In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

Example Input: SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Government Waste 
Reduction Act of 2013''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Establishment of Board.
Sec. 3. Duties of the Board.
Sec. 4. Powers of the Board.
Sec. 5. Board personnel matters.
Sec. 6. Congressional consideration of Board recommendations.
Sec. 7. Termination of the Board.

SEC. 2. ESTABLISHMENT OF BOARD.

    (a) Establishment.--There is established the Independent Government 
Waste Reduction Board (hereafter in this Act referred to as the 
``Board'').
    (b) Membership.--
            (1) In general.--
                    (A) Appointment.--The Board shall be composed of 15 
                members appointed by the President, by and with the 
                advice and consent of Congress.
                    (B) Qualifications.--The members of the Board shall 
                include individuals with national recognition for their 
                expertise in agencies, efficiency, waste reduction, 
                finance and economics, actuarial sciences, who provide 
                a mix of different professionals, broad geographic 
                representation, and a balance between urban and rural 
                representatives.
                    (C) Ethical disclosure.--The President shall 
                establish a system for public disclosure by members of 
                the Board of financial and other potential conflicts of 
                interest relating to such members. Members of the Board 
                shall be treated as officers in the executive branch 
                for purposes of applying title I of the Ethics in 
                Government Act of 1978 (Public Law 95-521).
                    (D) Conflicts of interest.--No individual may serve 
                as a member of the Board if that individual engages in 
                any other business, vocation, or employment.
                    (E) Consultation with congress.--In selecting 
                individuals for nominations for appointments to the 
                Board, the President shall consult with--
                            (i) the majority leader of the Senate 
                        concerning the appointment of 3 members;
                            (ii) the Speaker of the House of 
                        Representatives concerning the appointment of 3 
                        members;
                            (iii) the minority leader of the Senate 
                        concerning the appointment of 3 members; and
                            (iv) the minority leader of the House of 
                        Representatives concerning the appointment of 3 
                        members.
            (2) Term of office.--Each member shall hold office for the 
        duration of the Board.
            (3) Chairperson.--
                    (A) In general.--The Chairperson shall be appointed 
                by the President, by and with the advice and consent of 
                the Senate, from among the members of the Board.
                    (B) Duties.--The Chairperson shall be the principal 
                executive officer of the Board, and shall exercise all 
                of the executive and administrative functions of the 
                Board, including functions of the Board with respect 
                to--
                            (i) the appointment and supervision of 
                        personnel employed by the Board;
                            (ii) the distribution of business among 
                        personnel appointed and supervised by the 
                        Chairperson and among administrative units of 
                        the Board; and
                            (iii) the use and expenditure of funds.
                    (C) Governance.--In carrying out any of the 
                functions under subparagraph (B), the Chairperson shall 
                be governed by the general policies established by the 
                Board and by the decisions, findings, and 
                determinations the Board shall by law be authorized to 
                make.
                    (D) Requests for appropriations.--Requests or 
                estimates for regular, supplemental, or deficiency 
                appropriations on behalf of the Board may not be 
                submitted by the Chairperson without the prior approval 
                of a majority vote of the Board.
            (4) Removal.--Any member may be removed by the President 
        for neglect of duty or malfeasance in office, but for no other 
        cause.
    (c) Vacancies; Quorum; Seal; Vice Chairperson; Voting on Reports.--
            (1) Vacancies.--No vacancy on the Board shall impair the 
        right of the remaining members to exercise all the powers of 
        the Board.
            (2) Quorum.--A majority of the members of the Board shall 
        constitute a quorum for the transaction of business, but a 
        lesser number of members may hold hearings.
            (3) Seal.--The Board shall have an official seal, of which 
        judicial notice shall be taken.
            (4) Vice chairperson.--The Board shall elect a Vice 
        Chairperson to act in the absence or disability of the 
        Chairperson or in case of a vacancy in the office of the 
        Chairperson.
            (5) Voting on proposals.--Any proposal of the Board must be 
        approved by the majority of members present.

SEC. 3. DUTIES OF THE BOARD.

    (a) Submission of Report.--Not later than one year after the date 
of the enactment of this Act, the Board shall submit to Congress and 
the President a report that advises specific implementation of the 
recommendations from the March 2011 Government Accountability Office 
report to Congress, entitled ``Opportunities to Reduce Potential 
Duplication in Government Programs, Save Tax Dollars, and Enhance 
Revenue'' (GAO-11-318SP) and the February 2012 Government 
Accountability Office report to Congress, entitled ``Opportunities to 
Reduce Duplication, Overlap and Fragmentation, Achieve Savings, and 
Enhance Revenue'' (GAO-12-342SP) and shall include--
            (1) a summary of the recommendations;
            (2) an explanation of each recommendation contained in the 
        report and the reasons for including such recommendation;
            (3) an opinion by the Government Accountability Office on 
        whether each recommendation is consistent with the intent of 
        such Government Accountability Office reports;
            (4) a legislative proposal that implements the 
        recommendations; and
            (5) other information determined appropriate by the Board.
    (b) Recommendations Requirements.--
            (1) Requirements.--Each recommendation in the report 
        submitted under subsection (a)--
                    (A) shall result in a decrease of overall 
                Government spending or an increase of Government 
                revenue; and
                    (B) shall not result in--
                            (i) any cut in benefits for veterans, 
                        members of the Armed Forces, or their families; 
                        or
                            (ii) any cut in benefits for seniors, 
                        including--
                                    (I) the elimination of guaranteed 
                                health insurance benefits for seniors 
                                or people with disabilities;
                                    (II) the conversion of Medicare 
                                into a voucher plan that provides 
                                limited payments to seniors or people 
                                with disabilities to purchase health 
                                care in the private health insurance 
                                market;
                                    (III) cuts in Medicaid health 
                                insurance benefits;
                                    (IV) cuts in nursing home care; or
                                    (V) privatization of Social 
                                Security benefits.
            (2) Consultation with other agencies.--The Board shall 
        consult regularly with the Government Accountability Office and 
        other agencies in making the recommendations required under 
        this section.

SEC. 4. POWERS OF THE BOARD.

    (a) Hearings.--The Board may hold such hearings, sit and act at 
such times and places, take such testimony, and receive such evidence 
as the Board considers advisable to carry out this Act.
    (b) Obtaining Official Data.--The Board may secure directly from 
any department or agency information necessary to enable it to carry 
out this section. Upon request of the Chairperson, the head of that 
department or agency shall furnish that information to the Board on an 
agreed upon schedule.
    (c) Postal Services.--The Board may use the United States mails in 
the same manner and under the same conditions as other agencies of the 
Federal Government.
    (d) Gifts.--The Board may accept, use, and dispose of gifts or 
donations of services or property.
    (e) Offices.--The Board shall maintain a principal office and such 
field offices as it determines necessary, and may meet and exercise any 
of its powers at any other place.

SEC. 5. BOARD PERSONNEL MATTERS.

    (a) Compensation of Members and Chairperson.--Each member of the 
Board, other than the Chairperson, shall be compensated at a rate equal 
to the annual rate of basic pay prescribed for level III of the 
Executive Schedule under section 5315 of title 5, United States Code. 
The Chairperson shall be compensated at a rate equal to the daily 
equivalent of the annual rate of basic pay prescribed for level II of 
the Executive Schedule under section 5315 of title 5, United States 
Code.
    (b) Travel Expenses.--The members of the Board shall be allowed 
travel expenses, including per diem in lieu of subsistence, at rates 
authorized for employees of agencies under subchapter I of chapter 57 
of title 5, United States Code, while away from their homes or regular 
places of business in the performance of services for the Board.
    (c) Staff.--
            (1) In general.--The Chairperson may, without regard to the 
        civil service laws and regulations, appoint and terminate an 
        executive director and such other additional personnel as may 
        be necessary to enable the Board to perform its duties. The 
        employment of an executive director shall be subject to 
        confirmation by the Board.
            (2) Compensation.--The Chairperson may fix the compensation 
        of the executive director and other personnel without regard to 
        chapter 51 and subchapter III of chapter 53 of title 5, United 
        States Code, relating to classification of positions and 
        General Schedule pay rates, except that the rate of pay for the 
        executive director and other personnel may not exceed the rate 
        payable for level V of the Executive Schedule under section 
        5316 of such title.
    (d) Detail of Government Employees.--Any Federal Government 
employee may be detailed to the Board without reimbursement, and such 
detail shall be without interruption or loss of civil service status or 
privilege.
    (e) Procurement of Temporary and Intermittent Services.--The 
Chairperson may procure temporary and intermittent services under 
section 3109(b) of title 5, United States Code, at rates for 
individuals which do not exceed the daily equivalent of the annual rate 
of basic pay prescribed for level V of the Executive Schedule under 
section 5316 of such title.

SEC. 6. CONGRESSIONAL CONSIDERATION OF BOARD RECOMMENDATIONS.

    (a) Introduction.--
            (1) In general.--On the day on which the report is 
        submitted by the Board to the Congress under section 3(a), the 
        legislative proposal (described in section 3(a)(4)) contained 
        in the report shall be introduced (by request) in the Senate by 
        the majority leader of the Senate or by Members of the Senate 
        designated by the majority leader of the Senate and shall be 
        introduced (by request) in the House by the majority leader of 
        the House or by Members of the House designated by the majority 
        leader of the House.
            (2) Not in session.--If either House is not in session on 
        the day on which such legislative proposal is submitted, the 
        legislative proposal shall be introduced in that House, as 
        provided in subparagraph (A), on the first day thereafter on 
        which that House is in session.
            (3) Any member.--If the legislative proposal is not 
        introduced in either House within 5 days on which that House is 
        in session after the day on which the legislative proposal is 
        submitted, then any Member of that House may introduce the 
        legislative proposal.
            (4) Referral.--The legislation introduced under this 
        subsection in the House of Representatives shall be referred to 
        the Committee on Oversight and Government Reform of the House 
        of Representatives. The legislation introduced under this 
        subsection in the Senate shall be referred to the Committee on 
        Homeland Security and Governmental Affairs of the Senate.
    (b) Discharge.--If the committee to which a legislative proposal 
described in subsection (a) is referred has not reported the bill 
containing such proposal by the end of the 20-day period beginning on 
the date on which the Board submits the report to Congress under 
section 3(a), such committee shall be, at the end of such period, 
discharged from further consideration of such bill, and such bill shall 
be placed on the appropriate calendar of the House involved.
    (c) Expedited Consideration.--
            (1) Consideration.--On or after the third day after the 
        date on which the committee to which such a bill is referred 
        has reported, or has been discharged (under subsection (b)) 
        from further consideration of, such a bill, it is in order 
        (even though a previous motion to the same effect has been 
        disagreed to) for any Member of the respective House to move to 
        proceed to the consideration of the bill. A member may make the 
        motion only on the day after the calendar day on which the 
        Member announces to the House concerned the Member's intention 
        to make the motion, except that, in the case of the House of 
        Representatives, the motion may be made without such prior 
        announcement if the motion is made by direction of the 
        committee to which the bill was referred. The motion is highly 
        privileged in the House of Representatives and is privileged in 
        the Senate and is not debatable. The motion is not subject to 
        amendment, or to a motion to postpone, or to a motion to 
        proceed to the consideration of other business. A motion to 
        reconsider the vote by which the motion is agreed to or 
        disagreed to shall not be in order. If a motion to proceed to 
        the consideration of the bill is agreed to, the respective 
        House shall immediately proceed to consideration of the bill 
        without intervening motion, order, or other business, and the 
        bill shall remain the unfinished business of the respective 
        House until disposed of.
            (2) Debate.--Debate on the bill, and on all debatable 
        motions and appeals in connection therewith, shall be limited 
        to not more than 2 hours, which shall be divided equally 
        between those favoring and those opposing the bill. An 
        amendment to the bill is not in order. A motion further to 
        limit debate is in order and not debatable. A motion to 
        postpone, or a motion to proceed to the consideration of other 
        business, or a motion to recommit the bill is not in order. A 
        motion to reconsider the vote by which the bill is agreed to or 
        disagreed to is not in order.
            (3) Vote on final passage.--Immediately following the 
        conclusion of the debate on the bill and a single quorum call 
        at the conclusion of the debate if requested in accordance with 
        the rules of the appropriate House, the vote on final passage 
        of the bill shall occur.
            (4) Appeals.--Appeals from the decisions of the Chair 
        relating to the application of the rules of the Senate or the 
        House of Representatives, as the case may be, to the procedure 
        relating to the bill shall be decided without debate.
    (d) Consideration by Other House.--
            (1) Before passage.--If, before the passage by one House of 
        a bill of that House described in subsection (b), that House 
        receives from the other House a bill described in subsection 
        (b), then the following procedures shall apply--
                    (A) the bill of the other House shall not be 
                referred to a committee and may not be considered in 
                the House receiving it except in the case of final 
                passage as provided in subparagraph (B)(ii); and
                    (B) with respect to a bill described in subsection 
                (b) of the House receiving the bill (i) the procedure 
                in that House shall be the same as if no bill had been 
                received from the other House; but (ii) the vote on 
                final passage shall be on the bill of the other House.
            (2) After passage.--Upon disposition of the bill received 
        from the other House, it shall no longer be in order to 
        consider the bill that originated in the receiving House.
    (e) Rules of the Senate and House.--This section is enacted by 
Congress--
            (1) as an exercise of the rulemaking power of the Senate 
        and House of Representatives, respectively, and as such it is 
        deemed a part of the rules of each House, respectively, but 
        applicable only with respect to the procedure to be followed in 
        that House in the case of a bill described in subsection (b), 
        and it supersedes other rules only to the extent that it is 
        inconsistent with such rules; and
            (2) with full recognition of the constitutional right of 
        either House to change the rules (so far as relating to the 
        procedure of that House) at any time, in the same manner, and 
        to the same extent as in the case of any other rule of that 
        House.
    (f) Calendar Day Defined.--In this section, the term ``calendar 
day'' means a calendar day other than one on which either House is not 
in session because of an adjournment of more than three days to a date 
certain.

SEC. 7. TERMINATION OF THE BOARD.

    The Board shall terminate 120 days after the date on which the 
Board submits the report under section 3(a).
Example Output: Government Waste Reduction Act of 2013 - Establishes the Independent Government Waste Reduction Board, the membership of which shall include individuals with national recognition for expertise in agencies, waste reduction, finance and economics, and actuarial sciences. Requires the Board to submit to Congress and the President a report that advises specific implementation of the recommendations from the March 2011 Government Accountability Office (GAO) report &quot;Opportunities to Reduce Potential Duplication in Government Programs, Save Tax Dollars, and Enhance Revenue&quot; and the February 2012 GAO report &quot;Opportunities to Reduce Duplication, Overlap and Fragmentation, Achieve Savings, and Enhance Revenue.&quot; Sets forth procedures for congressional consideration of the Board's recommendations.

Example Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Depository Institution Community 
Development Investments Enhancement Act''.

SEC. 2. TECHNICAL CORRECTIONS.

    (a) National Banks.--The first sentence of the paragraph designated 
as the ``Eleventh'' of section 5136 of the Revised Statutes of the 
United States (12 U.S.C. 24) (as amended by section 305(a) of the 
Financial Services Regulatory Relief Act of 2006) is amended by 
striking ``promotes the public welfare by benefitting primarily'' and 
inserting ``is designed primarily to promote the public welfare, 
including the welfare of''.
    (b) State Member Banks.--The first sentence of the 23rd paragraph 
of section 9 of the Federal Reserve Act (12 U.S.C. 338a) is amended by 
striking ``promotes the public welfare by benefiting primarily'' and 
inserting ``is designed primarily to promote the public welfare, 
including the welfare of''.

SEC. 3. INVESTMENTS BY FEDERAL SAVINGS ASSOCIATIONS AUTHORIZED TO 
              PROMOTE THE PUBLIC WELFARE.

    Section 5(c) of the Home Owners' Loan Act (12 U.S.C. 1464) is 
amended--
            (1) in paragraph (3)--
                    (A) by striking subparagraph (A); and
                    (B) by redesignating subparagraphs (B) and (C), as 
                subparagraphs (A) and (B), respectively; and
            (2) in paragraph (4), by adding at the end the following 
        new subparagraph:
                    ``(G) Direct investments to promote the public 
                welfare.--
                            ``(i) In general.--A Federal savings 
                        association may make investments, directly or 
                        indirectly, each of which is designed primarily 
                        to promote the public welfare, including the 
                        welfare of low- and moderate-income communities 
                        or families through the provision of housing, 
                        services, and jobs.
                            ``(ii) Direct investments or acquisition of 
                        interest in other companies.--Investments under 
                        clause (i) may be made directly or by 
                        purchasing interests in an entity primarily 
                        engaged in making such investments.
                            ``(iii) Prohibition on unlimited 
                        liability.--No investment may be made under 
                        this subparagraph which would subject a Federal 
                        savings association to unlimited liability to 
                        any person.
                            ``(iv) Single investment limitation to be 
                        established by director.--Subject to clauses 
                        (v) and (vi), the Director shall establish, by 
                        order or regulation, limits on--
                                    ``(I) the amount that any savings 
                                association may invest in any 1 
                                project; and
                                    ``(II) the aggregate amount of 
                                investment of any savings association 
                                under this subparagraph.
                            ``(v) Flexible aggregate investment 
                        limitation.--The aggregate amount of 
                        investments of any savings association under 
                        this subparagraph may not exceed an amount 
                        equal to the sum of 5 percent of the capital 
                        stock of the savings association actually paid 
                        in and unimpaired and 5 percent of the 
                        unimpaired surplus of the savings association, 
                        unless--
                                    ``(I) the Director determines that 
                                the savings association is adequately 
                                capitalized; and
                                    ``(II) the Director determines, by 
                                order, that the aggregate amount of 
                                investments in a higher amount than the 
                                limit under this clause would pose no 
                                significant risk to the affected 
                                Deposit Insurance Fund.
                            ``(vi) Maximum aggregate investment 
                        limitation.--Notwithstanding clause (v), the 
                        aggregate amount of investments of any savings 
                        association under this subparagraph may not 
                        exceed an amount equal to the sum of 15 percent 
                        of the capital stock of the savings association 
                        actually paid in and unimpaired and 15 percent 
                        of the unimpaired surplus of the savings 
                        association.
                            ``(vii) Investments not subject to other 
                        limitation on quality of investments.--No 
                        obligation that a Federal savings association 
                        acquires or retains under this subparagraph 
                        shall be taken into account for purposes of the 
                        limitation contained in section 28(d) of the 
                        Federal Deposit Insurance Act on the 
                        acquisition and retention of any corporate debt 
                        security not of investment grade.
                            ``(viii) Applicability of standards to each 
                        investment.--The standards and limitations of 
                        this subparagraph shall apply to each 
                        investment under this subparagraph made by a 
                        savings association directly and by its 
                        subsidiaries.''.
Example Output: Depository Institution Community Development Investments Enhancement Act - Amends the Home Owners' Loan Act to revise requirements for community development investments by federal savings associations.

Authorizes a federal savings association to make investments, directly or indirectly, each of which is designed primarily to promote the public welfare, including the welfare of low- and moderate-income communities or families through the provision of housing, services, and jobs (community development investments).

Permits such investments to be made directly or by purchase of interests in an entity primarily engaged in making such investments.

Prohibits a federal savings association from making an investment which would subject it to unlimited liability to any person.

Requires the Director of the Office of Thrift Supervision to establish: (1) the amount any savings association may invest in any one project; and (2) the aggregate amount of investment of any savings association.

Restricts the aggregate amount of investment of any savings association, subject to specified determinations made by the Director.

Prohibits the maximum aggregate amount of investments of any savings association from exceeding the same 15% of its capital stock actually paid in and unimpaired and 15% of its unimpaired surplus as imposed by this Act on national banking associations and state member banks.

Example Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Quality Care for Nursing Home 
Patients Act of 2001''.

SEC. 2. NURSE STAFFING REQUIREMENTS.

    (a) In General.--Sections 1819(b)(4) and 1919(b)(4) of the Social 
Security Act (42 U.S.C. 1395i-3(b)(4); 1396r(b)(4)) are each amended by 
adding at the end the following new subparagraph:
                    ``(D) Minimum staffing requirements.--
                            ``(i) Licensed nurses.--A facility shall 
                        have at least one licensed nurse on duty on the 
                        premises for every--
                                    ``(I) 15 residents present during 
                                the day,
                                    ``(II) 20 residents present during 
                                the evening, and
                                    ``(III) 30 residents present during 
                                the night.
                            ``(ii) Direct caregivers.--In addition to 
                        the requirement under clause (i), a facility 
                        shall also have at least one direct caregiver 
                        on duty on the premises for every--
                                    ``(I) 5 residents present during 
                                the day,
                                    ``(II) 10 residents present during 
                                the evening, and
                                    ``(III) 15 residents present during 
                                the night.
                            ``(iii) Counting.--In determining 
                        compliance with the staffing levels under this 
                        subparagraph, an individual may not be counted 
                        while performing noncaregiving services, such 
                        as administrative services, food preparation, 
                        housekeeping, laundry, maintenance services, or 
                        other noncaregiving-related activities.
                            ``(iv) Authority to establish higher 
                        standards.--The Secretary may establish higher 
                        minimum staffing requirements, for resident 
                        case mix and such other factors as the 
                        Secretary determines appropriate, than those 
                        imposed under clauses (i) and (ii).
                            ``(v) Rules of construction.--
                                    ``(I) Nonpreemption.--Nothing in 
                                this subparagraph shall be construed to 
                                prohibit a State from imposing higher 
                                minimum staffing requirements on 
                                facilities than those imposed under 
                                this subparagraph.
                                    ``(II) Minimum standards only.--
                                Compliance with the staffing 
                                requirements imposed under this 
                                subparagraph alone shall not be 
                                construed as complying with the 
                                requirement under paragraph (2) to 
                                provide services to attain or maintain 
                                the highest practicable physical, 
                                mental, and psychosocial well-being of 
                                each resident.
                                    ``(III) Supplementary 
                                requirements.--The staffing 
                                requirements of this subparagraph are 
                                in addition to the requirements of 
                                subparagraph (C).
                            ``(vi) Definitions.--In this subparagraph 
                        and paragraph (8):
                                    ``(I) Licensed nurse.--The term 
                                `licensed nurse' means a registered 
                                professional nurse, licensed practical 
                                nurse, or licensed vocational nurse who 
                                meets State licensing requirements, and 
                                who furnishes any of the following 
                                services:
                                            ``(aa) Direct care 
                                        (including treatment and 
                                        medications).
                                            ``(bb) Resident assessment 
                                        and observation.
                                            ``(cc) Supervision of 
                                        direct patient care at the unit 
                                        level.
                                            ``(dd) Planning or 
                                        coordination of nursing 
                                        services with other resident 
                                        services.
                                    ``(II) Direct caregiver.--The term 
                                `direct caregiver' means a certified 
                                nurse assistant who provides direct 
                                care (as defined by the Secretary) or a 
                                licensed nurse who primarily provides 
                                direct care.
                                    ``(III) Day.--The term `day' means 
                                an eight-hour period commencing not 
                                earlier than 6 a.m. nor later than 8 
                                a.m.
                                    ``(IV) Evening.--The term `evening' 
                                means an eight-hour period commencing 
                                not earlier than 2 p.m. nor later than 
                                4 p.m.
                                    ``(V) Night.--The term `night' 
                                means an eight-hour period commencing 
                                not earlier than 10 p.m. nor later than 
                                12 midnight.''.
    (b) Adjustment to Payments.--
            (1) Medicare.--Section 1888(e)(4)(G) of such Act (42 U.S.C. 
        1395yy(e)(4)(G)) is amended by adding at the end the following 
        new clause:
                            ``(iv) Adjustment to reflect costs of 
                        minimum staffing.--The Secretary shall provide 
                        for an appropriate adjustment to account for 
                        the costs attributable to meeting the minimum 
                        staffing requirements of subsections (b)(4)(D) 
                        and (f)(8) of section 1819.''.
            (2) Medicaid.--Section 1902(a)(13)(A) of such Act (42 
        U.S.C. 1396a(a)(13)(A)) is amended--
                    (A) in clause (iii), by striking the final ``and'';
                    (B) in clause (iv), by striking the semicolon and 
                inserting ``, and''; and
                    (C) by inserting after clause (iv) the following 
                new clause:
                            ``(v) in the case of nursing facilities, 
                        such rates take into account the costs 
                        attributable to the requirements of section 
                        1919(b)(4)(D).''.
    (c) Effective Date.--The amendments made by this section shall 
apply to services provided on or after the date that is two years after 
the date of enactment of this Act.
    (d) Report to Congress on Adequacy of Personnel To Meet Staffing 
Requirements.--Not later than one year after the date of enactment of 
this Act, the Secretary of Health and Human Services shall submit to 
the Congress a report regarding the adequacy of personnel in nursing 
facilities covered under titles XVIII and XIX of the Social Security 
Act to meet the direct care staffing requirements required under 
sections 1819(b)(4)(D) and 1919(b)(4)(D) of the Social Security Act (as 
added by subsection (a)) and, if inadequate, recommendations on steps 
that should be taken to ensure that adequate numbers of trained staff 
are available to meet such requirements, including ways to attract and 
retain such direct caregiving personnel.

SEC. 3. DISCLOSURE OF STAFFING LEVELS.

    (a) In General.--Section 1819(b)(8) and 1919(b)(8) of the Social 
Security Act (42 U.S.C. 1395i-3(b)(8); 1396r(b)(8)), as added by 
section 941 of the Medicare, Medicaid, and SCHIP Benefits Improvement 
and Protection Act of 2000 (114 Stat. 2763A-585), as enacted into law 
by section 1(a)(6) of Public Law 106-554, are each amended to read as 
follows:
            ``(8) Disclosure of staffing levels.--
                    ``(A) In general.--A facility shall conspicuously 
                post the notices described in subparagraph (B), in the 
                manner described in subparagraph (C), in each area or 
                unit of the facility where residents reside.
                    ``(B) Notices described.--Notices referred to in 
                subparagraph (A) are the following:
                            ``(i) Minimum staffing requirements.--A 
                        notice describing the minimum staffing 
                        requirements set forth in subsection (b)(4)(D).
                            ``(ii) Current staff information.--A notice 
                        showing, separately for each shift in the area 
                        or unit of the facility in which it is posted--
                                    ``(I) the name of the direct care 
                                clinical supervisor for that area or 
                                unit;
                                    ``(II) the current number of direct 
                                caregivers (including licensed nurses) 
                                present on the premises who perform 
                                resident care and the name and 
                                credential or professional title of 
                                each such caregiver;
                                    ``(III) the current ratio of 
                                residents to licensed nurses present on 
                                the premises;
                                    ``(IV) the current ratio of 
                                residents to direct caregivers 
                                (including licensed nurses) present on 
                                the premises assigned to that area or 
                                unit; and
                                    ``(V) the current number of 
                                residents of such area or unit.
                    ``(C) Manner of posting; format of notice.--
                            ``(i) Manner of posting.--Notices posted 
                        under subparagraph (A) shall be posted adjacent 
                        to each other in each area or unit to which 
                        such notices apply in the facility, and posted 
                        in a manner visible and accessible to 
                        residents, their families, caregivers, and 
                        prospective residents of such facility.
                            ``(ii) Format of notice.--The Secretary 
                        shall develop a uniform format for the notices 
                        referred to in subparagraph (B) for facilities 
                        to carry out the requirements of this 
                        paragraph.
                    ``(D) Recordkeeping.--The facility shall retain 
                records of such notices for not fewer than two years, 
                and shall make the information contained in those 
                notices available upon request.''.
    (b) Conforming Amendments.--Sections 1819(b)(4) and 1919(b)(4) of 
such Act (42 U.S.C. 1395i-3(b)(4); 1396r(b)(4)) are each amended in 
subparagraph (D)(v), as added by section 2(a) of this Act, by inserting 
``and paragraph (8)'' after ``this subparagraph''.
    (c) Effective Date.--The amendments made by this section shall 
apply to services provided on or after the date that is two years after 
the date of enactment of this Act.

SEC. 4. ADMINISTRATIVE STAFFING REQUIREMENTS.

    (a) In General.--Sections 1819(d)(1) and 1919(d)(1) of the Social 
Security Act (42 U.S.C. 1395i-3(d)(1); 1396r(d)(1)) are each amended by 
adding at the end the following new subparagraph:
                    ``(D) Administrative staffing.--A facility must 
                maintain at least the administrative staff described in 
                the following clauses:
                            ``(i) Director of nursing services.--An 
                        individual who serves full time as a director 
                        of nursing services and who is a registered 
                        professional nurse.
                            ``(ii) Assistant director of nursing 
                        services.--An individual who serves full time 
                        as an assistant director of nursing services 
                        and who is a registered professional nurse, 
                        except that in a facility with fewer than 100 
                        beds, such individual may serve part time and 
                        may also serve as a direct care clinical 
                        nursing supervisor.
                            ``(iii) Director of in-service education.--
                        An individual who serves full time as a 
                        director of in-service education, who is a 
                        registered professional nurse, and who has, to 
                        the extent practicable and appropriate, 
                        training in adult education and gerontology, 
                        except that in a facility with fewer than 100 
                        beds, such individual may serve part time.
                            ``(iv) Direct care clinical nursing 
                        supervisor.--For each shift each day, an 
                        individual who serves full time as a direct 
                        care clinical nursing supervisor and who is a 
                        registered professional nurse, except that in a 
                        facility with fewer than 100 beds, such an 
                        individual may serve part time and may also 
                        serve as an assistant director of nursing.
                An individual may not satisfy more than one requirement 
                of clauses (i) through (iv), except as specifically 
                provided.''.
    (b) Conforming Amendments.--Sections 1819(b)(4) and 1919(b)(4) of 
such Act (42 U.S.C. 1395i-3(b)(4); 1396r(b)(4)) are each amended in 
subparagraph (D)(v), as added by section 2(a) and amended by section 
3(b) of this Act, by striking ``and paragraph (8)'' and by inserting 
``, paragraph (8), and subsection (d)(1)(D)''.
    (c) Payment Modification.--
            (1) Medicare.--Section 1888(e)(4)(G)(iv) of such Act (42 
        U.S.C. 1395yy(e)(4)(G)(iv)), as added by section 2(b)(1) of 
        this Act, is amended by striking ``section 1819(b)(4)(D)'' and 
        inserting ``subsections (b)(4)(D) and (d)(1)(D) of section 
        1819''.
            (2) Medicaid.--Section 1902(a)(13)(A)(v) of such Act (42 
        U.S.C. 1396a(a)(13)(A)(v)), as added by section 2(b)(2) of this 
        Act, is amended by striking ``section 1919(b)(4)(D)'' and 
        inserting ``subsections (b)(4)(D) and (d)(1)(D) of section 
        1919''.
    (d) Effective Date.--The amendments made by this section shall 
apply to services provided on or after the date that is two years after 
the date of enactment of this Act.

SEC. 5. APPLICATION OF REQUIREMENTS TO ALL BEDS.

    (a) Medicare.--Section 1819 of the Social Security Act (42 U.S.C. 
1395i-3) is amended--
            (1) by redesignating subsection (i) as subsection (j); and
            (2) by inserting after subsection (h) the following new 
        subsection:
    ``(i) Applicability of Protections to All Residents.--The 
provisions of this section shall apply with respect to all residents of 
a skilled nursing facility, without regard to whether the resident is 
entitled to have payment made for skilled nursing facility services 
under this title.''.
    (b) Medicaid.--Section 1919(g) of the Social Security Act (42 
U.S.C. 1396r(g)) is amended by adding at the end the following new 
paragraph:
            (1) by redesignating subsection (i) as subsection (j); and
            (2) by inserting after subsection (h) the following new 
        subsection:
    ``(i) Applicability of Protections to All Residents.--The 
provisions of this section shall apply with respect to all residents of 
a nursing facility, without regard to whether the resident is entitled 
to have payment made for nursing facility services under the State plan 
or under any other provision of this Act.''.
Example Output:
Quality Care for Nursing Home Patients Act of 2001 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act (SSA) to: (1) impose minimum direct care staffing requirements on nursing facilities receiving Medicare or Medicaid funding; (2) revise the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 with respect to disclosure of staffing levels at such facilities, adding notice requirements; (3) prescribe administrative staffing requirements for such facilities; and (4) apply quality of care requirements to all residents of skilled nursing facilities, without regard to whether the resident is entitled to have payment made for nursing facilities under Medicare or Medicaid.