In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
Q: That (a)(1) sections
1861(e)(9) and 1861(j)(15) of the Social Security Act (relating to
qualifications of hospitals and skilled nursing facilities) are each
amended by striking out ''health and safety'' and inserting in lieu
thereof ''health, safety, and rights''.
(2) Section 1864(c) of such Act is amended by striking out ''health
and safety of patients'' and inserting in lieu thereof ''the health,
safety, and rights of patients''.
(b) Part C of title XVIII of such Act is amended by adding after
section 1881 the following new sections:

''rights of patients of certain long-term care facilities

''Sec. 1882. (a) In prescribing standards under subsections (e)(9)
and (j)(15) of section 1861 with respect to the rights of individuals
(hereinafter in this section and section 1883 referred to as
'patients') furnished services in an institution which has (as
determined by the Secretary) an average duration-of-stay of more than
30 days (such an institution hereinafter in this section and section
1183 referred to as a 'facility'), the Secretary shall--
''(1) require the governing board of the facility to
establish written policies, consistent with the rights set
forth in subsection (b), regarding the rights and
responsibilities of patients and, through the administrator of
the facility, to develop and adhere to procedures for
implementing such policies;
''(2) require the facility to make these policies and
procedures available to the public, patients, guardians, and
relatives of patients, and to any relative or other person
serving as a representative payee of a patient pursuant to
section 205(j) of this Act; and
''(3) require the staff of the facility to be trained and
involved in the implementation of these policies and
procedures.
''(b) A facility's policies and procedures regarding rights of
patients of the facility must at least ensure that the following
patients' rights are provided:
''(1) Information on patient rights.--A patient's right to
be fully informed, as evidenced by the patient's written
acknowledgment, before or at the time of admission and during
stay of these rights and of all rules and regulations governing
patient conduct and responsibility.
''(2) Information on services and charges.--A patient's
right (A) to be fully informed, and given a written statement
before or at the time of admission and during stay, of services
available in the facility and of related charges for such
services, including any charges for services not covered under
this title or title XIX or not covered by the facility's basic
per diem rate, and (B) to be informed in writing at least 30
days in advance of any changes in the availability of services
or in the charges for these services.
''(3) Information on and participation in medical
treatment.--A patient's right (A) to be fully informed by a
physician of the patient's medical condition, unless medically
contraindicated for a specified and limited period of time (as
documented, by a physician, in the patient's medical record),
(B) to be afforded the opportunity to participate in the
planning of his medical treatment, and (C) to refuse to
participate in experimental research.
''(4) Conditions of transfer or discharge.--A patient's
right (A) to be transferred within the facility or discharged
from the facility only for medical reasons, for his welfare or
that of other patients, or for nonpayment of his stay (except
as prohibited by this title or title XIX), (B) to be informed
before admission of the causes for such a transfer or
discharge, (C) to be given 30 days' advance notice of such a
transfer or discharge (except for emergencies threatening the
health or safety of the patient), and (D) to be given
sufficient preparation and orientation to ensure safe and
orderly transfer or discharge and adjustment and to have this
preparation and orientation documented in his medical record.
''(5) Grievances.--A patient's right to be assisted,
throughout his period of stay, in his exercise of his rights as
a patient and as a citizen, and to this end the patient's right
to file complaints under section 1883, voice grievances, and
recommend changes in policies and service to the staff of the
facility and to outside representatives of his choice
(including representatives of governmental agencies
administering the programs under this title and title XIX) free
from restraint, interference, coercion, discrimination, or
reprisal.
''(6) Management of personal financial affairs.--A
patient's right to manage his personal financial affairs or be
given, at least quarterly, an itemized accounting of financial
transactions made on his behalf whenever the facility accepts
his written delegation of this responsibility for any period of
time in conformance with State law.
''(7) Freedom from abuse and restraints.--A patient's
right--
''(A) to be free from mental and physical abuse,
and
''(B) to be free from chemical and physical
restraints, except (i) as authorized in writing by a
physician for a specified and limited period of time,
or (ii) in emergencies when necessary to protect the
patient from injury to himself or to others (in which
case notice of the use of such restraints, and an
explanation of the circumstances thereof, shall be
promptly provided to the attending physician and noted
in the patient's medical record).
''(8) Confidentiality of treatment and medical records.--A
patient's right--
''(A) to be assured confidential treatment of his
personal and medical records, and
''(B) to approve or refuse the release of such
records to any individual outside the facility, except
in the case of a transfer to another health care
institution or as required by law or third-party
payment contract.
''(9) Dignity and privacy.--A patient's right to be treated
with consideration, respect, and full recognition of his
dignity and individuality, including privacy in treatment and
in care for his personal needs.
''(10) Work requirements.--A patient's right not to be
required to perform services for the facility.
''(11) Freedom of association.--A patient's right to
associate and communicate privately (in writing or otherwise)
with persons of his choice.
''(12) Participation in activities of choice.--A patient's
right to meet with, and participate in activities of, social,
religious, and community groups at his discretion.
''(13) Use of personal possessions.--A patient's right to
retain and use his personal clothing and possessions as space
permits, unless to do so would infringe upon rights of other
patients, and to be provided security in storing possessions.
''(14) Privacy for married patients.--A married patient's
right to be assured privacy in visits by the patient's spouse
and, if spouses are both patients in the facility, the right of
the patients to share the same room if they so desire.
''(c) The patient's rights and responsibilities specified in
paragraphs (1) through (4) of subsection (b), as they pertain to a
patient adjudicated incompetent in accordance with State law, devolve
to the patient's guardian, next of kin, sponsoring agency (or
agencies), or relative or other person serving as representative payee
under section 205(j) of this Act (except when the facility itself is
representative payee).

''enforcement of patient's rights

''Sec. 1883. (a) The Secretary shall establish, by regulation, a
schedule of the maximum amount of civil penalties which may be imposed
under this section for the violation of each of the patient's rights
set forth in section 1882(b). No such penalty shall exceed $500 for a
single violation, except that the civil penalty for a violation of a
patient's right, under paragraph (5) of such section, to file a
complaint under this section free from restraint, interference,
coercion, discrimination, or reprisal shall not exceed $1,000. The
Secretary shall define in those regulations what constitutes a separate
violation for purposes of this section.
''(b)(1) Any patient, or any person on behalf of such a patient,
who claims to have had a right under section 1882(b) violated by the
facility may submit a complaint, written or oral, with the appropriate
enforcing agency (as defined in subsection (f)). No such complaint with
respect to a violation shall be considered by an enforcing agency under
this section unless it is filed with the agency within 180 days after
the date the alleged violation occurred.
''(2) Upon receiving a complaint concerning a facility under
paragraph (1), an enforcing agency shall promptly notify the facility
of the complaint (including the date, place, and circumstances of the
alleged violation), shall investigate the complaint (keeping
confidential insofar as possible the identity of the complainant and
the name of the patient or patients involved if the complainant is not
such a patient), and shall provide the complainant with a written
report thereon within 30 days of the date the complaint was filed. A
copy of the report of the agency, including the complaint (with
identities of the complainant and any patients deleted), shall be made
part of the permanent files of the agency and made available to the
public.
''(c)(1)(A) If, as a result of an investigation conducted under
subsection (b)(2), the enforcing agency determines that a facility has
not violated any patients' rights under section 1882(b), the enforcing
agency shall notify the facility and the complainant of such
determination.
''(B) If, as a result of such an investigation, the enforcing
agency determines that a facility has violated one or more patients'
rights under section 1882(b), the enforcing agency shall endeavor to
provide appropriate adjustment with respect to any such alleged
violation (and to prevent future similar violations) by informal
methods of conference, conciliation, and persuasion. Nothing said or
done during and as part of such informal endeavors may be made public
by the enforcing agency or used as evidence in a subsequent proceeding
without the written consent of the persons concerned. If after such
endeavors (but in a period no longer than 30 days), the enforcing
agency is not able to secure from the facility a conciliation agreement
or other understanding acceptable to the agency and the complainant,
the agency shall assess against the facility a civil penalty
(determined in accordance with the schedule developed under subsection
(a)) by an order made--
''(i) after written notice (including notice of the
enforcing agency's proposed order and the facility's
opportunity to request, within 15 days after the date the
notice is received, a hearing on the proposed order), and
''(ii) after opportunity for a hearing in accordance with
procedures to be specified by the Secretary in regulations.
''(2) Such an order shall provide that the penalty shall be paid
(in accordance with subsection (d)(2)) to the enforcing agency and the
agency shall promptly make payment to patients (or heirs of patients,
in the case of deceased patients) in accordance with the penalties
assessed for violation of their rights. Notwithstanding any other
provision of law, civil penalties paid to any individual in accordance
with this paragraph shall not constitute income or resources or
otherwise be taken into account (A) for purposes of determining the
eligibility of the individual, or the family or household of the
individual, for assistance under a State plan approved under title XIX,
or for aid, assistance, or benefits in any form under any Federal
program, or any State or local program financed in whole or in part
with Federal funds, which conditions such eligibility to any extent
upon the income or resources of the individual, family, or household,
or (B) for purposes of determining the amount or extent of such aid,
assistance, or benefits.
''(3) An enforcing agency may suspend imposition of an order of
assessment against a facility if the facility can provide assurances,
satisfactory to the agency, that the facility has taken such actions as
will prevent the reoccurrence of the violation (and similar violations)
from which the order results. To the extent that the enforcing agency
determines, based on a later complaint or investigation, that such
actions have not been taken in accordance with such assurances, the
agency shall reimpose such an order.
''(d)(1)(A) Not later than 60 days after the final action of an
enforcing agency with respect to a complaint or suspension of an order
of assessment under this section, any person adversely affected or
aggrieved by the action is entitled to judicial review thereof in the
appropriate United States district court or State court of competent
jurisdiction. The provisions of sections 701(b)(2), and 702 through 706
of title 5, United States Code, shall apply to such reviews.
''(B) Where a patient or facility brings an action for review of a
determination by an enforcing agency which is not in the patient's or
facility's favor, respectively, and the action is determined to
constitute harassment of the facility or patient, respectively, the
patient or facility shall be liable to the enforcing agency for all the
agency's legal fees and costs (including reasonable attorney's fees) in
connection with the action.
''(2)(A) If an enforcing agency has issued a final order of an
assessment of a penalty against a facility and--
''(i) the order has not been suspended under subsection
(c)(3), the facility shall pay the amount of the penalty to the
enforcing agency within 60 days after the date the order
becomes final, or
''(ii) the order has been suspended but has been reimposed,
the facility shall pay the amount of the penalty to the
enforcing agency within 60 days after the date the order was
reimposed.
''(B)(i) The agency will hold any such amounts paid to it in escrow
and, except as provided in clause (ii), shall make payment of it, in
accordance with subsection (b)(2), at the end of the applicable 60-day
period described in subparagraph (A).
''(ii) If judicial review of such an order of an enforcing agency
has been sought, the agency shall make payment of any penalty collected
at the conclusion of the review and in accordance with the order of the
court.
''(3) If a facility fails to make timely payment of a civil penalty
according to paragraph (2), the enforcing agency shall recover the
amount assessed (plus interest at currently prevailing rates from the
last date of such 60-day period) in an action brought in any
appropriate district court of the United States or State court of
competent jurisdiction and shall hold or transfer it in the manner
provided in that paragraph.
''(e) The imposition of a civil penalty under this section shall
not preclude, and shall be in addition to, any other monetary damages
recoverable by, or other relief available to, patients or enforcing
agencies as a result of violation of patients' rights.
''(f) For purposes of this section, the term 'enforcing agency'
means, with respect to an alleged violation occurring in a State in
which the Secretary--
''(1) has entered into an agreement under section
1864(d)(1), the appropriate State or local agency or agencies
specified in that agreement, or
''(2) has not entered into such an agreement, such office
within the Department of Health, Education, and Welfare as the
Secretary shall designate by regulation.''.
(c) Section 1864 of such Act is amended by adding at the end the
following new subsection:
''(d)(1) The Secretary shall make an agreement with any State which
is able and willing to do so and has an agreement under subsection (a)
under which the agency (or agencies) under subsection (a) will serve as
an appropriate agency for the purpose of enforcing patients' rights
under section 1883. The Secretary shall pay for the services of such an
agency in the manner prescribed in subsection (b).
''(2) Any agreement under this section with a State with regard to
determining whether a facility meets the standards relating to
patients' rights and described in section 1882 shall include a
provision that each routine certification survey of such a facility
shall include a private meeting between patients and survey personnel
to discuss patients' experiences within the facility as regards such
rights and compliance with such standards generally.''.
(d) Section 1865(a) of such Act is amended by inserting after the
second sentence the following new sentence: ''No institution shall be
so deemed to meet standards relating to patients' rights and described
in section 1882 unless the accreditation survey of the institution
includes a private meeting between patients and survey personnel to
discuss patients' experiences within the institution as regards such
rights and compliance with such standards generally.''.
Sec. 2. The Secretary of Health, Education, and Welfare shall first
publish proposed regulations for carrying out the amendments made by
this Act not later than six months after the date of the enactment of
this Act and such regulations shall first become final and fully
effective on the first day of the ninth month which begins after the
date of the enactment of this Act.
A:
Amends title XVIII (Medicare) of the Social Security Act to require the governing boards of hospitals and skilled nursing facilities having an average duration of patient stay of more than 30 days to establish written policies guaranteeing specified rights of patients, including: (1) information on services and charges; (2) information on and participation in medical treatment; (3) conditions of transfer or discharge; (4) grievances; (5) management of personal financial affairs; (6) freedom from abuse and restraints; (7) confidentiality of records; and (8) freedom of association.
Directs the Secretary of Health and Human Services to establish civil penalties for the violation of such rights.
Sets forth provisions concerning the processing and investigation of complaints arising from such violations.