‘‘(A) the covered individual shall be subject 
to a civil money penalty of not more than 
$200,000; or 
‘‘(B) the Secretary shall classify the cov-
ered individual as an excluded individual, for a 
period of not more than 3 years. 
‘‘(2) INCREASED
HARM.—If a covered indi-
vidual violates subsection (b) and the violation exac-
erbates the harm to the victim of the crime or re-
sults in harm to another individual— 
‘‘(A) the covered individual shall be subject 
to a civil money penalty of not more than 
$300,000; and 
‘‘(B) the Secretary shall classify the cov-
ered individual as an excluded individual, for a 
period of not more than 3 years. 
‘‘(3) EXCLUDED INDIVIDUAL.—During any pe-
riod for which a covered individual is classified as an 
excluded individual under paragraph (1)(B) or 
(2)(B), a long-term care facility that employs such 
individual shall be ineligible to receive Federal funds 
under this Act. 
‘‘(4) EXTENUATING CIRCUMSTANCES.— 
‘‘(A) IN
GENERAL.—The Secretary may 
take into account the financial burden on pro-
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viders with underserved populations in deter-
mining any penalty to be imposed under this 
subsection. 
‘‘(B) UNDERSERVED
POPULATION
DE-
FINED.—In this paragraph, the term ‘under-
served population’ means the population of an 
area designated by the Secretary as an area 
with a shortage of elder justice programs or a 
population group designated by the Secretary 
as having a shortage of such programs. Such 
areas or groups designated by the Secretary 
may include— 
‘‘(i) areas or groups that are geo-
graphically isolated (such as isolated in a 
rural area); 
‘‘(ii) racial and ethnic minority popu-
lations; and 
‘‘(iii) populations underserved because 
of special needs (such as language barriers, 
disabilities, alien status, or age). 
‘‘(d) ADDITIONAL PENALTIES FOR RETALIATION.— 
‘‘(1) IN GENERAL.—A long-term care facility 
may not— 
‘‘(A) discharge, demote, suspend, threaten, 
harass, or deny a promotion or other employ-
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ment-related benefit to an employee, or in any 
other manner discriminate against an employee 
in the terms and conditions of employment be-
cause of lawful acts done by the employee; or 
‘‘(B) file a complaint or a report against a 
nurse or other employee with the appropriate 
State professional disciplinary agency because 
of lawful acts done by the nurse or employee, 
for making a report, causing a report to be made, 
or for taking steps in furtherance of making a report 
pursuant to subsection (b)(1). 
‘‘(2) PENALTIES FOR RETALIATION.—If a long- 
term care facility violates subparagraph (A) or (B) 
of paragraph (1) the facility shall be subject to a 
civil money penalty of not more than $200,000 or 
the Secretary may classify the entity as an excluded 
entity for a period of 2 years pursuant to section 
1128(b), or both. 
‘‘(3) REQUIREMENT
TO
POST
NOTICE.—Each 
long-term care facility shall post conspicuously in an 
appropriate location a sign (in a form specified by 
the Secretary) specifying the rights of employees 
under this section. Such sign shall include a state-
ment that an employee may file a complaint with the 
Secretary against a long-term care facility that vio-
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lates the provisions of this subsection and informa-
tion with respect to the manner of filing such a com-
plaint. 
‘‘(e) PROCEDURE.—The provisions of section 1128A 
(other than subsections (a) and (b) and the second sen-
tence of subsection (f)) shall apply to a civil money penalty 
under this section in the same manner as such provisions 
apply to a penalty or proceeding under section 1128A(a). 
‘‘(f) DEFINITIONS.—In this section, the terms ‘elder 
justice’, ‘long-term care facility’, and ‘law enforcement’ 
have the meanings given those terms in section 2011. 
‘‘ENSURING SAFETY OF RESIDENTS WHEN FEDERALLY 
FUNDED LONG-TERM CARE FACILITIES CLOSE 
‘‘SEC. 1150B. (a) IN GENERAL.— 
‘‘(1) NOTIFICATION OF FACILITY CLOSURE.— 
Subject to paragraph (2), if the owner or operator 
determines under section 1150A(a)(1) that a long- 
term care facility received at least $10,000 in Fed-
eral funds under this Act during the preceding year, 
the owner or operator of the facility shall— 
‘‘(A) submit to the Secretary and the ap-
propriate State regulatory agency written notifi-
cation of an impending closure not later than 
the date that is 60 days prior to the date of 
such closure; 
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‘‘(B) include in the notice a plan for the 
transfer and adequate relocation of the resi-
dents of the facility prior to closure, including 
assurances that the residents will be transferred 
to the most appropriate facility in terms of 
quality, services, and location; and 
‘‘(C) not later than 10 days after the facil-
ity closure, submit to the Secretary and the ap-
propriate State agency information identifying 
where residents of the closed facility were trans-
ferred and on what date. 
‘‘(2) EXCEPTION WHERE THE SECRETARY HAS 
ISSUED A TERMINATION NOTICE.—In the case of a 
long-term care facility described in paragraph (1) for 
which the Secretary has issued a termination notice 
for the facility to close by not later than 15 days 
after the issuance of such notice, the Secretary shall 
establish requirements for the notification, transfer, 
and adequate relocation of residents within an ap-
propriate timeframe. 
‘‘(b) SANCTIONS.—Any person owning or operating 
a long-term care facility that fails to comply with the re-
quirements of subsection (a) shall be subject to— 
‘‘(1) a civil monetary penalty of up to 
$1,000,000; 
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‘‘(2) exclusion from participation in the pro-
grams under this Act (in accordance with the proce-
dures of section 1128); and 
‘‘(3) any other applicable civil monetary pen-
alties and assessments. 
‘‘(c) PROCEDURE.—The provisions of section 1128A 
(other than subsections (a) and (b) and the second sen-
tence of subsection (f)) shall apply to a civil money penalty 
or assessment under this section in the same manner as 
such provisions apply to a penalty or proceeding under 
section 1128A(a). 
‘‘(d) DEFINITION.—In this section, the term ‘long- 
term care facility’ has the meaning given that term in sec-
tion 2011.’’. 
(4) REPORT TO CONGRESS ON PILOT PROGRAM 
FOR NATIONAL AND STATE BACKGROUND CHECKS 
ON DIRECT PATIENT ACCESS EMPLOYEES OF LONG- 
TERM CARE FACILITIES OR PROVIDERS.—Not later 
than the date that is 6 months after the completion 
of the pilot program for national and State back-
ground checks on direct patient access employees of 
long-term care facilities or providers established 
under section 307 of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 
(42 U.S.C. 1395aa note), the Secretary shall submit 
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to the Committee on Finance of the Senate and the 
Committee on Ways and Means and the Committee 
on Energy and Commerce of the House of Rep-
resentatives a report containing the results of the 
evaluation required under subsection (e) of such sec-
tion of such Act, together with recommendations for 
such legislation and administrative action as the 
Secretary determines appropriate. 
(c) NATIONAL NURSE AIDE REGISTRY.— 
(1) DEFINITION OF NURSE AIDE.—In this sub-
section, the term ‘‘nurse aide’’ has the meaning 
given that term in sections 1819(b)(5)(F) and 
1919(b)(5)(F) of the Social Security Act (42 U.S.C. 
1395i–3(b)(5)(F); 1396r(b)(5)(F)). 
(2) STUDY AND REPORT.— 
(A) IN GENERAL.—The Secretary, in con-
sultation with appropriate government agencies 
and private sector organizations, shall conduct 
a study on establishing a national nurse aide 
registry. 
(B) AREAS EVALUATED.—The study con-
ducted under this subsection shall include an 
evaluation of— 
(i) who should be included in the reg-
istry; 
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