SKILLED NURSING FACILITIES.

SEC. 106. SKILLED NURSING FACILITIES. (a) Construction of Wage Index.— Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall begin to collect data on employee compensation and paid hours of employment in skilled nursing facilities for the purpose of constructing a skilled nursing facility wage index adjustment to the routine service cost limits required under section 1888(a)(4) of the Social Security Act. (b) Clarification of Repeal of Utilization Review Requirements.— (1) In general.— (A) Section 1814(a)(5) (42 U.S.C. 1395f(a)(5)) is amended— (i) by striking “and with respect” and all that follows through “regulations”; (ii) by striking “or skilled nursing facility, as the case may be”; and 108 STAT. 4406 (iii) by striking “or facility”. (B) Section 1866(a) (42 U.S.C. 1395cc(d)) is amended— (i) by striking “or skilled nursing facility”; (ii) by striking “or facility” each place it appears; (iii) by striking “or for post-hospital” and all that follows through “the case may be”; and (iv) by striking “, or (in the case of47” and all that follows through “transfer agreement,”. (2) Effective date.— The amendments made by paragraph (1) shall take effect as if included in the enactment of OBRA-1987. (c) Conforming Amendments to Nursing Home Reform.— (1) Suspension of decertification of nurses aide training and competency evaluation programs based on extended surveys.— (A) In general.— Section 1819(f)(2)(B)(iii)(I)(b) (42 U.S.C. 1395i–3(f)(2)(B)(iii)(I)(b)) is amended by striking the semicolon and inserting the following: “, unless the survey shows that the facility is in compliance with the requirements of subsections (b), (c), and (a) of this section;”. (B) Effective date.— The amendment made by subparagraph (A) shall take effect as if included in the enactment of OBRA-1990. (2) Requirements for consultants conducting reviews on use of drugs.— (A) In general.— Section 1819(c)(1)(D) (42 U.S.C. 1395i–3(c)(1)(D)) is amended by adding at the end the following sentence: “In determining whether such a consultant is qualified to conduct reviews under the preceding sentence, the Secretary shall take into account the needs of nursing facilities under this title to have access to the services of such a consultant on a timely basis.”. (B) Effective date.— The amendment made by subparagraph (A) shall take effect as if included in the enactment of OBRA-1987. (3) Increase in minimum amount required for separate deposit of personal funds.— (A) In general.— Section 1819(c)(6)(B)(i) (42 U.S.C. 1395i–3(c)(6)(B)(i)) is amended by striking “$50” and inserting “$100”. (B) Effective date.— The amendment made by subparagraph (A) shall take effect January 1, 1995. (4) Due process protections for nurses aides.— (A) Prohibiting state from including undocumented allegations in nurses aide registry.— Section 1819(e)(2)(B) (42 U.S.C. 1395i–3(e)(2)(B)) is amended by striking the period at the end of the first sentence and inserting the following: “, but shall not include any allegations of resident abuse or neglect or misappropriation of resident property that are not specifically documented by the State under such subsection.”. (B) Due process requirements for rebutting allegations.— Section 1819(g)(1)(C) (42 U.S.C. 1395i–3(g)(1)(C)) is amended by striking the second sentence and inserting the following: “The State shall, after providing the individual involved with a written notice of the allegations (including a statement of the availability of a hearing108 STAT. 4407 for the individual to rebut the allegations) and the opportunity for a hearing on the record, make a written finding as to the accuracy of the allegations.”. (C) Effective date.— The amendments made by this paragraph shall take effect January 1, 1995. (d) Corrections Relating to Section 4008.— (1) Section 1819(b)(5)(D) (42 U.S.C. 1395i–3(b)(5)(D)), as amended by section 4008(h)(1)(D) of OBRA-1990, is amended by striking the comma before “or a new competency evaluation program.”. (2) Section 1819(b)(5)(G) (42 U.S.C. 1395i–3(b)(5)(G)) is amended by striking “or licensed or certified social worker” and inserting “licensed or certified social worker, registered respiratory therapist, or certified respiratory therapy technician”. (3) Section 1819(f)(2)(B)(i) (42 U.S.C. 1395i—3(f)(2)(B)(i)) is amended by striking “facilities,” and inserting “facilities (subject to clause (iii)),”. (4) Section 1819(f)(2)(B)(iii)(I)(c) (42 U.S.C. 1395i–3(f)(2)(B)(iii)(I)(c)) is amended by striking “clauses” each place it appears and inserting “clause”. (5) Section 1819(g)(5)(B) (42 U.S.C. 1395i–3(g)(5)(B)) is amended by striking “paragraphs” and inserting “paragraph”. (6) Section 4008(h)(1)(F)(ii) of OBRA-1990 is amended— (A) by striking “The amendments” and inserting “(I) The amendments”; (B) by striking “nursing facility” each place it appears and inserting “skilled nursing facility”; (C) by redesignating subclauses (I) through (V) as items (aa) through (ee); and (D) by adding at the end the following new subclause: “(II) Notwithstanding subclause (I) and subject to section 1819(f)(2)(B)(iii)(I) of the Social Security Act (as amended by clause (i)), a State may approve a training and competency evaluation program or a competency evaluation program offered by or in a skilled nursing facility described in subclause (I) if, during the previous 2 years, item (aa), (bb), (cc), (dd), or (ee) of subclause (I) did not apply to the facility.”. (7) Effective date.— The amendments made by this subsection shall take effect as if included in the enactment of OBRA-1990.