PRIA, Government Policy, Made Personal

Summary

The Secretary of Health and Human Services must hire an organization to create and run a National Training Institute for Federal and State surveyors. The Institute must train and improve how surveyors investigate reports of abuse, neglect, and taking residents’ money or belongings in programs and long-term care facilities paid by Medicare or Medicaid. It must check how States use special surveyors, find ways to improve surveyor skills and give feedback to agencies, give national training and tools, share best practices, make sure complaint hotlines work 24 hours a day, 7 days a week (and, if the Secretary approves, provide a national 24/7 backup), report each year on the number and sources of complaints, how many go to law enforcement, and general investigation results, and study the cost to States of investigating complaints about skilled nursing and nursing facilities under sections 1819 and 1919 and recommend ways to make investigations more efficient. Up to $12,000,000 is authorized for these activities for fiscal years 2011 through 2014. The Secretary must also give grants to State agencies that inspect skilled nursing or nursing facilities under sections 1819 or 1919. Grant money must be used to build complaint investigation systems that quickly prioritize the most serious complaints, respond effectively and on time, and improve teamwork among state agencies, the State Long-Term Care Ombudsman, local law enforcement, consumer and advocacy groups, State aging units, Area Agencies on Aging, and other local partners. Up to $5,000,000 is authorized for each of fiscal years 2011 through 2014.

Title 42, §1395i–3a

The Public Health and Welfare, Source: USLM XML via OLRC

(1)(A)The Secretary of Health and Human Services shall enter into a contract with an entity for the purpose of establishing and operating a National Training Institute for Federal and State surveyors. Such Institute shall provide and improve the training of surveyors with respect to investigating allegations of abuse, neglect, and misappropriation of property in programs and long-term care facilities that receive payments under title XVIII or XIX of the Social Security Act [42 U.S.C. 1395 et seq., 1396 et seq.].

(B)The contract entered into under subparagraph (A) shall require the Institute established and operated under such contract to carry out the following activities:

(i)Assess the extent to which State agencies use specialized surveyors for the investigation of reported allegations of abuse, neglect, and misappropriation of property in such programs and long-term care facilities.

(ii)Evaluate how the competencies of surveyors may be improved to more effectively investigate reported allegations of such abuse, neglect, and misappropriation of property, and provide feedback to Federal and State agencies on the evaluations conducted.

(iii)Provide a national program of training, tools, and technical assistance to Federal and State surveyors on investigating reports of such abuse, neglect, and misappropriation of property.

(iv)Develop and disseminate information on best practices for the investigation of such abuse, neglect, and misappropriation of property.

(v)Assess the performance of State complaint intake systems, in order to ensure that the intake of complaints occurs 24 hours per day, 7 days a week (including holidays).

(vi)To the extent approved by the Secretary of Health and Human Services, provide a national 24 hours per day, 7 days a week (including holidays), back-up system to State complaint intake systems in order to ensure optimum national responsiveness to complaints of such abuse, neglect, and misappropriation of property.

(vii)Analyze and report annually on the following:

(I)The total number and sources of complaints of such abuse, neglect, and misappropriation of property.

(II)The extent to which such complaints are referred to law enforcement agencies.

(III)General results of Federal and State investigations of such complaints.

(viii)Conduct a national study of the cost to State agencies of conducting complaint investigations of skilled nursing facilities and nursing facilities under section 1819 and 1919, respectively, of the Social Security Act (42 U.S.C. 1395i–3; 1396r), and making recommendations to the Secretary of Health and Human Services with respect to options to increase the efficiency and cost-effectiveness of such investigations.

(C)There are authorized to be appropriated to carry out this paragraph, for the period of fiscal years 2011 through 2014, $12,000,000.

(2)(A)The Secretary of Health and Human Services shall make grants to State agencies that perform surveys of skilled nursing facilities or nursing facilities under section 1819 or 1919, respectively, of the Social Security Act (42 U.S.C. 1395i–3; 1395r [1396r]).

(B)A grant awarded under subparagraph (A) shall be used for the purpose of designing and implementing complaint investigations systems that—

(i)promptly prioritize complaints in order to ensure a rapid response to the most serious and urgent complaints;

(ii)respond to complaints with optimum effectiveness and timeliness; and

(iii)optimize the collaboration between local authorities, consumers, and providers, including—

(I)such State agency;

(II)the State Long-Term Care Ombudsman;

(III)local law enforcement agencies;

(IV)advocacy and consumer organizations;

(V)State aging units;

(VI)Area Agencies on Aging; and

(VII)other appropriate entities.

(C)There are authorized to be appropriated to carry out this paragraph, for each of fiscal years 2011 through 2014, $5,000,000.

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Social Security Act, referred to in par. (1)(A), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Titles XVIII and XIX of the Act are classified generally to this subchapter (§ 1395 et seq.) and subchapter XIX (§ 1396 et seq.), respectively, of this chapter. For complete classification of this Act to the Code, see section 1305 of this title and Tables. Codification Section was enacted as part of the Elder Justice Act of 2009 and also as part of the Patient Protection and Affordable Care Act, and not as part of the Social Security Act which comprises this chapter.

Statutory Notes and Related Subsidiaries

Definitions Pub. L. 111–148, title VI, § 6702, Mar. 23, 2010, 124 Stat. 782, provided that: “Except as otherwise specifically provided, any term that is defined in section 2011 of the Social Security Act [42 U.S.C. 1397j] (as added by section 6703(a)) and is used in this subtitle [subtitle H (§§ 6701–6703) of title VI of Pub. L. 111–148, enacting this section and section 1320b–25, 1397j, 1397j–1, 1397k to 1397k–3, 1397l, and 1397m to 1397m–5 of this title, amending section 602, 604, 622, 671 to 673, 1320a–7, 1320a–7a, 1397, 1397a, 1397c to 1397e, and 1397g of this title, and enacting provisions set out as notes under section 602 and 1305 of this title] has the meaning given such term by such section.”

§1395i–3a Protecting Residents of Long-term Care Facilities