,,ii #aafth ,,congress #b;d ,session ,s4 #cgfh ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ai1 #bjbj ,mr4 ,casey 7for himself1 ,mr4 ,whitehouse1 ,mr4 ,schumer1 ,mr4 ,jones1 ,ms4 ,warren1 ,ms4 ,baldwin1 ,mr4 ,markey1 ,mrs4 ,shaheen1 ,mr4 ,menendez1 ,mr4 ,reed1 ,mr4 ,van ,hollen1 ,mr4 ,blumenthal1 ,ms4 ,hirono1 ,ms4 ,cortez ,masto1 ,ms4 ,rosen1 and ,mr4 ,peters7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to protect older adults and people with disabilities living in nursing homes1 intermediate care facilities1 and psychiatric hospitals from ,,covid-#ai4 #a4 ,short title ,this ,act may be cited as the ,nursing ,home ,,covid-#ai ,protection and ,prevention ,act of #bjbj4 #b4 ,,covid-#ai nursing home protections 7a7 ,program ,to support ,,covid-#ai response 7#a7 ,in general ,not later than #cj days after the date of enactment of this ,act1 the ,secretary shall carry out a program under which payments are made to ,states and ,indian ,tribes in order to support cohorting individuals in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals based on ,,covid-#ai status4 7#b7 ,application ,to be eligible to receive a payment under this subsection1 a ,state or ,indian ,tribe shall submit to the ,secretary an application4 ,such application shall include evidence that the ,state or ,indian ,tribe 7and involved skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals7 are able to cohort individuals in compliance with guidance issued by the ,secretary during the emergency period4 ,if feasible1 the ,secretary shall provide for an expedited application process4 7#c7 ,requirements ,to be eligible to receive a payment under this subsection1 a ,state or ,indian ,tribe shall comply with the following3 7,a7 ,following guidance ,the ,state or ,indian ,tribe shall follow the guidance established by the ,secretary under paragraph 7#e7 and all other guidance issued by the ,secretary during the emergency period4 7,b7 ,reporting ,the ,state or ,indian ,tribe shall1 as determined appropriate by the ,secretary1 periodically report to the ,secretary on the following3 7i7 ,the convening and recommendations of the task force under subparagraph 7,c71 cohorting strategies being used1 the use of surge teams1 and the technical assistance and resources provided under subparagraph 7,d74 7ii7 ,the ,state or ,indian ,tribe's distribution of the payments received under the program under this subsection and what facilities are using such payments for 7as permitted under paragraph 7#d77;,b774 7iii7 ,other items determined appropriate by the ,secretary4 7,c7 ,task force 7i7 ,in general ,the ,state or ,indian ,tribe shall establish a task force to provide advice on the ,state's or ,tribe's use and distribution of payments received under the program under this section1 including on cohorting strategies1 the use of surge teams1 resident rights 7particularly involving discharges and transfers71 and other topics as determined appropriate by the ,secretary4 7ii7 ,membership ,a task force established under clause 7i7 shall include representation from the following3 7,i7 ,consumers1 including older adults age #fe and older1 individuals with disabilities1 family caregivers1 and their advocates4 7,,ii7 ,skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7,,iii7 ,health care providers and other congregate settings 7including hospitals and permanent or transitional housing facilities7 that transfer residents to and from skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7,,iv7 ,health professionals1 such as direct care professionals1 physicians1 nurses1 and pharmacists4 7,v7 ,experts in public health and infectious diseases4 7,,vi7 ,experts in geriatrics and long-term care medicine4 7,,vii7 ,the ,state ,long-,term ,care ,ombudsman program 7as described in section #gab7;a77#a7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;g7a77#a7774 7,,viii7 ,the protection and advocacy system 7as established under subtitle ,c of title ,i of the ,developmental ,disabilities ,assistance and ,bill of ,rights ,act 7#db ,u4,s4,c4 #aejda et seq474 7,,ix7 ,state agencies1 including the ,state surveying agency and the agency that administers the ,state plan under the ,medicaid program under title ,,xix of the ,social ,security ,act4 7,x7 ,other representatives as the ,secretary determines appropriate4 7,d7 ,protocol to evaluate ,the ,state or ,indian ,tribe shall establish an expedited protocol to evaluate a facility's ability 7including a facility retrofitted under paragraph 7#d77;,b77i77 to cohort individuals who test positive for ,,covid-#ai1 individuals who test negative for ,,covid-#ai1 or individuals with unknown status or who are under observation4 ,such protocol shall include an infection control self-assessment and an abbreviated survey and may include a standard survey4 7,e7 ,technical assistance and resources 7i7 ,in general ,the ,state or ,indian ,tribe shall ensure that skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals receive technical assistance and the necessary resources to-- 7,i7 implement proper infection control protocols and practices2 7,,ii7 minimize unnecessary transfers2 7,,iii7 ensure adequate staffing1 including the use of surge teams2 7,,iv7 effectively use and provide access to testing and personal protective equipment1 including guidance on how to effectively use personal protective equipment when access is limited2 7,v7 safely transition residents to home and community-based settings2 and 7,,vi7 other topics1 as determined appropriate by the ,secretary4 7ii7 ,requirement for technical assistance ,the technical assistance required under clause 7i7 shall be provided by-- 7,i7 quality improvement organizations under part ,b of title ,,xi of the ,social ,security ,act2 or 7,,ii7 other independent organizations of a similar type that do not have conflicts of interest and are deemed appropriate by the ,secretary4 7#d7 ,use of funds 7,a7 ,in general ,a ,state or ,indian ,tribe that receives a payment under the program under this subsection shall use funds to support skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals that cohort1 and provide services to1 individuals who test positive for ,,covid-#ai1 individuals who test negative for ,,covid-#ai1 and individuals with unknown status or who are under observation4 ,such cohorting shall be in compliance with all guidance issued by the ,secretary during the emergency period4 7,b7 ,permissible uses and authorized costs ,states and ,indian ,tribes shall use the payments received under the program under this subsection for the following purposes3 7i7 ,to retrofit non-traditional facility-based settings1 such as hotels1 dormitories1 schools1 churches1 and other temporary or permanent shelters1 for temporary use as skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7ii7 ,to support skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals with the establishment of specialized units within such facilities4 7iii7 ,to provide testing kits or other supplies needed for rapid turnaround to test staff members and residents of skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals for ,,covid-#ai4 7iv7 ,to provide personal protective equipment to staff members of skilled nursing facilities1 nursing facilities1 intermediate care facilities1 psychiatric hospitals and1 where appropriate1 to residents of such facilities4 7v7 ,to safely facilitate necessary transfers to and from skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7vi7 ,to safely facilitate voluntary discharges to home and community-based settings from skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7vii7 ,to provide additional staffing 7including the use of surge teams7 associated with the ,,covid-#ai pandemic for skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals1 which may include providing premium or hazard pay1 overtime pay1 enhanced payment rates1 paid sick and family medical leave1 childcare1 temporary housing1 transportation1 and other supportive services for staff members4 7viii7 ,to provide support for individuals who have no other mechanism to pay for their care at skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals and are unable to pay4 7ix7 ,other purposes relating to the cohorting described in subparagraph 7,a74 7#e7 ,additional guidance ,for purposes of the program under this subsection1 not later than #cj days after the date of enactment of this ,act 7and prior to making any payments to ,states or ,indian ,tribes under the program7 the ,secretary shall establish guidance on the following3 7,a7 ,which skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals are permitted to cohort individuals who test positive for ,,covid-#ai1 individuals who test negative for ,,covid-#ai1 and individuals with unknown status or who are under observation4 ,such guidance shall account for-- 7i7 the facility's history of compliance with the requirements of participation under titles ,,xviii and ,,xix of the ,social ,security ,act1 including requirements relating to infection control and emergency preparedness2 7ii7 the facility's current or past affiliation 7as either a candidate or participant7 with the special focus facility program under section #ahai7;f77#h7 of such ,act 7#db ,u4,s4,c4 #acie;i-#c7;f77#h77 and section #aiai7;f77#aj7 of such ,act 7#db ,u4,s4,c4 #acifr7f77#aj772 and 7iii7 the facility's ability to treat high-severity residents1 as applicable4 7,b7 ,consumer protections for residents of skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals affected by ,,covid-#ai cohorting policies1 including by-- 7i7 prohibiting facilities from discharging residents for failure to pay for services2 and 7ii7 requiring written notification to be provided to residents and their family and legal representatives at least #gb hours prior to discharge or transfers1 with such notice containing-- 7,i7 information on the rights of the resident2 7,,ii7 contact information for the ,state ,long-,term ,care ,ombudsman program 7as described in section #gab7;a77#a7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;g7a77#a7772 and 7,,iii7 contact information for the protection and advocacy system 7as established under subtitle ,c of title ,i of the ,developmental ,disabilities ,assistance and ,bill of ,rights ,act 7#db ,u4,s4,c4 #aejda et seq474 7,c7 ,strategies to effectively cohort residents of skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals based on ,,covid-#ai status1 including-- 7i7 the temporary utilization of non-traditional facility-based settings1 such as hotels1 dormitories1 schools1 churches1 and other temporary or permanent shelters1 as skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals2 7ii7 how to safely and effectively move1 shelter in place1 and cohort within facilities2 7iii7 how to establish separate facilities for individuals who test positive for ,,covid-#ai2 7iv7 how to establish separate facilities for individuals who test negative for ,,covid-#ai2 7v7 proper procedures for conducting ,,covid-#ai testing1 sending tests to be analyzed1 and effective use of ,,covid-#ai testing2 7vi7 adequate staffing1 with contingency plans during shortages1 including the use of-- 7,i7 separate staffing according to ,,covid-#ai status2 and 7,,ii7 surge teams2 7vii7 effective use of personal protective equipment1 including in cases where access to an adequate supply of personal protective equipment is limited2 7viii7 how to minimize resident transfers to and from the facilities2 7ix7 how to safely effectuate resident transfers to home and community-based settings from the facilities2 and 7x7 how to uphold resident rights in accordance with titles ,,xviii and ,,xix of the ,social ,security ,act4 7#f7 ,report ,not later than #b years after the date of the enactment of this section1 the ,secretary shall submit to the appropriate ,committees of ,congress a report on the program under this section1 together with recommendations for such legislation and administrative action as the ,secretary determines appropriate4 7#g7 ,funding ,out of any monies in the ,treasury of the ,united ,states not otherwise appropriated1 there are appropriated to the ,secretary #bj1jjj1jjj1jjj for fiscal year #bjbj for making payments to ,states and ,indian ,tribes under this subsection4 ,amounts appropriated under the preceding sentence shall remain available until expended4 7b7 ,,covid-#ai data collection and disclosure 7#a7 ,data collection and publication by the ,secretary 7,a7 ,in general ,beginning after the date of enactment of this ,act and continuing through the end of the emergency period1 or through a later date determined appropriate by the ,secretary1 the ,secretary shall make publicly available on the ,nursing ,home ,compare websites described in sections #ahai7;i7 and #aiai7;i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#c7;i72 #db ,u4,s4,c4 #acifr7i77 and on the internet website of the ,centers for ,medicare ,medicaid ,services information1 within each ,state1 ,indian ,tribe1 and each skilled nursing facility1 nursing facility1 intermediate care facility1 and psychiatric hospitals1 on the following3 7i7 ,the number of suspected and confirmed ,,covid-#ai cases among residents in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7ii7 ,the number of suspected and confirmed ,,covid-#ai cases among staff persons in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7iii7 ,the number of total deaths and ,,covid-#ai deaths 7among both residents and staff persons1 including by age1 gender1 race1 and ethnicity7 in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7iv7 ,personal protective equipment and hand hygiene supplies in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7v7 ,ventilator capacity and supplies available in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7vi7 ,resident beds and census in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7vii7 ,access to testing in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7viii7 ,staffing shortages in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7ix7 ,other items determined appropriate by the ,secretary4 7,b7 ,update ,the data described in subparagraph 7,a7 shall be updated not less frequently than on a daily basis4 7,c7 ,data sharing and transfer ,the ,secretary shall share the data described in subparagraph 7,a7 with-- 7i7 the ,department of ,veterans ,affairs2 7ii7 the ,federal ,emergency ,management ,agency2 7iii7 ,states2 7iv7 ,indian ,tribes2 and 7v7 other entities determined appropriate by the ,secretary4 7,d7 ,privacy ,the ,secretary shall take all necessary steps to protect the privacy of individual residents and staff persons associated with the affected skilled nursing facility1 nursing facility1 intermediate care facility1 or psychiatric hospital4 7#b7 ,disclosure by facilities 7,a7 ,in general ,beginning after the date of enactment of this ,act and continuing through the end of the emergency period1 or through a later date determined appropriate by the ,secretary1 the ,secretary shall ensure that skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals provide notification when a case of ,,covid-#ai is confirmed among a resident or staff person or when #c or more residents or staff exhibit the new-onset of respiratory symptoms occurring within #gb hours of each other to the following3 7i7 ,residents of such facility and residents' family or legal representative4 7ii7 ,state ,long-,term ,care ,ombudsman programs 7as described in section #gab7;a77#a7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;g7a77#a7774 7iii7 ,the protection and advocacy system 7as established under subtitle ,c of title ,i of the ,developmental ,disabilities ,assistance and ,bill of ,rights ,act 7#db ,u4,s4,c4 #aejda et seq474 7,b7 ,timing ,the notification required under subparagraph 7,a7 shall be provided-- 7i7 within #ab hours of the confirmation of a ,,covid-#ai case or the confirmation of #c or more residents or staff persons exhibiting new-onset respiratory symptoms with #gb hours of each other2 and 7ii7 in the most expedient manner available1 to be followed-up with written notification to residents of the facility and residents' family or legal representative4 7#c7 ,,hhs study and report on ,,covid-#ai outbreaks 7,a7 ,study 7i7 ,in general ,the ,secretary shall conduct a study on ,,covid-#ai outbreaks in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 ,such study shall include an analysis of-- 7,i7 the characteristics of skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals that experienced ,,covid-#ai outbreaks2 7,,ii7 the size of the outbreaks2 7,,iii7 the number of deaths of residents and staff persons from ,,covid-#ai2 and 7,,iv7 the total number of deaths of residents4 7ii7 ,characteristics ,the characteristics described in clause 7i7 shall include-- 7,i7 the facility's history of compliance with the requirements of participation under titles ,,xviii and ,,xix of the ,social ,security ,act1 including requirements relating to infection control and emergency preparedness2 7,,ii7 the facility's current or past affiliation 7as either a candidate or participant7 with the special focus facility program under section #ahai7;f77#h7 of such ,act 7#db ,u4,s4,c4 #acie;i-#c7;f77#h77 and section #aiai7;f77#aj7 of such ,act 7#db ,u4,s4,c4 #acifr7f77#aj772 7,,iii7 the facility's resident size1 including the number of occupied beds2 7,,iv7 the facility's geographic location2 and 7,v7 the facility's for-profit or non-profit status4 7,b7 ,report ,not later than #f months after the end of the emergency period1 and every #f months thereafter through the end of the #b-year period that begins at the end of the emergency period1 the ,secretary shall submit to the appropriate ,committees of ,congress a report containing the results of the study conducted under paragraph 7#a71 together with recommendations for such legislation and administrative action as the ,secretary determines appropriate4 7c7 ,monthly briefings on the ,,covid-#ai response 7#a7 ,monthly briefings ,not later than #ae days after the date of enactment of this ,act1 and at least once every #cj days thereafter through the end of the emergency period1 the ,secretary shall brief the appropriate ,committees of ,congress 7including all members of such ,committees7 on the ,,covid-#ai outbreak in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals and the response by the ,secretary to such outbreak4 7#b7 ,report ,not later than #a year after the date of enactment of this ,act1 the ,inspector ,general of the ,department of ,health and ,human ,services shall submit to ,congress a report that evaluates the response of the ,secretary to the ,,covid-#ai outbreak in skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals such as guidance1 rules1 or waivers established by the ,secretary4 7d7 ,rule of construction ,nothing in this section shall be construed to affect the requirements or conditions of participation under titles ,,xviii and ,,xix of the ,social ,security ,act with respect to skilled nursing facilities1 nursing facilities1 intermediate care facilities1 and psychiatric hospitals4 7e7 ,definitions ,in this section3 7#a7 ,appropriate ,committees of ,congress ,the term appropriate ,committee of ,congress means-- 7,a7 the ,committee on ,finance of the ,senate2 7,b7 the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate2 7,c7 the ,special ,committee on ,aging of the ,senate2 7,d7 the ,committee on ,ways and ,means of the ,house of ,representatives2 and 7,e7 the ,committee on ,energy and ,commerce of the ,house of ,representatives4 7#b7 ,emergency period ,the term ,emergency period means the emergency period described in section #aace7;g77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;b-#e7;g77#a77;,b774 7#c7 ,indian ,tribe ,the term ,indian ,tribe has the meaning given that term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#d7 ,intermediate care facility ,the term intermediate care facility means an intermediate care facility described in section #aije7;d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7d774 7#e7 ,nursing facility ,the term nursing facility has the meaning given that term in section #aiai7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr7a774 7#f7 ,psychiatric hospital ,the term psychiatric hospital has the meaning given that term in section #ahfa7;f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7f774 7#g7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#h7 ,skilled nursing facility ,the term skilled nursing facility has the meaning given that term in section #ahai7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#c7;a774 7#i7 ,state ,the term ,state means the #ej ,states1 the ,district of ,columbia1 the ,commonwealth of ,puerto ,rico1 the ,united ,states ,virgin ,islands1 ,guam1 the ,commonwealth of the ,northern ,mariana ,islands1 and ,american ,samoa4 7#aj7 ,surge team ,the term surge team means a short-term staffing team4