[106th Congress Public Law 4]
[From the U.S. Government Printing Office]

[DOCID: f:publ004.106]

[[Page 113 STAT. 7]]

Public Law 106-4
106th Congress

                                 An Act

 To amend title XIX of the Social Security Act to prohibit transfers or 
discharges of residents of nursing facilities as a result of a voluntary 
withdrawal from participation in the Medicaid Program. <<NOTE: Mar. 25, 
                          1999 -  [H.R. 540]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Nursing Home 
Resident Protection Amendments of 1999.>> 

SECTION 1. SHORT TITLE. <<NOTE: 42 USC 1305 note.>> 

    This Act may be cited as the ``Nursing Home Resident Protection 
Amendments of 1999''.


    (a) In General.--Section 1919(c)(2) of the Social Security Act (42 
U.S.C. 1396r(c)(2)) is amended by adding at the end the following new 
                    ``(F) Continuing rights in case of voluntary 
                withdrawal from participation.--
                          ``(i) In general.--In the case of a nursing 
                      facility that voluntarily withdraws from 
                      participation in a State plan under this title but 
                      continues to provide services of the type provided 
                      by nursing facilities--
                                    ``(I) the facility's voluntary 
                                withdrawal from participation is not an 
                                acceptable basis for the transfer or 
                                discharge of residents of the facility 
                                who were residing in the facility on the 
                                day before the effective date of the 
                                withdrawal (including those residents 
                                who were not entitled to medical 
                                assistance as of such day);
                                    ``(II) the provisions of this 
                                section continue to apply to such 
                                residents until the date of their 
                                discharge from the facility; and
                                    ``(III) in the case of each 
                                individual who begins residence in the 
                                facility after the effective date of 
                                such withdrawal, the facility shall 
                                provide notice orally and in a prominent 
                                manner in writing on a separate page at 
                                the time the individual begins residence 
                                of the information described in clause 
                                (ii) and shall obtain from each such 
                                individual at such time an 
                                acknowledgment of receipt of such 
                                information that is in writing, signed 
                                by the indi-
                                vidual, and separate from other 
                                documents signed by such individual.

[[Page 113 STAT. 8]]

                      Nothing in this subparagraph shall be construed as 
                      affecting any requirement of a participation 
                      agreement that a nursing facility provide advance 
                      notice to the State or the Secretary, or both, of 
                      its intention to terminate the agreement.
                          ``(ii) Information for new residents.--The 
                      information described in this clause for a 
                      resident is the following:
                                    ``(I) The facility is not 
                                participating in the program under this 
                                title with respect to that resident.
                                    ``(II) The facility may transfer or 
                                discharge the resident from the facility 
                                at such time as the resident is unable 
                                to pay the charges of the facility, even 
                                though the resident may have become 
                                eligible for medical assistance for 
                                nursing facility services under this 
                          ``(iii) Continuation of payments and oversight 
                      authority.--Notwithstanding any other provision of 
                      this title, with respect to the residents 
                      described in clause (i)(I), a participation 
                      agreement of a facility described in clause (i) is 
                      deemed to continue in effect under such plan after 
                      the effective date of the facility's voluntary 
                      withdrawal from participation under the State plan 
                      for purposes of--
                                    ``(I) receiving payments under the 
                                State plan for nursing facility services 
                                provided to such residents;
                                    ``(II) maintaining compliance with 
                                all applicable requirements of this 
                                title; and
                                    ``(III) continuing to apply the 
                                survey, certification, and enforcement 
                                authority provided under subsections (g) 
                                and (h) (including involuntary 
                                termination of a participation agreement 
                                deemed continued under this clause).
                          ``(iv) No application to new residents.--This 
                      paragraph (other than subclause (III) of clause 
                      (i)) shall not apply to an individual who begins 
                      residence in a facility on or after the effective 
                      date of the withdrawal from participation under 
                      this subparagraph.''.

    (b) <<NOTE: 42 USC 1396r note.>> Effective Date.--The amendment made 
by subsection (a) applies to voluntary withdrawals from participation 
occurring on or after the date of the enactment of this Act.

    Approved March 25, 1999.


HOUSE REPORTS: No. 106-44 (Comm. on Commerce).
SENATE REPORTS: No. 106-13 (Comm. on Finance).
            Mar. 9, 10, considered and passed House.
            Mar. 15, considered and passed Senate.