Quality Care for Nursing Home Residents and Workers During COVID–19 Act
Bill: S.317 | Sponsor: Sen. Booker, Cory A. (D-NJ)
Policy area: Health

Summary:
Quality Care for Nursing Home Residents and Workers During COVID-19 Act
This bill modifies several requirements for Medicare skilled nursing facilities (SNFs) and Medicaid nursing facilities (NFs) during the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019).
Specifically, SNFs and NFs must comply with specified quality of care, worker safety, and transparency requirements, subject to civil penalties. Requirements include (1) testing residents and employees for COVID-19 weekly or before shifts, respectively, and reporting any lack of available testing kits on a daily basis; (2) providing at least two weeks of paid sick leave to each employee; and (3) reporting the number of COVID-19 cases and deaths, including demographic information, on a daily basis.
The Centers for Medicare & Medicaid Services must also distribute funds to allow states to establish strike teams that may be deployed to SNFs and NFs within 72 hours of three or more COVID-19 diagnoses to help separate those who have been exposed, supervise testing, and ensure enforcement of whistleblower protections, among other needs. Teams must include members of the National Guard, public health officials, medical experts, and representatives of residents and workers.

To amend titles XVIII and XIX of the Social Security Act to improve the 
    quality of care for residents of and workers in skilled nursing 
facilities and nursing facilities during the COVID-19 emergency period, 
                        and for other purposes.

    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 ``Quality Care for Nursing Home 
Residents and Workers During COVID-19 Act''.

SEC. 2. IMPROVING QUALITY OF CARE IN SKILLED NURSING FACILITIES AND 
              NURSING FACILITIES DURING COVID-19 EMERGENCY PERIOD.

    (a) Medicare.--Section 1819 of the Social Security Act (42 U.S.C. 
1395i-3) is amended by adding at the end the following new subsection:
    ``(k) Additional Requirements During Certain Public Health 
Emergency.--
            ``(1) Skilled nursing facilities.--
                    ``(A) In general.--During the portion of the 
                emergency period defined in paragraph (1)(B) of section 
                1135(g) beginning on or after the date of the enactment 
                of this subsection, a skilled nursing facility shall 
                comply with the quality of care requirements described 
                in subparagraph (B), the worker safety requirements 
                described in subparagraph (C), and the transparency 
                requirements described in subparagraph (D).
                    ``(B) Quality of care requirements.--The quality of 
                care requirements described in this subparagraph are 
                each of the following:
                            ``(i) Employ, on a full-time basis, an 
                        infection preventionist who--
                                    ``(I) has primary professional 
                                training in nursing, medical 
                                technology, microbiology, epidemiology, 
                                or other related field;
                                    ``(II) is qualified by education, 
                                training, experience or certification; 
                                and
                                    ``(III) has completed specialized 
                                training in infection prevention and 
                                control.
                            ``(ii) In the case of a resident who elects 
                        to reside with a family member of such resident 
                        for any portion of the emergency period 
                        described in subparagraph (A), guarantee the 
                        right of such resident to resume residency in 
                        the facility at any time during the 180-day 
                        period immediately following the end of such 
                        emergency period.
                            ``(iii) Notwithstanding subparagraphs (A) 
                        and (B) of subsection (c)(2), permit a resident 
                        to remain in the facility and not discharge or 
                        transfer the resident from the facility 
                        unless--
                                    ``(I) the State survey agency 
                                approves the discharge or transfer;
                                    ``(II) in the case of a transfer, 
                                the transfer is to a facility dedicated 
                                to the care of residents who have been 
                                diagnosed with COVID-19 if the resident 
                                has been diagnosed with COVID-19, or a 
                                facility dedicated to the care of 
                                residents who have not been diagnosed 
                                with COVID-19 if the resident has not 
                                been diagnosed with COVID-19;
                                    ``(III) before effecting the 
                                discharge or transfer, the facility 
                                records the reasons in the resident's 
                                clinical record;
                                    ``(IV) at least 72 hours in advance 
                                of the discharge or transfer, the 
                                facility provides a notice of the 
                                discharge or transfer to the resident 
                                (or legal representative of the 
                                resident, if applicable), including the 
                                reasons therefor and the items 
                                described in clause (iii) of subsection 
                                (c)(2)(B); and
                                    ``(V) the resident (or legal 
                                representative of the resident, if 
                                applicable) acknowledges receipt of the 
                                notice described in subclause (IV) and 
                                provides written consent to the 
                                discharge or transfer.
                            ``(iv) Test (on a weekly basis) each 
                        resident for COVID-19, or, in the case that the 
                        facility does not have a sufficient number of 
                        testing kits for COVID-19, screen each resident 
                        for symptoms of COVID-19 and report (on a daily 
                        basis until the facility has a sufficient 
                        number of such testing kits) to the State 
                        survey agency that the facility does not have a 
                        sufficient number of such testing kits and what 
                        steps the facility is taking to procure a 
                        sufficient number of such testing kits.
                            ``(v) Ensure there is an adequate number of 
                        employees to assist residents in communicating 
                        with family members and friends through phone 
                        calls, e-mail, and virtual communications on at 
                        least a weekly basis, without regard to whether 
                        a resident has been diagnosed with COVID-19.
                    ``(C) Worker safety requirements.--The worker 
                safety requirements described in this subparagraph are 
                each of the following:
                            ``(i) In the case the facility is not 
                        otherwise subject to the Occupational Safety 
                        and Health Act of 1970 (or a State occupational 
                        safety and health plan that is approved under 
                        section 18(c) of such Act), comply with the 
                        Bloodborne Pathogens standard under section 
                        1910.1030 of title 29, Code of Federal 
                        Regulations (or a successor regulation).
                            ``(ii) In the case of a predicted shortage 
                        of personal protective equipment, report such 
                        predicted shortage to the State health 
                        department of the State in which the facility 
                        is located at least 24 hours in advance of when 
                        such predicted shortage is expected to occur.
                            ``(iii) Educate each employee on the 
                        transmission of COVID-19.
                            ``(iv) Notwithstanding any other provision 
                        of law, provide at least two weeks of paid sick 
                        leave to each employee.
                            ``(v) Before each employee's shift, test 
                        the employee for COVID-19, or, in the case that 
                        the facility does not have a sufficient number 
                        of testing kits for COVID-19, screen each 
                        employee for symptoms of COVID-19 and report 
                        (on a daily basis until the facility has a 
                        sufficient number of such testing kits) to the 
                        State survey agency that the facility does not 
                        have a sufficient number of such testing kits 
                        and what steps the facility is taking to 
                        procure a sufficient number of such testing 
                        kits.
                    ``(D) Transparency requirements.--The transparency 
                requirements described in this subparagraph are each of 
                the following:
                            ``(i) Report (on a daily basis) to the 
                        State survey agency, the Centers for Medicare & 
                        Medicaid Services, and the Centers for Disease 
                        Control and Prevention each of the following:
                                    ``(I) The number of confirmed and 
                                suspected cases COVID-19 among 
                                residents and staff, including the age 
                                and race or ethnicity of such residents 
                                and staff.
                                    ``(II) The number of deaths related 
                                to COVID-19 among residents and staff, 
                                including the age and race or ethnicity 
                                of such residents and staff.
                                    ``(III) The total number of deaths 
                                (without regard to whether a death is 
                                related to COVID-19) among residents 
                                and staff.
                                    ``(IV) The amount of personal 
                                protective equipment available and any 
                                projected need regarding such 
                                equipment.
                                    ``(V) Information on staffing 
                                levels that would otherwise be required 
                                to be submitted through the Payroll-
                                Based Journal of the Centers for 
                                Medicare & Medicaid Services.
                                    ``(VI) The number of residents and 
                                staff who have been tested for COVID-
                                19.
                            ``(ii) In the case that a resident or 
                        employee is diagnosed with COVID-19 or dies as 
                        a result of COVID-19, notify all residents, 
                        legal representatives of residents, and 
                        employees not later than 12 hours after such 
                        diagnosis is made or such death occurs.
                            ``(iii) At any time three or more residents 
                        or employees have newly onset COVID-19 
                        symptoms, notify all residents, legal 
                        representatives of residents, and employees not 
                        later than 72 hours after such three or more 
                        residents or employees are known to the 
                        facility.
                            ``(iv) In the case that a resident or 
                        employee is suspected to have or is diagnosed 
                        with COVID-19, post a notice of such suspicion 
                        or diagnosis at each entrance of the facility 
                        for the remaining portion of the emergency 
                        period described in subparagraph (A).
                            ``(v) For each day of the portion of the 
                        emergency period described in subparagraph (A), 
                        post a notice at each entrance of the facility 
                        with the information required under subsection 
                        (b)(8) for such day.
            ``(2) States and federal government.--
                    ``(A) Public availability of information.--
                            ``(i) In general.--As soon as possible, but 
                        not later than 24 hours after receiving any 
                        information required under paragraph (1)(D)(i), 
                        the Administrator of the Centers for Medicare & 
                        Medicaid Services, in coordination with the 
                        Director of the Centers for Disease Control and 
                        Prevention, shall make such information 
                        publicly available on the Nursing Home Compare 
                        website of the Centers for Medicare & Medicaid 
                        Services and the COVIDView website of the 
                        Centers for Disease Control and Prevention.
                            ``(ii) HIPAA compliant information only.--
                        Information may only be made publicly available 
                        under clause (i) if the disclosure of such 
                        information would otherwise be permitted under 
                        the Federal regulations (concerning the privacy 
                        of individually identifiable health 
                        information) promulgated under section 264(c) 
                        of the Health Insurance Portability and 
                        Accountability Act of 1996 (42 U.S.C. 1320d-2 
                        note).
                    ``(B) Designation of covid-19 facilities.--For 
                purposes of paragraph (1)(B)(iii)(II)--
                            ``(i) the Administrator of the Centers for 
                        Medicare & Medicaid Services shall specify 
                        criteria (which shall include the provision of 
                        the services of a registered nurse on a 24-
                        hours basis) for each State survey agency to 
                        carry out the designation requirement described 
                        in clause (ii) with respect to skilled nursing 
                        facilities; and
                            ``(ii) each State survey agency shall 
                        designate a skilled nursing facility in the 
                        State as a facility dedicated to the care of 
                        residents who have been diagnosed with COVID-19 
                        if such facility meets the criteria specified 
                        by the Administrator under clause (i).
                    ``(C) Remote monitoring and surveys.--A State 
                survey agency shall--
                            ``(i) remotely monitor all skilled nursing 
                        facilities with at least one resident or 
                        employee who has been diagnosed with COVID-19;
                            ``(ii) in addition to surveys required 
                        under subsection (g), conduct a survey of a 
                        skilled nursing facility, in the same manner 
                        and subject to the same requirements applicable 
                        to standard surveys conducted under subsection 
                        (g), if the facility has a ratio of the number 
                        of deaths resulting from COVID-19 to the number 
                        of COVID-19 diagnoses that exceeds 5 percent, 
                        or the State survey agency receives a COVID-19 
                        or staffing related immediate jeopardy 
                        complaint regarding the facility; and
                            ``(iii) ensure that each survey team that 
                        conducts a survey under clause (ii) has 
                        adequate personal protective equipment while 
                        conducting such survey.
            ``(3) Civil money penalties.--The Secretary shall impose a 
        civil money penalty against the operators of a skilled nursing 
        facility in an amount equal to $10,000 per day for each 
        violation of a requirement described in subparagraph (B), (C), 
        or (D) of paragraph (1) or the reporting of false information 
        under clause (i) of such subparagraph (D). The provisions of 
        section 1128A (other than subsections (a) and (b)) shall apply 
        to a civil money penalty under the previous sentence in the 
        same manner as such provisions apply to a penalty or proceeding 
        under section 1128A(a).''.
    (b) Medicaid.--Section 1919 of the Social Security Act (42 U.S.C. 
1396r) is amended by adding at the end the following new subsection:
    ``(k) Additional Requirements During Certain Public Health 
Emergency.--
            ``(1) Nursing facilities.--
                    ``(A) In general.--During the portion of the 
                emergency period defined in paragraph (1)(B) of section 
                1135(g) beginning on or after the date of the enactment 
                of this subsection, a nursing facility shall comply 
                with the quality of care requirements described in 
                subparagraph (B), the worker safety requirements 
                described in subparagraph (C), and the transparency 
                requirements described in subparagraph (D).
                    ``(B) Quality of care requirements.--The quality of 
                care requirements described in this subparagraph are 
                each of the following:
                            ``(i) Employ, on a full-time basis, an 
                        infection preventionist who--
                                    ``(I) has primary professional 
                                training in nursing, medical 
                                technology, microbiology, epidemiology, 
                                or other related field;
                                    ``(II) is qualified by education, 
                                training, experience or certification; 
                                and
                                    ``(III) has completed specialized 
                                training in infection prevention and 
                                control.
                            ``(ii) In the case of a resident who elects 
                        to reside with a family member of such resident 
                        for any portion of the emergency period 
                        described in subparagraph (A), guarantee the 
                        right of such resident to resume residency in 
                        the facility at any time during the 180-day 
                        period immediately following the end of such 
                        emergency period.
                            ``(iii) Notwithstanding subparagraphs (A) 
                        and (B) of subsection (c)(2), permit a resident 
                        to remain in the facility and not discharge or 
                        transfer the resident from the facility 
                        unless--
                                    ``(I) the State survey agency 
                                approves the discharge or transfer;
                                    ``(II) in the case of a transfer, 
                                the transfer is to a facility dedicated 
                                to the care of residents who have been 
                                diagnosed with COVID-19 if the resident 
                                has been diagnosed with COVID-19, or a 
                                facility dedicated to the care of 
                                residents who have not been diagnosed 
                                with COVID-19 if the resident has not 
                                been diagnosed with COVID-19;
                                    ``(III) before effecting the 
                                discharge or transfer, the facility 
                                records the reasons in the resident's 
                                clinical record;
                                    ``(IV) at least 72 hours in advance 
                                of the discharge or transfer, the 
                                facility provides a notice of the 
                                discharge or transfer to the resident 
                                (or legal representative of the 
                                resident, if applicable), including the 
                                reasons therefor and the items 
                                described in clause (iii) of subsection 
                                (c)(2)(B); and
                                    ``(V) the resident (or legal 
                                representative of the resident, if 
                                applicable) acknowledges receipt of the 
                                notice described in subclause (IV) and 
                                provides written consent to the 
                                discharge or transfer.
                            ``(iv) Test (on a weekly basis) each 
                        resident for COVID-19, or, in the case that the 
                        facility does not have a sufficient number of 
                        testing kits for COVID-19, screen each resident 
                        for symptoms of COVID-19 and report (on a daily 
                        basis until the facility has a sufficient 
                        number of such testing kits) to the State 
                        survey agency that the facility does not have a 
                        sufficient number of such testing kits and what 
                        steps the facility is taking to procure a 
                        sufficient number of such testing kits.
                            ``(v) Ensure there is an adequate number of 
                        employees to assist residents in communicating 
                        with family members and friends through phone 
                        calls, e-mail, and virtual communications on at 
                        least a weekly basis, without regard to whether 
                        a resident has been diagnosed with COVID-19.
                    ``(C) Worker safety requirements.--The worker 
                safety requirements described in this subparagraph are 
                each of the following:
                            ``(i) In the case the facility is not 
                        otherwise subject to the Occupational Safety 
                        and Health Act of 1970 (or a State occupational 
                        safety and health plan that is approved under 
                        section 18(c) of such Act), comply with the 
                        Bloodborne Pathogens standard under section 
                        1910.1030 of title 29, Code of Federal 
                        Regulations (or a successor regulation).
                            ``(ii) In the case of a predicted shortage 
                        of personal protective equipment, report such 
                        predicted shortage to the State health 
                        department of the State in which the facility 
                        is located at least 24 hours in advance of when 
                        such predicted shortage is expected to occur.
                            ``(iii) Educate each employee on the 
                        transmission of COVID-19.
                            ``(iv) Notwithstanding any other provision 
                        of law, provide at least two weeks of paid sick 
                        leave to each employee.
                            ``(v) Before each employee's shift, test 
                        the employee for COVID-19, or, in the case that 
                        the facility does not have a sufficient number 
                        of testing kits for COVID-19, screen each 
                        employee for symptoms of COVID-19 and report 
                        (on a daily basis until the facility has a 
                        sufficient number of such testing kits) to the 
                        State survey agency that the facility does not 
                        have a sufficient number of such testing kits 
                        and what steps the facility is taking to 
                        procure a sufficient number of such testing 
                        kits.
                    ``(D) Transparency requirements.--The transparency 
                requirements described in this subparagraph are each of 
                the following:
                            ``(i) Report (on a daily basis) to the 
                        State survey agency, the Centers for Medicare & 
                        Medicaid Services, and the Centers for Disease 
                        Control and Prevention each of the following:
                                    ``(I) The number of confirmed and 
                                suspected cases COVID-19 among 
                                residents and staff, including the age 
                                and race or ethnicity of such residents 
                                and staff.
                                    ``(II) The number of deaths related 
                                to COVID-19 among residents and staff, 
                                including the age and race or ethnicity 
                                of such residents and staff.
                                    ``(III) The total number of deaths 
                                (without regard to whether a death is 
                                related to COVID-19) among residents 
                                and staff.
                                    ``(IV) The amount of personal 
                                protective equipment available and any 
                                projected need regarding such 
                                equipment.
                                    ``(V) Information on staffing 
                                levels that would otherwise be required 
                                to be submitted through the Payroll-
                                Based Journal of the Centers for 
                                Medicare & Medicaid Services.
                                    ``(VI) The number of residents and 
                                staff who have been tested for COVID-
                                19.
                            ``(ii) In the case that a resident or 
                        employee is diagnosed with COVID-19 or dies as 
                        a result of COVID-19, notify all residents, 
                        legal representatives of residents, and 
                        employees not later than 12 hours after such 
                        diagnosis is made or such death occurs.
                            ``(iii) At any time three or more residents 
                        or employees have newly onset COVID-19 
                        symptoms, notify all residents, legal 
                        representatives of residents, and employees not 
                        later than 72 hours after such three or more 
                        residents or employees are known to the 
                        facility.
                            ``(iv) In the case that a resident or 
                        employee is suspected to have or is diagnosed 
                        with COVID-19, post a notice of such suspicion 
                        or diagnosis at each entrance of the facility 
                        for the remaining portion of the emergency 
                        period described in subparagraph (A).
                            ``(v) For each day of the portion of the 
                        emergency period described in subparagraph (A), 
                        post a notice at each entrance of the facility 
                        with the information required under subsection 
                        (b)(8) for such day.
            ``(2) States and federal government.--
                    ``(A) Public availability of information.--
                            ``(i) In general.--As soon as possible, but 
                        not later than 24 hours after receiving any 
                        information required under paragraph (1)(D)(i), 
                        the Administrator of the Centers for Medicare & 
                        Medicaid Services, in coordination with the 
                        Director of the Centers for Disease Control and 
                        Prevention, shall make such information 
                        publicly available on the Nursing Home Compare 
                        website of the Centers for Medicare & Medicaid 
                        Services and the COVIDView website of the 
                        Centers for Disease Control and Prevention.
                            ``(ii) HIPAA compliant information only.--
                        Information may only be made publicly available 
                        under clause (i) if the disclosure of such 
                        information would otherwise be permitted under 
                        the Federal regulations (concerning the privacy 
                        of individually identifiable health 
                        information) promulgated under section 264(c) 
                        of the Health Insurance Portability and 
                        Accountability Act of 1996 (42 U.S.C. 1320d-2 
                        note).
                    ``(B) Designation of covid-19 facilities.--For 
                purposes of paragraph (1)(B)(iii)(II)--
                            ``(i) the Administrator of the Centers for 
                        Medicare & Medicaid Services shall specify 
                        criteria (which shall include the provision of 
                        the services of a registered nurse on a 24-
                        hours basis) for each State survey agency to 
                        carry out the designation requirement described 
                        in clause (ii) with respect to nursing 
                        facilities; and
                            ``(ii) each State survey agency shall 
                        designate a nursing facility in the State as a 
                        facility dedicated to the care of residents who 
                        have been diagnosed with COVID-19 if such 
                        facility meets the criteria specified by the 
                        Administrator under clause (i).
                    ``(C) Remote monitoring and surveys.--A State 
                survey agency shall--
                            ``(i) remotely monitor all nursing 
                        facilities with at least one resident or 
                        employee who has been diagnosed with COVID-19;
                            ``(ii) in addition to surveys required 
                        under subsection (g), conduct a survey of a 
                        nursing facility, in the same manner and 
                        subject to the same requirements applicable to 
                        standard surveys conducted under subsection 
                        (g), if the facility has a ratio of the number 
                        of deaths resulting from COVID-19 to the number 
                        of COVID-19 diagnoses that exceeds 5 percent, 
                        or the State survey agency receives a COVID-19 
                        or staffing related immediate jeopardy 
                        complaint regarding the facility; and
                            ``(iii) ensure that each survey team that 
                        conducts a survey under clause (ii) has 
                        adequate personal protective equipment while 
                        conducting such survey.
            ``(3) Civil money penalties.--The Secretary shall impose a 
        civil money penalty against the operators of a nursing facility 
        in an amount equal to $10,000 per day for each violation of a 
        requirement described in subparagraph (B), (C), or (D) of 
        paragraph (1) or the reporting of false information under 
        clause (i) of such subparagraph (D). The provisions of section 
        1128A (other than subsections (a) and (b)) shall apply to a 
        civil money penalty under the previous sentence in the same 
        manner as such provisions apply to a penalty or proceeding 
        under section 1128A(a).''.

SEC. 3. FUNDING FOR STATE STRIKE TEAMS FOR RESIDENT AND EMPLOYEE SAFETY 
              IN SKILLED NURSING FACILITIES AND NURSING FACILITIES.

    (a) In General.--Of the amounts made available under subsection 
(c), the Secretary of Health and Human Services (referred to in this 
section as the ``Secretary'') shall allocate such amounts among the 
States, in a manner that takes into account the percentage of skilled 
nursing facilities and nursing facilities in each State that have 
residents or employees who have been diagnosed with COVID-19, for 
purposes of establishing and implementing strike teams in accordance 
with subsection (b).
    (b) Use of Funds.--A State that receives funds under this section 
shall use such funds to establish and implement a strike team that will 
be deployed to a skilled nursing facility or nursing facility in the 
State, not later than 72 hours after three or more residents or 
employees of the facility are diagnosed with or suspected of having 
COVID-19, to assist the facility in separating residents and employees 
who have been exposed to COVID-19 from those residents and employees 
who have not been so exposed, supervising testing for COVID-19, 
ensuring any applicable whistleblower protections are being enforced, 
and such other needs as determined necessary by the strike team. Such 
strike team shall include members of the National Guard, public health 
officials from State and local health departments, experts in 
geriatrics and long-term care medicine, representatives of residents or 
consumers, and representatives of workers.
    (c) Authorization of Appropriations.--For purposes of carrying out 
this section, there is authorized to be appropriated $500,000,000.
    (d) Definitions.--In this section:
            (1) Nursing facility.--The term ``nursing facility'' means 
        a nursing facility under the Medicaid program under title XIX 
        of the Social Security Act (42 U.S.C. 1396 et seq.).
            (2) Skilled nursing facility.--The term ``skilled nursing 
        facility'' means a skilled nursing facility under the Medicare 
        program under title XVIII of the Social Security Act (42 U.S.C. 
        1395 et seq.).

SEC. 4. REINSTITUTION OF REQUIREMENTS WAIVED FOR SKILLED NURSING 
              FACILITIES AND NURSING FACILITIES DURING COVID-19 
              EMERGENCY PERIOD.

    (a) In General.--With respect to requirements that the 
Administrator of the Centers for Medicare & Medicaid Services (referred 
to in this section as the ``Administrator'') waived for skilled nursing 
facilities and nursing facilities under section 1135 or 1812(f) of the 
Social Security Act (42 U.S.C. 1320b-5, 1395d(f)) for the period 
beginning on March 1, 2020, and ending on the last day of the emergency 
period defined in subsection (g)(1)(B) of such section 1135, the 
Administrator shall terminate the waiver of such requirements before 
the last day of such emergency period upon the determination that 
skilled nursing facilities and nursing facilities have the capacity to 
comply with such requirements and that such waiver is no longer 
necessary.
    (b) Plan for Conducting Waived or Postponed Surveys.--With respect 
to any survey under section 1819(g) or 1919(g) of the Social Security 
Act (42 U.S.C. 1395i-3(g), 1396r(g)) that is waived or postponed during 
the period beginning on March 1, 2020, and ending on the last day of 
the emergency period described in subsection (a), the Administrator 
shall develop a plan for conducting such survey after such last day.
    (c) Training and Certification of Nurse Aides.--With respect to any 
nurse aide with respect to whom the Administrator waived the 
application of the requirements under section 483.35(d) of title 42, 
Code of Federal Regulations, for the period beginning on March 1, 2020, 
and ending on the last day of the emergency period described in 
subsection (a), the Administrator shall prohibit the skilled nursing 
facility or nursing facility employing such nurse aide from retaining 
such nurse aide after such last day unless such nurse aide satisfies 
applicable training and certification requirements under such section 
not later than 15 days after such last day.
    (d) Definitions.--In this section:
            (1) Nursing facility.--The term ``nursing facility'' means 
        a nursing facility under the Medicaid program under title XIX 
        of the Social Security Act (42 U.S.C. 1396 et seq.).
            (2) Skilled nursing facility.--The term ``skilled nursing 
        facility'' means a skilled nursing facility under the Medicare 
        program under title XVIII of the Social Security Act (42 U.S.C. 
        1395 et seq.).

SEC. 5. GUIDANCE FOR CERTAIN RESIDENTIAL CARE FACILITIES DURING COVID-
              19 EMERGENCY PERIOD.

    Not later than 15 days after the date of the enactment of this Act, 
the Secretary of Health and Human Services (referred to in this section 
as the ``Secretary'') shall issue guidance for long-term health care 
facilities, including assisted living facilities, other residential 
care facilities, and such facilities that are temporary during the 
emergency period defined in section 1135(g)(1)(B) of the Social 
Security Act (42 U.S.C. 1320b-5(g)(1)(B)), that are not subject to 
oversight by the Centers for Medicare & Medicaid Services on providing 
access to virtual visitation during any portion of such emergency 
period in which in-person visitation is restricted and ensuring 
appropriate infection control and prevention and employee safety during 
such emergency period. Such guidance shall include--
            (1) steps that health care facilities described in this 
        subsection should take to provide residents with access to 
        virtual visitation, including through the purchase or 
        installation of devices purchased for the use or benefit of 
        individual or multiple residents, that allows residents to 
        communicate with their families during such emergency period;
            (2) options for such facilities in notifying residents and 
        resident representatives of such access to virtual visitation 
        and how the facility is addressing any operational issues 
        related to such access to virtual visitation; and
            (3) steps that health care facilities described in this 
        subsection should take to provide residents and employees with 
        appropriate infection control and prevention, based on 
        requirements for skilled nursing facilities under subsection 
        (k) of section 1819 of the Social Security Act (42 U.S.C. 
        1395i-3), as added by section 2(a), and requirements for 
        nursing facilities under subsection (k) of section 1919 of such 
        Act (42 U.S.C. 1396r), as added by section 2(b).
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