An Act to amend the hospital survey and construction provisions of the Public Health Service Act to provide assistance to the States for surveying the need for diagnostic or treatment centers, for hospitals for the chronically ill and impaired, for rehabilitation
PL 83-482 (H.R.8149), enacted 07/12/1954

68 S T A T . ] 
PUBLIC LAW 482-JULY 12, 1954 
461 
deposited as refunds to the appropriation from which paid, in the 
manner provided for in section 524 of the Tariff Act of 1930, as 
amended (19 U. S. C , sec. 1524). 
Approved July 10, 1954. 
52 Stat. 1087. 
Public Law 482 
CHAPTER 471 
AN ACT 
Tuly 12 1954 
To amend the hospital survey and construction provisions of the Public Health 
[H. R. &149] 
Service Act to provide assistance to the States for surveying the need for 
diagnostic or treatment centers, for hospitals for the chronically ill and 
impaired, for rehabilitation facilities, and for nursing homes, and to provide 
assistance in the construction of such facilities through grants to public and 
nonprofit agencies, and for other purposes. 
Be it enacted hy the Senate and House of Representatives 
of the 
United States of America in Congress assemhled^ That this Act may ti^^sif^ey^and 
be cited as the "Medical Facilities Survey and Construction Act of construction Act 
1954". 
°'^^"-
SEC. 2. Title VI of the Public Health Service Act is amended bv 
l%u&c->V\ty^Q^r. 
adding immediately after part D thereof the following new parts: 
"PART E—DECLARATION OF PURPOSE W I T H RESPECT TO DIAGNOSTIC OR 
TREAT3IENT CENTERS, CHRONIC DISEASE HOSPITALS, 
REHABILITATION 
FACILITIES, AND NURSING HOMES 
SEC. 641. The purpose of parts F and G of this title is— 
"(a) to assist the several States (1) to inventory their existing 
diagnostic or treatment centers, hospitals for the chronically ill 
and impaired, rehabilitation facilities, and nursing homes, (2) 
to survey the need for the construction of facilities of the types 
referred to in clause (1), and (3) to develop programs for the 
construction of such public and other nonprofit facilities of the 
types referred to in clause (1) as will, in conjunction with existing 
facilities, afford the necessary physical facilities for furnishing 
to all their people adequate services of the kinds which may be 
supplied by facilities of the types referred to in clause (1); and 
"(b) to assist in the construction, in accordance with such pro-
grams, of public and other nonprofit facilities of the types 
referred to in subsection (a). 
"PART F—SURVEYS AND PLANNING W I T H RESPECT TO DIAGNOSTIC OR 
TREATMENT CENTERS, CHRONIC DISEASE HOSPITALS, 
REHABILITATION 
FACILITIES, AND NURSING HOMES 
(( 
AUTHORIZATION OF APPROPRIATION 
"SEC. 646. In order to assist the States in carrying out the purposes 
of section 641 (a) there is hereby authorized to be appropriated the 
sum of $2,000,000, to remain available until expended. 
The sums ap-
propriated under this section shall be used for making payments to 
States which have submitted, and had approved by the Surgeon Gen-
eral, State applications for funds for carrying out such purposes. 
(( 
STATE APPLICATIONS 
"SEC. 647. The Surgeon General shall approve a State application 
for funds for carrying out the purposes of section 641 (a) which— 
"(1) designates as the sole agency for carrying out such pur-
poses, or for supervising the carrying out of sucn purposes, the 
State agency designated in accordance with section 623 (a) (1); 
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462 
PUBLIC LAW 482-JULY 12, 1954 
[68 STAT. 
"(2) provides for the utilization of the State advisory council 
provided in section 623 (a) (3), and if such council does not 
include representatives of nongovernment organizations or groups, 
or State agencies, concerned with rehabilitation, provides for 
consultation with organizations, groups, and State agencies so 
concerned; and 
"(3) provides for making an inventory and survey containing 
all information required by the Surgeon General and for develop-
ing a construction program in accordance with section 653. 
a 
ALLOTMENTS TO STATES 
"SEO. 648. Each State shall be entitled to an allotment of such pro-
portion of any appropriation made pursuant to section 646 as its popu-
lation bears to the population of all the States, and within such allot-
ment shall be entitled to receive 50 per centum of its expenditures in 
carrying out the purposes of section 641 (a) in accordance with its 
application: Provided^ That no such allotment to any State shall be 
less than $25,000. The Surgeon General shall from time to time esti-
mate the sum to which each State will be entitled under this section, 
during such ensuing period as he may determine, and shall thereupon 
certify to the Secretary of the Treasury the amount so estimated, 
reduced or increased, as the case may be, by any sum by which the 
Surgeon General finds that his estimate for any prior period was 
greater or less than the amount to which the State was entitled for 
such period. The Secretary of the Treasury shall thereupon, prior 
to audit or settlement by the General Accounting Office, pay to the 
State, at the time or times fixed by the Surgeon General, the amount 
so certified. 
"(b) Any funds paid to a State under this section and not expended 
for the purposes for which paid shall be repaid to the Treasury of 
the United States." 
42Usc29W9in. 
g^c. 3. Title VI of the Public Health Service Act is further 
amended by adding a new part G to read as follows: 
"PART G—CONSTKUCTION or 
DIAGNOSTIC OR TREATMENT 
CENTERS, 
CHRONIC 
DISEASE 
HOSPITALS, 
EEHABILITATION 
FACILITIES, 
AND 
NURSING HOMES 
"AUTHORIZATION OF APPROPRIATION 
"SEC. 651. In order to assist the States in carrying out the purposes 
of section 641 (b), there is hereby authorized to be appropriated for 
the fiscal year ending June 30, 1955, and for each of the two succeed-
ing fiscal years— 
"(1) $20,000,000 for grants for the construction of public and 
other nonprofit diagnostic or treatment centers; 
"(2) $20,000,000 for grants for the construction of public and 
other nonprofit hospitals for the chronically ill and impaired; 
"(3) $10,000,000 for grants for the construction of public and 
other nonprofit rehabilitation facilities; and 
"(4) $10,000,000 for grants for the construction of public and 
other nonprofit nursing homes. 
u 
ALLOTMENTS TO STATES 
"SEC. 652. Each State shall be entitled for each fiscal year to an 
allotment of a sum bearing the same ratio to the sums appropriated for 
such year pursuant to paragraphs (1), (2), (3), and (4), respectively, 
of section 651, as the product of (a) the population of such State and 
68 S T A T . ] 
PUBLIC LAW 4 8 2 - J U L Y 12, 1954 
463 
(b) the square of its allotment percentage (as defined in section 631 
(a)) bears to the sum of the corresponding products for all of the 
^2 use 2911. 
States: Provided^ That no such allotment to any State for the purposes 
of paragraph (1) or (2) of section 651 shall be less than $100,000 and 
no such allotment to any State for the purpose of paragraph (3) or 
(4) shall be less than $50,000, but for the purpose of this proviso the 
term "State" shall not include the Virgin Islands. Sums allotted to 
a State for a jfiscal year and remaining unobligated at the end of such 
year shall remain available to such State for the same purpose for the 
next fiscal year (and for such year only) in addition to the sums al-
lotted to such State for such next fiscal year, 
"REGULATIONS AND APPROVAL or STATE PLANS 
"SEC. 653. (a) Within six months after this part becomes effective, 
the Surgeon General, with the approval of the Federal Hospital Coun-
cil and the Secretary of Health, Education, and Welfare (hereinafter 
referred to as the 'Secretary'), shall revise and supplement the regula-
tions issued under section 622 to provide general standards of construe- 
^2 use 29ie. 
tion and equipment, general standards of adequacy and priority, and 
requirements comparable to those provided in such regulations as to 
nondiscrimination and persons unalble to pay, and as to general meth-
ods of administration of the State plan, for facilities for which pay-
ments are authorized under this part. 
After such regulations have 
been issued, any State desiring to take advantage of this part may 
submit, as a revision of, or supplement to, its plan under section 623, 
a plan for a construction program for diagnostic or treatment centers, 
hospitals for the chronically ill and impaired, rehabilitation facilities, 
and nursing homes. The Surgeon General shall approve any such 
revision of, or supplement to, the State plan which is based upon a 
statew^ide inventory of existing facilities available for such purposes 
and which— 
"(1) meets the requirements of paragraphs (1), (2), (3), (6), 
(8), and (9) of section 623 (a) : Provided, That if the designated 
^2 use 29if. 
advisory council does not include representatives of nongovern-
mental organizations or groups, or State agencies, concerned with 
rehabilitation, the plan shall provide for consultation with organi-
zations, groups, and State agencies so concerned ; 
"(2) conforms with the regulations prescribed under section 
622 as revised and supplemented for the purposes of this part; 
••2 use 29ie. 
"(3) sets forth, with respect to each type of facility, the 
relative need determined in accordance with such revised regula-
tions, and provides for the construction, insofar as financial 
resources available therefor and for maintenance and operation 
make possible, of such facilities in the order of such relative needs; 
and 
"(4) provides that the State agency will from time to time 
review its construction program for such facilities as a part of its 
, 
State plan and submit to the Surgeon General any modifications 
thereof which it considers necessary. 
"(b) The provisions of subsections (b) and (c) of section 623 shall 
^^ use 29if. 
be applicable to State plans with respect to projects for construction 
under this part. 
Except with respect to hospitals, the provisions of 
subsection (d) of such section shall not be applicable to State plans 
with respect to projects for construction under this part. 
"APPROVAL OF PROJECTS AND PAYMENTS—FEDERAL SHARE 
"SEC. 654. (a) Applications under this part by States, political 
subdivisions, or public or other nonprofit agencies for (1) public or 
464 
PUBLIC LAW 482-JULY 12, 1954 
[68 S T A T . 
other nonprofit diagnostic or treatment centers, (2) public or other 
nonprofit hospitals for the chronically ill and impaired, (3) public 
or other nonprofit rehabilitation facilities, or (4) public or other non-
profit nursing homes shall be submitted, and shall be approved by the 
Surgeon General (subject also, in the case of rehabilitation facilities, 
to the approval of the Secretary) if sufficient funds are available from 
the State's allotment under this part for such type of facility, in 
accordance with the procedures and subject to the conditions pre-
scribed in subsection (a) of section 625 and the regulations issued 
29*ii."^^ 2 9ih, under section 622 as revised and supplemented for the purposes of 
this part: Provided^ however^ That (except with respect to hospitals) 
the assurances required for compliance with State standards for 
operation and maintenance shall be limited to such standards, if any, 
as the State may prescribe. Approved applications shall be subject 
to amendment as provided in subsection (c) of section 625. 
"(b) Upon the request of any State that a specified portion of any 
allotment to such State for the purposes of paragraph (1), (2), or 
(4) of section 651 be added to another allotment of such State for the 
purposes of one of such paragraphs, and upon the simultaneous cer-
tification to the Surgeon General by the State agency in such State 
to the effect that it has afforded a reasonable opportunity to make 
applications for the portion so specified and there have been no 
approvable applications for such portion, the Surgeon General shall 
promptly adjust the allotments in accordance with such request and 
shall notify the State agency, and thereafter the allotments as so 
adjusted shall be deemed the State's allotments for the purposes of 
such paragraphs. 
"(c) In accordance with regulations, any State may file with the 
Surgeon General a request that a specified portion of an allotment to 
it under this part for any type of facility be added to the correspond-
ing allotment of another State for the purpose of meeting a portion 
of the Federal share of the cost of a project for the construction of a 
facility of that type in such other State. If it is found by the Sur-
geon General (or, in the case of a rehabilitation facility, by the Sur-
geon General and the Secretary) that construction of the facility with 
respect to which the request is made would meet needs of the State 
making the request and that use of the specified portion of such 
State's allotment, as requested by it, would assist in carrying out the 
purposes of this part, such portion of such State's allotment shall be 
added to the corresponding allotment of the other State, to be used 
for the purpose referred to above. 
"(d) Procedures and conditions for payments under this part shall 
42 use 29ih. 
]3g {vi accord with the provisions of subsection (b) of section 625. 
"(e) Notwithstanding subsection (a) of this section, no applica-
tion for a diagnostic or treatment center shall be approved under such 
subsection unless the applicant is (1) a State, political subdivision, or 
public agency, or (2) a corporation or association which owns and 
Post, p. 465. 
operates a nonprofit hospital (as defined in section 631 (g))." 
AMENDMENT OF PARTS A, C, AND D OF TITLE VI 
42 use 291. 
SEC. 4. (a) That part of section 601 of the Public Health Service 
Act which precedes paragraph (a) is amended by striking out "pur-
pose of this title" and inserting in lieu thereof "purpose of parts B 
through D of this title". 
42 use 29ih. 
(b) Subsection (e) of section 625 of the Public Health Service Act 
is hereby amended to read: 
"(e) If any hospital, diagnostic or treatment center, rehabilitation 
facility, or nursing home for which funds have been paid under this 
68 S T A T . ] 
PUBLIC LAW 482-JULY 12, 1954 
465 
section or under section 654 shall, at any time within twenty years 
after the completion of construction, (A) be sold or transferred to any 
person, agency, or organization, (1) which is not qualified to file an 
application under this section, or (2) which is not approved as a 
transferee by the State agency designated pursuant to section 623 (a) 
"^^ "^c 29if. 
(1), or its successor, or (B) cease to be a nonprofit hospital, nonprofit 
diagnostic or treatment center, nonprofit rehabilitation facility, or 
nonprofit nursing home as defined in section 631 (g), the United States 
^"''a* 
shall be entitled to recover from either the transferor or the transferee 
(or, in the case of a hospital, diagnostic or treatment center, rehabili-
tation facility, or nursing home, which has ceased to be nonprofit, 
from the owners thereof) an amount bearing the same ratio to the then 
value (as determined by agreement of the parties or by action brought 
in the district court of the United States for the district in which such 
hospital, center, facility, or nursing home is situated) of so much of 
the hospital, center, facility, or nursing home as constituted an 
approved project or projects, as the amount of the Federal participa-
tion bore to the cost of the construction of such project or projects."' 
(c) Subsection (g) of section 633 is amended to read: 
'•s use 29n. 
"(g) The terms'nonprofit hospital', Tionprofit diagnostic or treat- 
j'^°fP'"°^^* *
>
*
*
•
" 
ment center', 'nonprofit rehabilitation facility', and 'nonprofit nursing 
home' mean any hospital, diagnostic or treatment center, rehabilitation 
facility, and nursing home, as the case may be, which is owned and 
operated by one or more nonprofit corporations or associations no part 
of the net earnings of which inures, or may lawfully inure, to the 
benefit of any private shareholder or individual;". 
(d) Subsection (h) of section 631 is amended to read: 
42 use 2911. 
"(h) The term 'construction' includes construction of new build- 
"Construction." 
ings, expansion, remodeling, and alteration of existing buildings, and 
initial equipment of any such buildings (including medical trans-
portation facilities) ; including architects' fees, but excluding tlie cost 
of off-site improvements and, except with respect to public health 
centers, the cost of the acquisition of land;". 
(e) Subsection (k) of section 631 is amended to read: 
42 use 2911. 
" (k) (1) The term 'Federal share' with respect to any project means 
"Federal share/' 
the proportion of the cost of construction of such project to be paid 
by the Federal Government. 
In the case of any project approved 
prior to October 25, 1949, the Federal share shall be 33i^ per centum 
of the cost of construction of such project. In the case of any project 
approved on or after October 25, 1949, the Federal share, except as 
otherwise provided in paragraph (2) of this subsection, shall be deter-
mined as follows— 
" (A) if the State plan, as of the date of approval of the project 
application, contains standards approved by the Surgeon General 
pursuant to section 623 (e), the Federal share with respect to such 
••2 use 29if. 
project shall be determined by the State agency in accordance 
with such standards; 
"(B) if the State plan does not contain such standards, the 
Federal share shall be the amount (not less than 331^ per centum 
and not more than either 66% per centum or the State's allotment 
percentage, whichever is the lower) established by the State 
agency for all projects in the State: Provided, That prior to the 
approval of the first project in the State during any fiscal year, 
the State agency shall give to the Surgeon General written noti-
fication of the Federal share established under this subparagraph 
for projects in such State to be approved by the Surgeon General 
during such fiscal year, and the Federal share for projects in such 
State approved during such fiscal year shall not be changed after 
such approval. 
39777 O—55—pt. 1 
32 
466 
PUBLIC LAW 482-JULY 12, 1954 
[68 ST A T . 
42 use 291f. 
Definitions* 
42 use 29Ij. 
Withholding of 
certification, etc. 
42 use 291b. 
Ante, p. 461. 
42 use 29 If. 
Ante, p, 461. 
42 use 29 le. 
42 use 291h. 
Ante, p. 463. 
"(2) In the case of projects eligible for approval under part G and 
approved after the effective date of that part, the Federal share shall 
be determined as provided in paragraph (1) of this subsection, or, 
if the State so elects, shall be 50 per centum of the cost of construction 
of the project: Provided, That prior to the approval of the first such 
project in the State during any fiscal year, the State agency shall 
give to the Surgeon General written notification of such election; 
and such election shall not be subject to change during such fiscal year 
after such approval." 
(f) Section 631 of the Public Health Service Act is further 
amended by the addition of the following subsections: 
"(1^ The term 'diagnostic or treatment center' means a facility for 
the diagnosis or diagnosis and treatment of ambulatory patients— 
"(1) which is operated in connection with a hospital, or 
"(2) in which patient care is under the professional super-
vision of persons licensed to practice medicine or surgery in the 
State, or, in the case of dental diagnosis or treatment, under the 
professional supervision of persons licensed to practice dentistry 
in the State. 
" (m) The term 'hospital for the chronically ill and impaired' shall 
not include any hospital primarily for the care and treatment of 
mentally ill or tuberculous patients. 
"(n) The term 'rehabilitation facility' means a facility which is 
operated for the primary purpose of assisting in the rehabilitation of 
disabled persons through an integrated program of medical, psycho-
logical, social, and vocational evaluation and services under com-
petent professional supervision, and in the case of which— 
"(1) the major portion of such evaluation and services is fur-
nished within the facility; and 
"(2) either (A) the facility is operated in connection with a 
hospital, or (B) all medical and related health services are pre-
scribed by, or are under the general direction of, persons licensed 
to practice medicine or surgery in the State, 
"(o) The term 'nursing home' means a facility for the accommoda-
tion of convalescents or other persons who are not acutely ill and not 
in need of hospital care, but who require skilled nursing care and 
related medical services— 
" (1) which is operated in connection with a hospital, or 
"(2) in which such nursing care and medical services are pre-
scribed by, or are performed under the general direction of, per-
sons licensed to practice medicine or surgery in the State." 
(g) Subsection (a) and subsection (b), paragraph (1), of section 
G32 are hereby amended to read: 
"SEC: 632. (a) Whenever the Surgeon General, after reasonable 
notice and opportunity for hearing to the State agency designated in 
accordance with section 612 (a) (1) or section 647 (1) finds that the 
State agency is not complying substantially with the provisions re-
([uired by section 612 (a) or section 647 to be contained in its applica-
tion for funds under part B or part F, as the case may be, or after 
reasonable notice and opportunity for hearing to the State agency 
designated in accordance with section 623 (a) (1) or section 647 (1) 
finds (1) that the State agency is not complying substantially with 
the provisions required by section 623 (a), or by regulations prescribed 
pursuant to section 622, or with the provisions required iDy section 
647, or by regulations prescribed pursuant to section 653, to be con-
tained in its plan submitted under section 623 (a) or section 653, as the 
case may be, or (2) that any funds have been diverted from the pur-
poses for which they have been allotted or paid, or (3) that any assur-
ance given in an application filed under section 625 or section 654, as 
68 
S T A T . ] 
PUBLIC LAW 483-JULY 14, 1954 
467 
the case may be, is not being or cannot be carried out, or (4) that there 
is a substantial failure to carry out plans and specifications approved 
by the Surgeon General under section (>25 or section 654, as the case 
may be, or (5) that adequate State funds are not being provided an-
nually for the direct administration of the State plan, the Surgeon 
General may forthwith notify the Secretary of the Treasury and the 
State agency that no further certification will be made under part B, 
part C, part F, or part G, as the case may be, or that no further cer-
tification will be made for any project or projects designated by the 
Surgeon General as being affected by the default, as the Surgeon Gen-
eral may determine to be appropriate under the circumstances; and, 
except with regard to any project for which the application has al-
ready been approved and which is not directly affected by such de-
fault, he may withhold further certifications until there is no longer 
any failure to comply, or, if compliance is impossible, until the State 
repays or arranges for the repayment of Federal moneys which have 
been diverted or improperly expended. 
"(b) (1) If the Surgeon General refuses to approve any applica-
tion under section 625 or section 654, the State agency through which 
the application was submitted, or if any State is dissatisfied with the 
Surgeon General's action under subsection (a) of this section, such 
State may appeal to the United States circuit court of appeals for the 
circuit in which such State is located. 
The summons and notice of 
appeal may be served at any place in the United States. The Surgeon 
(xeneral shall forthwith certify and file in the court the transcript of 
the proceedings and the record on which he based his action." 
(h) Section 635 is hereby amended to read: 
Appeal. 
42 u s e 29 Ih. 
Ante, p« 463* 
42 u s e 291m. 
u 
STATE CONTROL OF OPERATIONS 
"SEC. 635. Except as otherwise specifically provided, nothing in this 
title shall be construed as conferring on any Federal officer or employee 
the right to exercise any supervision or control over the administra-
tion, personnel, maintenance, or operation of any hospital, diagnostic 
or treatment center, rehabilitation facility, or nursing home with 
respect to which any funds have been or may be expended under this 
title." 
Approved July 12, 1954. 
Public Law 483 
CHAPTER 472 
AN ACT 
To provide that each grant of exchange assignment on tribal lands on the 
Cheyenne River Sioux Reservation and the Standing Rock Sioux Reservation 
shall have the same force and effect as a trust patent, and for other purposes. 
Be it enacted hy the Senate and House of Representatives 
of the 
United States of America in Congress assemhled^ That, from and after 
the date of the approval of this Act, each grant of exchange assignment 
of tribal lands on the Cheyenne River Sioux Reservation and the 
Standing Rock Sioux Reservation shall have the same force and effect, 
and shall confer the same rights, including all timber, mineral, and 
water rights now vested in or held by the Cheyenne River Sioux Tribe 
or the Standing Rock Sioux Tribe, upon the holder or holders thereof, 
that are conveyed by a trust patent issued pursuant to section 5 of the 
Act of February 8,1887 (24 Stat. 388), as amended and supplemented, 
except that the period of trust and tax exemption shall continue until 
otherwise directed by Congress. 
July 14,1954 
[S. 2488] 
Sioux IndicoiB. 
Exchange grants. 
25 u s e 348.