISTER TO COLLECT IN-
FORMATION ABOUT LONG-TERM CARE PRO-
VIDER EMPLOYEES OTHER THAN NURSE 
AIDES. 
(a) MEDICAID PROGRAM.—Section 1919 of the Social 
Security Act (42 U.S.C. 1396r) is amended—
(1) in subsection (e)(2)—
(A) in the paragraph heading, by striking 
‘‘NURSE AIDE REGISTRY’’ and inserting ‘‘LONG-
TERM CARE REGISTRY’’; 
(B) in subparagraph (A)—
(i) by striking ‘‘By not later than 
January 1, 1989, the’’ and inserting 
‘‘The’’; 
(ii) by striking ‘‘a registry of all indi-
viduals’’ and inserting ‘‘a registry of (i) all 
individuals’’; and 
(iii) by inserting before the period ‘‘, 
and (ii) all other long-term care provider 
employees with respect to whom the State 
has made a finding described in subpara-
graph (B)’’; 
(C) in subparagraph (B), by striking ‘‘in-
volving an individual listed in the registry’’ and 
inserting ‘‘involving a long-term care em-
ployee’’; and
(D) in subparagraph (C), by striking 
‘‘nurse aide’’ and inserting ‘‘long-term care em-
ployee or applicant for employment’’; and 
(2) in subsection (g)(1)—
(A) in subparagraph (C)—
(i) in the first sentence, by striking 
‘‘nurse aide’’ and inserting ‘‘long-term care 
employee’’; and 
(ii) in the third sentence, by striking 
‘‘nurse aide’’ and inserting ‘‘long-term care 
employee’’ each place it appears; and 
(B) in subparagraph (D)—
(i) 
in 
the 
heading, 
by 
striking 
‘‘NURSE
AIDE
REGISTRY’’ and inserting 
‘‘LONG-TERM CARE PROVIDER REGISTRY’’; 
and 
(ii) by striking ‘‘nurse aide’’ and in-
serting ‘‘long-term care provider employee’’ 
each place it appears. 
(b) MEDICARE PROGRAM.—Section 1819 of the So-
cial Security Act (42 U.S.C. 1395i–3) is amended—
(1) in subsection (e)(2)—
(A) in the paragraph heading, by striking 
‘‘NURSE AIDE REGISTRY’’ and inserting ‘‘LONG-
TERM CARE EMPLOYEE REGISTRY’’;
(B) in subparagraph (A)—
(i) by striking ‘‘By not later than 
January 1, 1989, the’’ and inserting 
‘‘The’’; 
(ii) by striking ‘‘a registry of all indi-
viduals’’ and inserting ‘‘a registry of (i) all 
individuals’’; and 
(iii) by inserting before the period ‘‘, 
and (ii) all other long-term care employees 
with respect to whom the State has made 
a finding described in subparagraph (B)’’; 
(C) in subparagraph (B), by striking ‘‘in-
volving an individual listed in the registry’’ and 
inserting ‘‘involving a long-term care em-
ployee’’; and 
(D) in subparagraph (C), by striking 
‘‘nurse aide’’ and inserting ‘‘skilled long-term 
care provider employee or applicant for employ-
ment’’; and 
(2) in subsection (g)(1)—
(A) in subparagraph (C)—
(i) in the first sentence, by striking 
‘‘nurse aide’’ and inserting ‘‘skilled long-
term care employee’’; and
(ii) in the third sentence, by striking 
‘‘nurse aide’’ and inserting ‘‘long-term care 
employee’’ each place it appears; and 
(B) in subparagraph (D)—
(i) 
in 
the 
heading, 
by 
striking 
‘‘NURSE
AIDE
REGISTRY’’ and inserting 
‘‘LONG-TERM CARE EMPLOYEE REGISTRY’’; 
and 
(ii) by striking ‘‘nurse aide’’ and in-
serting ‘‘long-term care employee’’ each 
place it appears. 
SEC. 4. INCLUSION OF ABUSIVE WORKERS IN THE DATA-
BASE ESTABLISHED AS PART OF NATIONAL 
HEALTH CARE FRAUD AND ABUSE DATA COL-
LECTION PROGRAM. 
(a) COVERAGE OF LONG-TERM CARE WORKERS.—
Section 1128E(g)(2) of the Social Security Act (42 U.S.C. 
1320a–7e(g)(2)) is amended by adding at the end the fol-
lowing: ‘‘Such term also includes any individual of a long-
term care provider (other than a volunteer) that has direct 
access to a patient or resident of such a provider under 
an employment or other contract, or both, with the pro-
vider (including individuals who are licensed or certified 
by the Secretary to provide services at or through the pro-
vider, and non-licensed individuals, as defined by the Sec-
retary, providing services at or through the provider, in-
cluding nurse assistants, nurse aides, home health aides, 
and personal care workers and attendants)’’. 
(b) MANDATORY CHECK OF DATABASE BY LONG-
TERM CARE FACILITIES OR PROVIDERS.—Section 1134A 
of the Social Security Act, as added by section 2(a), is 
amended by adding at the end the following new sub-
section: 
‘‘(g) MANDATORY CHECK OF DATABASE BY LONG-
TERM CARE FACILITIES OR PROVIDERS.—A long-term 
care provider shall check the registry maintained under 
sections 1818(e)(2) and 1919(e)(2) prior to hiring under 
an employment or other contract, or both, any individual 
as an employee of such a provider who will have direct 
access to a patient or resident of the provider (including 
individuals who are licensed or certified by the State to 
provide services at or through the provider, and non-
licensed individuals, as defined by the Secretary, that will 
provide services at or through the provider, including 
nurse assistants, nurse aides, home health aides, and per-
sonal care workers and attendants).’’. 
(c) DEFINITION OF LONG-TERM CARE PROVIDER.—
Section 1128E(g) of the Social Security Act (42 U.S.C. 
1320a–7e(g)) is amended by adding at the end the fol-
lowing:
‘‘(6) LONG-TERM CARE PROVIDER.—The term 
‘long-term care provider’ has the meaning given such 
term in section 1134A(f)(4).’’.
SEC. 5. PREVENTION AND TRAINING DEMONSTRATION 
PROJECT. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services shall establish a demonstration program 
to provide grants to develop information on best practices 
in patient abuse prevention training (including behavior 
training and interventions) for managers and staff of long-
term care facilities. 
(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity shall be a public or private 
entity and prepare and submit to the Secretary an applica-
tion at such time, in such manner, and containing such 
information as the Secretary may require. 
(c) USE
OF FUNDS.—Amounts received under a 
grant under this section shall be used to—
(1) examine ways to improve collaboration be-
tween State health care survey and provider certifi-
cation agencies, long-term care ombudsman pro-
grams, the long-term care industry, and local com-
munity members; 
(2) examine patient care issues relating to regu-
latory oversight, community involvement, and pro-
vider staffing and management with a focus on staff 
training, staff stress management, and staff super-
vision; 
(3) examine the use of patient abuse prevention 
training programs by long-term care entities, includ-
ing the training program developed by the National 
Association of Attorneys General, and the extent to 
which such programs are used; and 
(4) identify and disseminate best practices for 
preventing and reducing patient abuse. 
(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section. 
SEC. 6. IMPROVED BACKGROUND CHECK SYSTEM. 
(a) THE ESTABLISHMENT.—The Secretary of Health 
and Human Services and the Attorney General shall es-
tablish a more efficient background check system that pro-
vides for a more immediate determination of criminal sta-
tus. 
(b) IMPLEMENTATION.—The Secretary of Health and 
Human Services and the Attorney General shall imple-
ment such more efficient background check system under 
subsection (a) not later than 5 years after the date of the 
enactment of this Act.
(c) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section. 
SEC. 7. STATE FUNDING. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, upon application by a State, may provide 
an annual grant to carry out the provisions of this Act. 
(b) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out the provi-
sions of this Act (other than sections 5 and 6) 
$50,000,000 in each of fiscal years 2004 through 2008.
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