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<PRE>[DOCID: f:h540enr.txt]
        H.R.540

                       One Hundred Sixth Congress

                                 of the

                        United States of America


                          AT THE FIRST SESSION

         Begun and held at the City of Washington on Wednesday,
   the sixth day of January, one thousand nine hundred and ninety-nine


                                 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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

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

SEC. 2. RESTRICTIONS ON TRANSFERS OR DISCHARGES OF NURSING FACILITY 
              RESIDENTS IN THE CASE OF VOLUNTARY WITHDRAWAL FROM 
              PARTICIPATION UNDER THE MEDICAID PROGRAM.

    (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 
subparagraph:
            ``(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 individual, and separate 
                from other documents signed by such individual.

            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 title.

                ``(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) 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.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.

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