To amend title XIX of the Social Security Act to repeal the requirement for annual resident review for nursing facilities under the Medicaid program and to require resident reviews for mentally ill or mentally retarded residents when there is a significant change in physical or mental condition.
PL 104-315 (H.R.3632), enacted 10/19/1996

110 STAT. 3824 
PUBLIC LAW 104-315—OCT. 19, 1996 
Public Law 104-315 
104th Congress 
An Act 
To amend title XIX of the Social Security Act to repeal the requirement for 
Oct. 19, 1996 
annual resident review for nursing facilities under the Medicaid program and 
[HR 3632] 
^ require resident reviews for mentally ill or mentally retarded residents when 
there is a significant change in physical or mental condition. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. REPEAL OF REQUIREMENT FOR ANNUAL RESIDENT 
REVIEW FOR MENTALLY ILL AND MENTALLY RETARDED 
NURSING FACILITY RESIDENTS. 
(a) IN GENERAL.—Section 1919(e)(7) of the Social Security Act 
(42 U.S.C. 1396r(e)(7)) is amended— 
(1) in subparagraph (B)— 
(A) by striking "ANNUAL" in the heading, and 
(B) by striking clause (iii); sind 
(2) in subparagraph (D)(i), by striking "ANNUAL" in the 
heading. 
42 use I396r 
(b) EFFECTIVE DATE.—^The amendments made by subsection 
note. 
(a) shall take effect on the date of the enactment of this Act. 
SEC. 2. REQUIREMENT FOR REVIEW IN CASE OF SIGNIFICANT CHANGE 
IN PHYSICAL OR MENTAL CONDITION OF MENTALLY ELL 
OR 
MENTALLY 
RETARDED 
NURSING 
FACILITY 
RESIDENTS. 
(a) REQUIREMENT FOR NOTIFICATION OF STATE AUTHORITY.— 
Section 1919(b)(3)(E) of the Social Security Act (42 U.S.C. 
1396r(b)(3)(E)) is amended by adding at the end the following: 
"In addition, a nursing faciHty shall notify the State mental health 
authority or State mental retardation or developmental disability 
authority, as applicable, promptly £ifter a significant change in 
the physical or mental condition of a resident who is mentally 
ill or mentally retarded.". 
(b) REQUIREMENT FOR REVIEW.—Section 1919(e)(7)(B) of such 
Act (42 U.S.C. 1396r(e)(7)(B)), as amended by section 1(a)(1), is 
amended by inserting after clause (ii) the following new clause: 
PUBLIC LAW 104-315—OCT. 19, 1996 
110 STAT. 3825 
"(iii) 
REVIEW 
REQUIRED 
UPON 
CHANGE 
IN 
RESIDENT'S CONDITION.—^A review and determination 
\mder clause (i) or (ii) must be conducted promptly 
after a nursing facility has notified the State mental 
health authority or State mental retardation or 
developmental disabiUty authority, as applicable, 
imder subsection (bXSXE) with respect to a mentally 
ill or mentally retarded resident, that there has been 
a significant change in the resident's physical or mental 
condition.", 
(c) EFFECTIVE DATE.—^The amendments made by this section 42USCi396r 
shall apply to changes in physical or mental condition occurring note. 
on or after the date of the enactment of this Act. 
Approved October 19, 1996. 
LEGISLATIVE HISTORY—H.R. 3632: 
HOUSE REPORTS: No. 104-817 (Comm. on Commerce). 
CONGRESSIONAL RECORD, Vol. 142 (1996): 
Sept. 28, considered and passed House. 
Oct. 3, considered and passed Senate.