#aad? ,,congress  #b;d ,session  ,h4 ,r4
 #cbcd  ,,an ,,act  ,to am5d title #ch1 
,unit$ ,/ates ,code1 to direct !        
,secret>y ( ,vet]ans ,affairs to        
evaluate ! ability ( ea* m$ical c5t] ( !
 ,dep>tm5t to provide quality heal? c>e 
to vet]ans1 to ensure t ! ,secret>y     
improves su* m$ical c5t]s t are         
und]p]=m+1 & = o!r purposes4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,,va    
,m$ical ,c5t] ,recov]y ,act4  #b4       
,evaluation & improvem5t ( m$ical c5t]s 
7a7 und]p]=m+ m$ical c5t]s  7#a7 ,9     
g5]al ,*apt] #gc ( title #ch1 ,unit$    
,/ates ,code1 is am5d$ by ins]t+ aft]   
section #gcaa;,a ! foll[+ new section3  
#gcaa;,b4 ,evaluation & improvem5t (    
m$ical c5t]s  7a7 ,id5tification (      
und]p]=m+ m$ical c5t]s  7#a7 ,n lat] ?an
 #ae days aft] ! end ( ea* fiscal qu>t]1
 ! ,secret>y %all publi% 9 ! ,f$]al     
,regi/] & on a publically available1    
se>*able ,int]net website ( ! ,dep>tm5t 
a compilation ( key heal? metrics = ea* 
m$ical c5t] ( ! ,dep>tm5t4  7#b7 ,on a  

semiannual basis1 ! ,secret>y %all      
det]m9e1 "u ! key heal? metrics1 :e!r   
ea* m$ical c5t] ( ! ,dep>tm5t is        
satisfactory or und]p]=m+4  7b7 ,rapid  
deploym5t teams  7#a7 ,n lat] ?an #cj   
days aft] ! date on :i* ! ,secret>y     
id5tifies a m$ical c5t] z an und]p]=m+  
m$ical c5t] "u subsection 7a77#b71 !    
,secret>y %all deploy a rapid deploym5t 
team to ! m$ical c5t] to ensure t !     
m$ical c5t] a*ieves satisfactory        
p]=mance z quickly z practicable4  7#b7 
,ea* rapid deploym5t team deploy$ to an 
und]p]=m+ m$ical c5t] "u p>agraph 7#a7  
%all--  7,a7 id5tify ! areas ( ! m$ical 
c5t] t require improvem5t1 includ+ )    
respect to ! proc$ures ( ! m$ical c5t]1 
ineffici5cies ( ! m$ical c5t]1 & :e!r ! 
m$ical c5t] foll[s directives & be/     
practices2  7,b7 e/abli% a rem$iation   
plan to improve ! p]=mance ( ! m$ical   
c5t]2  7,c7 review & assesses ! /atus ( 
any-- 7i7 discipl9>y actions tak5 at !  
m$ical c5t]2  7ii7 recomm5dations made  
by ! ,inspector ,g5]al ( ! ,dep>tm5t    

applicable to ! m$ical c5t]2 &  7iii7   
f9d+s made by ! ,comptroll] ,g5]al ( !  
,unit$ ,/ates applicable to ! m$ical    
c5t]2 &  7,d7 provide tra9+ to !        
director & /aff ( ! m$ical c5t] )       
respect to c>ry+ out su* improvem5ts4   
7#c7 ,! ,secret>y %all ensure t--  7,a7 
! director ( ea* und]p]=m+ m$ical c5t]  
c>ries out ! rem$iation plan "u p>agraph
 7#b77;,b72 &  7,b7 ! rapid deploym5t   
team has access to all facilities & all 
electronic sy/ems1 records1 reports1    
audits1 reviews1 docum5ts1 pap]s1 or o!r
 mat]ials ! rapid deploym5t team        
det]m9es necess>y to c>ry out ?is       
subsection4  7#d7 ,ea* rapid deploym5t  
team deploy$ to an und]p]=m+ m$ical c5t]
 "u p>agraph 7#a7 %all consi/ (-- 7,a7  
subject matt] exp]ts ) exp]i5ce 9--  7i7
 cu/om] s]vice tra9+2  7ii7 increas+ !  
effici5cy ( organizations2  7iii7       
cl9ical c>e specific to ! areas 9 :i* ! 
und]p]=m+ m$ical c5t] requires          
improvem5t2 &  7iv7 any o!r areas t !   
,secret>y det]m9es appropriate to       

improve ! und]p]=m+ m$ical c5t]2 &  7,b7
 an employee ( ! ,(fice ( ! ,inspector  
,g5]al ( ! ,dep>tm5t4  7#e7 ,to ! ext5t 
practicable1 ea* rapid deploym5t team   
%all include process improvem5t subject 
matt] exp]ts f ! ,vet]ans ,exp]i5ce     
,(fice ( ! ,dep>tm5t4  7#f7 ,! ,secret>y
 %all det]m9e ! duration ( ! deploym5t (
 a rapid deploym5t team "u p>agraph     
7#a74  7c7 ,inve/igations & :i/lebl[]   
protections  7#a7 ,! ,inspector ,g5]al (
 ! ,dep>tm5t %all prioritize            
inve/igations relat+ to und]p]=m+ m$ical
 c5t]s4  7#b7 ,! ,(fice ( ,acc\ntability
 ,review %all prioritize inve/igations (
 :i/lebl[] retaliation relat+ to        
und]p]=m+ m$ical c5t]s4  7d7 ,qu>t]ly   
reports ,on a qu>t]ly basis1 ! ,secret>y
 %all submit to ,congress a report t    
includes1 ) respect to ! qu>t] cov]$ by 
! report--  7#a7 ea* id5tification ( an 
und]p]=m+ m$ical c5t] made by !         
,secret>y2  7#b7 ! actions tak5 by !    
,secret>y & rapid deploym5t teams )     
respect to improv+ und]p]=m+ m$ical     

c5t]s2 &  7#c7 an update on any progress
 made by ea* und]p]=m+ m$ical c5t]1     
includ+ :e!r ! und]p]=m+ m$ical c5t] is 
c>ry+ out ! rem$iation plan pursuant to 
subsection 7b77#c77;,a74  7e7           
,relation%ip to quality assurance &     
,national ,quality ,managem5t ,(fic] ,! 
requirem5ts ( ?is section are 9 addition
 to any requirem5ts "u sections #gcaa & 
#gcaa;,a ( ?is title4  7f7 ,def9itions  
,9 ?is section3 7#a7 ,! t]m und]p]=m+   
m$ical c5t] means a m$ical c5t] ( !     
,dep>tm5t t ! ,secret>y det]m9es is     
und]p]=m+ "u subsection 7a77#b74  7#b7  
,! t]m key heal? metrics means ! foll[+3
 7,a7 ,! ,/rategic ,analytics           
,improvem5t & ,le>n+ 7commonly ref]r$ to
 z ,,sail7 data us$ by ! ,dep>tm5t 7or  
su* successor data metric74  7,b7 ,an   
evaluation sy/em e/abli%$ by ! ,secret>y
 bas$ on ! total data describ$ 9        
subp>agraph 7,a7 to det]m9e :e!r !      
p]=mance ( a m$ical c5t] is satisfactory
 or und]p]=m+ & requires rem$iation     
pursuant to ?is section4  4  7#b7       

,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( *apt] #gc ( su* title is     
am5d$ by add+ aft] ! item relat+ to     
section #gcaa;,a ! foll[+ new item3     
#gcaa;,b4 ,evaluation & improvem5t (    
m$ical c5t]s  4  7b7 ,initial key heal? 
metrics publication ,! ,secret>y %all   
publi% ! initial key heal? metrics "u   
section #gcaa;,b7a77#a7 ( title #ch1    
,unit$ ,/ates ,code1 z add$ by          
subsection 7a77#a71 by n lat] ?an #ij   
days aft] ! date ( ! enactm5t ( ?is     
,act4  7c7 ,initial id5tification ( an  
und]p]=m+ m$ical c5t] ,! ,secret>y %all 
make ! initial id5tifications "u section
 #gcaa;,b7a77#b7 ( title #ch1 ,unit$    
,/ates ,code1 z add$ by subsection      
7a77#a71 by n lat] ?an #ahj days aft] ! 
date ( ! enactm5t ( ?is ,act4  #c4      
,/&>diz$ tra9+ = nurses  7a7 ,tra9+ ,!  
,secret>y ( ,vet]ans ,affairs %all seek 
to ent] into p>tn]%ips ) recogniz$      
s*ools ( nurs+ to provide und]graduate  
nurs+ /ud5ts enroll$ 9 su* s*ools )     
/&>diz$ tra9+ ) respect to ! foll[+3    

7#a7 ,! culture ( ! milit>y & vet]ans4  
7#b7 ,po/-traumatic /ress disord]4  7#c7
 ,traumatic bra9 injury4  7#d7          
,amputation & assi/ive devices4  7#e7   
,environm5tal1 *emical1 & toxic         
exposure4  7#f7 ,sub/ance use disord]s4 
7#g7 ,milit>y sexual trauma4  7#h7      
,suicide4  7#i7 ,homelessness4  7#aj7   
,s]i\s illness at ! end ( life4  7#aa7  
,b5efits1 s]vices1 & res\rces = vet]ans 
t are adm9i/]$ by ! ,f$]al ,gov]nm5t4   
7b7 ,developm5t ,9 develop+ ! tra9+ "u  
subsection 7a71 ! ,secret>y %all consult
 ) appropriate accr$it+ bodies1 s*ools (
 nurs+1 & indu/ry lead]s4  ,pass$ !     
,h\se ( ,repres5tatives ,febru>y #i1    
#bjaf4;,cl]k4