H. R. 540
One Hundred Sixth Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Wednesday,
the sixth day of January, one thousand nine hundred and ninety-nine
An Act
To amend title XIX of the Social Security Act to prohibit transfers or discharges
of residents of nursing facilities as a result of a voluntary withdrawal from
participation in the Medicaid Program.
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Nursing Home Resident Protec-
tion Amendments of 1999’’.
SEC. 2. RESTRICTIONS ON TRANSFERS OR DISCHARGES OF NURSING
FACILITY RESIDENTS IN THE CASE OF VOLUNTARY WITH-
DRAWAL FROM PARTICIPATION UNDER THE MEDICAID
PROGRAM.
(a) IN GENERAL.—Section 1919(c)(2) of the Social Security Act
(42 U.S.C. 1396r(c)(2)) is amended by adding at the end the follow-
ing new subparagraph:
‘‘(F) CONTINUING RIGHTS IN CASE OF VOLUNTARY WITH-
DRAWAL FROM PARTICIPATION.—
‘‘(i) IN GENERAL.—In the case of a nursing facility
that voluntarily withdraws from participation in a
State plan under this title but continues to provide
services of the type provided by nursing facilities—
‘‘(I) the facility’s voluntary withdrawal from
participation is not an acceptable basis for the
transfer or discharge of residents of the facility
who were residing in the facility on the day before
the effective date of the withdrawal (including
those residents who were not entitled to medical
assistance as of such day);
‘‘(II) the provisions of this section continue
to apply to such residents until the date of their
discharge from the facility; and
‘‘(III) in the case of each individual who begins
residence in the facility after the effective date
of such withdrawal, the facility shall provide notice
orally and in a prominent manner in writing on
a separate page at the time the individual begins
residence of the information described in clause
(ii) and shall obtain from each such individual
at such time an acknowledgment of receipt of such
information that is in writing, signed by the
individual, and separate from other documents
signed by such individual.
H. R. 540—2
Nothing in this subparagraph shall be construed as
affecting any requirement of a participation agreement
that a nursing facility provide advance notice to the
State or the Secretary, or both, of its intention to
terminate the agreement.
‘‘(ii) INFORMATION
FOR
NEW
RESIDENTS.—The
information described in this clause for a resident is
the following:
‘‘(I) The facility is not participating in the
program under this title with respect to that resi-
dent.
‘‘(II) The facility may transfer or discharge
the resident from the facility at such time as the
resident is unable to pay the charges of the facility,
even though the resident may have become eligible
for medical assistance for nursing facility services
under this title.
‘‘(iii) CONTINUATION OF PAYMENTS AND OVERSIGHT
AUTHORITY.—Notwithstanding any other provision of
this title, with respect to the residents described in
clause (i)(I), a participation agreement of a facility
described in clause (i) is deemed to continue in effect
under such plan after the effective date of the facility’s
voluntary withdrawal from participation under the
State plan for purposes of—
‘‘(I) receiving payments under the State plan
for nursing facility services provided to such resi-
dents;
‘‘(II) 
maintaining 
compliance 
with 
all
applicable requirements of this title; and
‘‘(III) continuing to apply the survey, certifi-
cation, and enforcement authority provided under
subsections (g) and (h) (including involuntary
termination of a participation agreement deemed
continued under this clause).
‘‘(iv) NO
APPLICATION
TO
NEW
RESIDENTS.—This
paragraph (other than subclause (III) of clause (i))
shall not apply to an individual who begins residence
in a facility on or after the effective date of the with-
drawal from participation under this subparagraph.’’.
H. R. 540—3
(b) EFFECTIVE DATE.—The amendment made by subsection (a)
applies to voluntary withdrawals from participation occurring on
or after the date of the enactment of this Act.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.