(A) to perform a criminal background
check on the individual;
(B) to determine, on the basis of such
check, whether the individual—
(i) has not been convicted of any
crime;
(ii) has been convicted of a national
disqualifying crime; or
(iii) has been convicted of a crime
that is a State disqualifying crime; and
(C) to submit to the registry a criminal
background check summary on the individual.
(4) APPLICATION
OF
CERTAIN
PROCEDURES
FOR CRIMINAL BACKGROUND CHECKS.—Under regu-
lations of the Secretary, the following provisions in
section 3 of the National Child Protection Act of
1993 (Public Law 103–209) shall apply to criminal
background checks required of a direct care em-
ployee with respect to a covered facility to be per-
formed under this Act in the same manner as they
apply to providers with respect to qualified entities:
(A) Subsection (a)(2) (relating to access to
records and timeliness of response).
(B) Subsection (b) (relating to guidelines
on background checks), other than paragraph
(1)(B), except that denial of unsupervised ac-
cess under paragraph (1)(E) shall be treated
for purposes of this section as a denial of unsu-
pervised access to patients in covered facilities
and determinations under paragraph (4) shall
be made only with respect to crimes relating to
patient abuse.
(C) Subsection (c) (relating to authority of
Attorney General).
(D) Subsection (d) (relating to limitation
on liability).
(d) PROCEDURES
FOR ABUSIVE WORK HISTORY
BACKGROUND CHECKS.—A registry shall carry out its re-
sponsibilities under subsection (a)(1)(B), in relation to
abusive work history background check with respect to an
individual, in a manner consistent with the following:
(1) INCLUSION
OF
INFORMATION
ON
DOCU-
MENTED FINDINGS OF PATIENT ABUSE.—The reg-
istry shall maintain a list of all individuals in the
State who are (or were) direct care employees and
with respect to whom there are specific documented
findings of patient abuse, as well as any brief state-
ment of the individual disputing the findings. Such
findings shall be made available in the same manner
as findings described in sections 1819(c)(2)(B) and
1919(c)(2)(B) of the Social Security Act.
(2) FORWARDING
INFORMATION
ON
INDIVID-
UALS
WITH
DOCUMENTED
FINDINGS
OF
PATIENT
ABUSE.—If the registry has a documented finding
described in paragraph (1) with respect to an indi-
vidual, the registry—
(A) shall provide the national registry co-
ordination system with—
(i) information on the identity of the
individual and the State;
(ii) information on the fact that such
a finding was made; and
(iii) such additional information re-
specting the finding as the Secretary may
require; and
(B) shall provide, to another State direct
care employee registry that requests informa-
tion on an individual for whom such a docu-
mented finding has been made through the sys-
tem, information respecting the finding.
(e) FEES.—A State may assess a covered facility a
fee for the conduct of a background check under section
2(a) in an amount that does not exceed the actual cost
to the State of obtaining the criminal background check
and the abusive work history background check on an indi-
vidual. Such a facility may recover all of the fee from the
individual involved.
SEC. 304. DEFINITIONS.
For purposes of this Act:
(1) BACKGROUND
CHECK; CRIMINAL
BACK-
GROUND
CHECK; ABUSIVE
WORK
HISTORY
BACK-
GROUND CHECK.—
(A) 
BACKGROUND
CHECK.—The 
term
‘‘background check’’ includes a criminal back-
ground check and an abusive work history back-
ground check.
(B) CRIMINAL BACKGROUND CHECK.—The
term ‘‘criminal background check’’ means a
check of the criminal history record system
maintained by the Federal Bureau of Investiga-
tion based on fingerprint identification or any
other method of positive identification for the
purpose of determining whether an individual
has been convicted of a disqualifying crime.
(C) ABUSIVE WORK HISTORY BACKGROUND
CHECK.—The term ‘‘abusive work history back-
ground check’’ means, with respect to an indi-
vidual, a check of State direct care employee
registries for the purpose of determining wheth-
er there is a documented finding that the indi-
vidual was involved in patient abuse.
(2) COVERED
FACILITY.—The term ‘‘covered
facility’’ means a nursing facility (including a skilled
nursing facility), home health agency, or hospice
program which receives payment under any federally
funded program.
(3) DIRECT CARE EMPLOYEE.—
(A) IN GENERAL.—The term ‘‘direct care
employee’’ means a nurse aide, home health
care aide, personal care assistant, private duty
nurse aide, day attendant, housekeeper, library
attendant, laundry assistant, or similar worker
who performs nursing or related tasks involving
direct patient care in a covered facility.
(B) EXCLUSIONS.—Such term does not in-
clude an individual—
(i) who is a physician, physician as-
sistant, 
nurse 
practitioner, 
physical,
speech, or occupational therapist, physical
or occupational therapy assistant, reg-
istered professional nurse, licensed prac-
tical nurse, or licensed or certified social
worker, or registered dietitian;