[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 863 Introduced in Senate (IS)]







107th CONGRESS
  1st Session
                                 S. 863

    To require medicare providers to disclose publicly staffing and 
   performance in order to promote improved consumer information and 
                                choice.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 10, 2001

   Mr. Reid introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
    To require medicare providers to disclose publicly staffing and 
   performance in order to promote improved consumer information and 
                                choice.

    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 ``Patient Safety Act of 2001''.

SEC. 2. PUBLIC DISCLOSURE OF STAFFING AND OUTCOMES DATA.

    (a) Disclosure of Staffing and Outcomes.--Any provider under the 
medicare program shall, as a condition of continued participation in 
such program, make publicly available information regarding nurse 
staffing and patient outcomes as specified by the Secretary. Such 
information shall include at least the following:
            (1) The number of registered nurses providing direct care. 
        This information shall be expressed both in raw numbers, in 
        terms of total hours of nursing care per patient (including 
        adjustment for case mix and acuity), and as a percentage of 
        nursing staff, and shall be broken down in terms of the total 
        nursing staff, each unit, and each shift.
            (2) The number of licensed practical nurses or licensed 
        vocational nurses providing direct care. This information shall 
        be expressed both in raw numbers, in terms of total hours of 
        nursing care per patient (including adjustment for case mix and 
        acuity), and as a percentage of nursing staff, and shall be 
        broken down in terms of the total nursing staff, each unit, and 
        each shift.
            (3) Numbers of unlicensed personnel utilized to provide 
        direct patient care. This information shall be expressed both 
        in raw numbers and as a percentage of nursing staff and shall 
        be broken down in terms of the total nursing staff, each unit, 
        and each shift.
            (4) The average number of patients per registered nurse 
        providing direct patient care. This information shall be broken 
        down in terms of the total nursing staff, each unit, and each 
        shift.
            (5) Risk-adjusted patient mortality rate (in raw numbers 
        and by diagnosis or diagnostic-related group).
            (6) Incidence of adverse patient care incidents, including 
        as such incidents at least medication errors, patient injury, 
        pressure ulcers, nosocomial infections, and nosocomial urinary 
        tract infections.
            (7) Methods used for determining and adjusting staffing 
        levels and patient care needs and the provider's compliance 
        with these methods.
    (b) Disclosure of Complaints.--Data regarding complaints filed with 
the State agency, the Health Care Financing Administration, or an 
accrediting agency, compliance with the standards of which have been 
deemed to demonstrate compliance with conditions of participation under 
the medicare program, and data regarding investigations and findings as 
a result of those complaints and the findings of scheduled inspection 
visits, shall be made publicly available.
    (c) Information on Data.--All data made publicly available under 
this section shall indicate the source and currency of the data 
provided.
    (d) Waiver for Small Providers.--The Secretary may waive or reduce 
reporting requirements under this section in the case of a small 
provider (as defined by the Secretary) for whom the imposition of the 
requirements would be unduly burdensome.
    (e) Definitions.--For purposes of this section:
            (1) Licensed practical nurse or licensed vocational 
        nurse.--The term ``licensed practical nurse or licensed 
        vocational nurse'' means an individual who is entitled under 
        State law or regulation to practice as a licensed practical 
        nurse or a licensed vocational nurse.
            (2) Made publicly available.--The term ``made publicly 
        available'' means, with respect to information of a provider, 
        information that is--
                    (A) provided to the Secretary and to any State 
                agency responsible for licensing or accrediting the 
                provider;
                    (B) provided to any State agency which approves or 
                oversees health care services delivered by the provider 
                directly or through an insuring entity or corporation; 
                and
                    (C) provided to any member of the public which 
                requests such information directly from the provider.
            (3) Medicare program.--The term ``medicare program'' means 
        the programs under title XVIII of the Social Security Act.
            (4) Provider.--The term ``provider'' means an entity that 
        is--
                    (A) a psychiatric hospital described in section 
                1861(f) of the Social Security Act (42 U.S.C. 
                1395x(f));
                    (B) a provider of services described in section 
                1861(u) of such Act (42 U.S.C. 1395x(u));
                    (C) a rural health clinic described in section 
                1861(aa)(2) of such Act (42 U.S.C. 1395x(aa)(2));
                    (D) an ambulatory surgical center described in 
                section 1832(a)(2)(F)(i) of such Act (42 U.S.C. 
                1395k(a)(2)(F)(i)); or
                    (E) a renal dialysis facility described in section 
                1881(b)(1)(A) of such Act (42 U.S.C. 1395rr(b)(1)(A)).
            (5) Registered nurse.--The term ``registered nurse'' means 
        an individual who is entitled under State law or regulation to 
        practice as a registered nurse.
            (6) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
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