109 HR 6199 IH: Long-term Care Quality and Modernization Act of 2006
U.S. House of Representatives
2006-09-27
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.Short title; table of contents
(a)This Act may be cited as the Long-term Care Quality and Modernization Act of 2006
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
Title I—Medicare and Medicaid Modernization
Sec. 101. Joint training of surveyors and providers.
Sec. 102. Facility-based training for new surveyors.
Sec. 103. Resumption of nurse aide training program after correction of deficiencies.
Sec. 104. Clarifying and eliminating the distinction between physician supervision requirements for skilled nursing facilities and nursing facilities.
Sec. 105. Permitting split or shared billing by physicians and nurse practitioners in skilled nursing facilities.
Sec. 106. Permitting nurse practitioners employed by skilled nursing facilities to certify skilled care.
Sec. 107. Modernization of therapy caps.
Sec. 108. Establishment of a Medicare skilled nursing facility specific wage index.
Sec. 109. Authority to exclude high cost and low probability drugs used in the treatment of cancer from the Medicare prospective payment system for skilled nursing facilities.
Sec. 110. Exclusion of all ambulance services from the Medicare prospective payment system for skilled nursing facilities.
Sec. 111. Authority to exclude additional items and services from the Medicare prospective payment system for skilled nursing facilities.
Sec. 112. Elimination of Medicare 3-day post-hospital stay requirement for coverage of skilled nursing facility services.
Title II—Workforce Support
Sec. 201. Nursing loan repayment program.
Sec. 202. National nursing database.
Sec. 203. Reports on nursing levels.
Title III—Tax Incentives
Sec. 301. 10-year recovery period for qualified long-term care improvement property.
<enum>I</enum><header>Medicare and Medicaid Modernization</header>
<section id="H7CC30513E52347E6A857BBFDB009636"><enum>101.</enum><header>Joint training of surveyors and providers</header>
<subsection id="HC9427F532CEA4CC9917F93E3183893C8"><enum>(a)</enum><header>Medicare program</header><text>Section 1819(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i-3">42 U.S.C. 1395i–3(e)</external-xref>) is amended by adding at the end the following new paragraph:</text>
<quoted-block id="H957F96D0FD2C42EC908CD28DD5E799E" style="OLC">
<paragraph id="HCBF5493CC2B84D429CB8DE638200D1C7"><enum>(6)</enum><header>Joint surveyor/provider training</header><text>The Secretary shall require the State to establish a process for joint training and education of surveyors and providers at least annually and periodically as changes to regulations, guidelines, and policy governing nursing facility operations are implemented and used in surveys of participating facilities.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H8AAA9079143C42A4B4AE46B74E02C71"><enum>(b)</enum><header>Medicaid program</header><text>Section 1919(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r">42 U.S.C. 1396r(e)</external-xref>) is amended by adding at the end the following new paragraph:</text>
<quoted-block id="H3604B3DCBD88477AA517F66114CE3D9" style="OLC">
<paragraph id="H1411DA324A954A05B7EAE382DEF6BE89"><enum>(8)</enum><header>Joint surveyor/provider training</header><text>The State shall establish a process for joint training and education to surveyors and providers at least annually and periodically as changes to regulations, guidelines, and policy governing nursing facility operations are implemented and used in surveys of participating facilities.</text></paragraph><after-quoted-block></after-quoted-block></quoted-block></subsection>
<subsection commented="no" id="HF22D1411B52B4ACE983D8805E4DA6F2E"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on January 1, 2007.</text></subsection></section>
<section id="H499C284F22214F00803CFA00A7709042"><enum>102.</enum><header>Facility-based training for new surveyors</header>
<subsection id="H4E2A3A5858CB4008A4ABC70099D84400"><enum>(a)</enum><header>Medicare program</header><text>Section 1819(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i-3">42 U.S.C. 1395i–3(e)</external-xref>), as amended by section 101(a), is amended by adding at the end the following new paragraph:</text>
<quoted-block id="H87413D0907F242F6824B76F83BA6D5D6" style="OLC">
<paragraph id="HE174486FCFF34281A6A4D1C33F22AEA4"><enum>(7)</enum><header>Facility-based training for new surveyors</header><text>The Secretary shall require the State to establish a process for assuring that—</text>
<subparagraph id="H92244EB3C1EB4D59AE4FB7FC72BB8DED"><enum>(A)</enum><text>each individual newly hired as a nursing home surveyor, as part of the individual’s basic training, is assigned full-time to a participating nursing facility for at least 5 days within a 7-day period to observe actual operations outside of the survey process before the individual begins oversight responsibilities;</text></subparagraph>
<subparagraph id="HF4953ABF45E245D383F11E077949596E"><enum>(B)</enum><text>such individual shall not assume oversight responsibility during this training period and such observations may not be the sole basis of a deficiency citation against the facility; and</text></subparagraph>
<subparagraph id="HB0C55F421E664F3BB928F858B8496358"><enum>(C)</enum><text>such individual shall not be assigned as a member of a survey team for the facility in which the individual received training for two standard surveys following the training period in the facility.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HF23B9B2A9C5D462DB557D14763CFE8F8"><enum>(b)</enum><header>Medicaid program</header><text display-inline="yes-display-inline">Section 1919(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r">42 U.S.C. 1396r(e)</external-xref>), as amended by section 101(b), is amended by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H0F4A4B1AA74F4F41B03585837330CA4D" style="OLC">
<paragraph id="H7540B17C446349ECA2217584B444A437"><enum>(9)</enum><header>Facility-based training for new surveyors</header><text>The State shall establish a process for assuring that—</text>
<subparagraph id="HB44932818F224FD7913EFF8405F8A9C9"><enum>(A)</enum><text>each individual newly hired as a nursing home surveyor, as part of the individual’s basic training, is assigned full-time to a participating nursing facility for at least 5 days within a 7-day period to observe actual operations outside of the survey process before the individual begins oversight responsibilities;</text></subparagraph>
<subparagraph id="H003EDCEE864645599F645770AB2946E0"><enum>(B)</enum><text>such individual shall not assume oversight responsibility during this training period and such observations may not be the sole basis of a deficiency citation against the facility; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HBBC1ACDC010343448F7417F717286A7"><enum>(C)</enum><text>such individual shall not be assigned as a member of a survey team for the facility in which the individual received training for two standard surveys following the training period in the facility.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection commented="no" id="H1B95D9A3E07D4DBE82C7BA3255003C61"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on January 1, 2007.</text></subsection></section>
<section id="H9EA9D79C782E4EC08B44BF7BBA65BA54"><enum>103.</enum><header>Resumption of nurse aide training program after correction of deficiencies</header>
<subsection id="H0BA2C24450CA4673A46E4C43392200EC"><enum>(a)</enum><header>Resumption of nurse aide training program for skilled nursing facilities</header><text>Section 1819(f)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i-3">42 U.S.C. 1395i–3(f)(2)</external-xref>) is amended—</text>
<paragraph id="HEDAC4EACD37F4E47AF20ED1BB2BED76"><enum>(1)</enum><text>in paragraph (B)(iii), in the matter preceding subclause (I), by striking <quote>(C) and (D)</quote> and inserting <quote>(C), (D), and (E)</quote>; and</text></paragraph>
<paragraph id="H6026AA9CF7604AEE985914922045DAFA"><enum>(2)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H5976B46BF0CC425A93B447E34B99220" style="OLC">
<subparagraph id="H283710E083FB4F418323A000E9597931"><enum>(E)</enum><header>Resumption of nurse aide training program after correction of deficiencies</header><text>Clause (iii)(I) of subparagraph (B) shall not apply to a program offered by or in a skilled nursing facility if the facility has—</text>
<clause id="H53F8B0EBF83B41A3A5477642858D4826"><enum>(i)</enum><text>corrected any deficiencies that resulted in the prohibition of approval of such program; and</text></clause>
<clause id="HD7BB0205B04648969BC6F6B1169109A0"><enum>(ii)</enum><text>demonstrated compliance with the requirements of subsections (b), (c), and (d) of this section.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H832A599F773941588285470117DD2045"><enum>(b)</enum><header>Resumption of nurse aide training program for nursing facilities</header><text>Section 1919(f)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r">42 U.S.C. 1396r(f)(2)</external-xref>) is amended—</text>
<paragraph id="HB7CBD47182F14447B26C2FDFD11E7920"><enum>(1)</enum><text>in paragraph (B)(iii), in the matter preceding subclause (I), by striking <quote>(C) and (D)</quote> and inserting <quote>(C), (D), and (E)</quote>; and</text></paragraph>
<paragraph id="H1F1EAEAC02554EC4834C3DBC981FDC6E"><enum>(2)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="HE03A4DA630894BA493AC4B3CB0F04C00" style="OLC">
<subparagraph id="H073D9C2883CF4B0A86227FE3CF004800"><enum>(E)</enum><header>Resumption of nurse aide training program after correction of deficiencies</header><text>Clause (iii)(I) of subparagraph (B) shall not apply to a program offered by or in a nursing facility if the facility has—</text>
<clause id="H6D71D9B4322A465A8CD5FA5E9485B56"><enum>(i)</enum><text>corrected any deficiencies that resulted in the prohibition of approval of such program; and</text></clause>
<clause id="H7F883F87E696487285F59D1FEA8429F1"><enum>(ii)</enum><text>been determined to be in compliance with the requirements of subsections (b), (c), and (d) of this section.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H532C53D4A6E44FDD9778222C30F3A1B9"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on January 1, 2007.</text></subsection></section>
<section commented="no" display-inline="no-display-inline" id="H247D5D012EC247E694A170733FDE285"><enum>104.</enum><header>Clarifying and eliminating the distinction between physician supervision requirements for skilled nursing facilities and nursing facilities</header>
<subsection id="H78230C91FAC64B28B544219411BACB4D"><enum>(a)</enum><header>Physician supervision requirements for skilled nursing facilities</header><text>Section 1819(b)(6)(A) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i-3">42 U.S.C. 1395i–3(b)(6)(A)</external-xref>) is amended by inserting <quote>(or, at the option of a State, under the supervision of a nurse practitioner, clinical nurse specialist, or physician assistant who is working in collaboration with a physician)</quote> before the semicolon at the end.</text></subsection>
<subsection id="H5A2D347837EC41C5A9B0BD99AEEBBADA"><enum>(b)</enum><header>Clarifying physician supervision requirements for nursing facilities</header><text>Section 1919(b)(6)(A) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r">42 U.S.C. 1396r(b)(6)(A)</external-xref>) is amended by striking <quote>who is not an employee of the facility but</quote>.</text></subsection>
<subsection id="H5C66A3CC28E744989904CCB0CFD3282"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on January 1, 2007.</text></subsection></section>
<section id="H8AC206ACEAA64E72B21CFDFB5BB98635"><enum>105.</enum><header>Permitting split or shared billing by physicians and nurse practitioners in skilled nursing facilities</header>
<subsection id="HBEB27F6C94E543EFB9E6AD2F601F14D6"><enum>(a)</enum><header>In general</header><text>Section 1888(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395yy">42 U.S.C. 1395yy(e)</external-xref>) is amended by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H5217E1A89883449A80C356475726E7AE" style="OLC">
<paragraph id="H0C4416553944441D9C3D62EFAF1EC593"><enum>(13)</enum><header>Permitting split or shared billing by physicians and nurse practitioners in skilled nursing facilities</header><text>Notwithstanding section 1861(s)(2)(K)(ii), a physician and a nurse practitioner may each submit a claim for payment for their portion of a service provided to a resident of a skilled nursing facility, except that, in no case may the total amount paid under this title be greater than it would have been if only one person had submitted a claim for such service.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HD7C6316BAE604B3A9120EF5513D474E9"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall apply to services furnished on or after January 1, 2007.</text></subsection></section>
<section id="HC03349B145554D9B003FC6A084D96FE3"><enum>106.</enum><header>Permitting nurse practitioners employed by skilled nursing facilities to certify skilled care</header>
<subsection id="HDF4660E44D4E4873AAC51DF15FE63B34"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1814(a)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395f">42 U.S.C. 1395f(a)(2)</external-xref>) is amended by striking <quote>or a nurse practitioner or</quote> and inserting <quote>a nurse practitioner, or a</quote>.</text></subsection>
<subsection id="H8103E57DB6F2457F84E52DF23D3DA01"><enum>(b)</enum><header>Effective date</header><text>The amendment made by this section shall take effect on January 1, 2007.</text></subsection></section>
<section id="H6CB2F4C1B20940D3BB38106653C98970"><enum>107.</enum><header>Modernization of therapy caps</header><text display-inline="no-display-inline">Section 1833(g) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(g)</external-xref>) is amended—</text>
<paragraph id="H59D12906784947B3A9009D1776965541"><enum>(1)</enum><text>in paragraph (4)—</text>
<subparagraph id="HEDEBC75612D4482CA4B3EB1672B57713"><enum>(A)</enum><text>by striking <quote>This subsection</quote> and inserting <quote>Except as provided in paragraph (6), this subsection</quote>; and</text></subparagraph>
<subparagraph id="H82080D44BCB34972B030CA598E6FF201"><enum>(B)</enum><text>by inserting <quote>and with respect to services furnished on or after January 1, 2009</quote> before the period at the end; and</text></subparagraph></paragraph>
<paragraph id="H8BB7DE7E70FF469CB938EA05D4552F"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H248C11A9C53B48F8AF67793F4F98CD35" style="OLC">
<paragraph id="H0356999C7F0D49E487FCC85E9163D013"><enum>(6)</enum><text>In the case of services described in paragraph (1), with respect to such services furnished on or after January 1, 2009, the Secretary shall establish and implement a condition-based system based on medical necessity for necessary and clinically appropriate services. Such system shall utilize a standardized patient assessment tool to evaluate the level of such services that are needed by an individual and impose a limitation on coverage of such services under this part based on such tool.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section>
<section id="H39B27209FFDE414600FBDDDA8EE86F00"><enum>108.</enum><header>Establishment of a Medicare skilled nursing facility specific wage index</header><text display-inline="no-display-inline">Section 1888(e)(4)(G)(ii) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395yy">42 U.S.C. 1395yy(e)(4)(G)(ii)</external-xref>) is amended by inserting after the first sentence the following new sentence: <quote>For services furnished on or after October 1, 2008, in making the adjustment under the preceding sentence, the Secretary shall utilize an area wage index for skilled nursing facilities based on wage data from such facilities and not from hospitals.</quote></text></section>
<section id="H20C1C41EFADD4950AAD6C0A961E9BFCA"><enum>109.</enum><header>Authority to exclude high cost and low probability drugs used in the treatment of cancer from the Medicare prospective payment system for skilled nursing facilities</header>
<subsection id="H65380FB0C3F741CC9300FC8F00EFED8B"><enum>(a)</enum><header>In general</header><text>Section 1888(e)(2)(A)(iii) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395yy">42 U.S.C. 1395yy(e)(2)(A)(iii)</external-xref>) is amended—</text>
<paragraph id="H7FBDB6F7DBC94469B7006698049CC455"><enum>(1)</enum><text>by redesignating subclauses (IV) and (V) as subclauses (V) and (VI), respectively; and</text></paragraph>
<paragraph id="H7E04A436223A4887A9F600740564B27B"><enum>(2)</enum><text>by inserting after subclause (III) the following new subclause:</text>
<quoted-block display-inline="no-display-inline" id="H2CB5CF488C9F4507B6C77997F6A6D7FD" style="OLC">
<subclause id="HEF45930675CF41D390812462AA3CEC00"><enum>(IV)</enum><text>Any drugs (not otherwise described in subclause (II)) used in the treatment of cancer, including antineoplastic drugs, antiemetics, and supportive medications, that the Secretary determines to be appropriate.</text></subclause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="HA34B1A043CF14A7B9B19166C9C8D8DEA"><enum>(b)</enum><header>Effective date</header><text>The amendments made by subsection (a) shall apply to drugs furnished on or after October 1, 2007.</text></subsection></section>
<section id="H811E6DFD539B4E1789CA8448C92664BD"><enum>110.</enum><header>Exclusion of all ambulance services from the Medicare prospective payment system for skilled nursing facilities</header>
<subsection id="H2A3C07BDCDF44E27A4DF4ED27CE0D44D"><enum>(a)</enum><header>In general</header><text>Section 1888(e)(2)(A)(iii)(I) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395yy">42 U.S.C. 1395yy(e)(2)(A)(iii)(I)</external-xref>) is amended by striking <quote>furnished to</quote> and all that follows before the period.</text></subsection>
<subsection id="H09916455CB224F83B9F0319841B2EFD0"><enum>(b)</enum><header>Effective date</header><text>The amendment made by subsection (a) shall apply to services furnished on or after October 1, 2007.</text></subsection></section>
<section id="H8F772EDA33844D0D9CE88F4C9990E744"><enum>111.</enum><header>Authority to exclude additional items and services from the Medicare prospective payment system for skilled nursing facilities</header>
<subsection id="H0C424698F85D4BFF9E5FB6F1C31364DA"><enum>(a)</enum><header>Authority</header><text>Section 1888(e)(2)(A) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395yy">42 U.S.C. 1395yy(e)(2)(A)</external-xref>) is amended—</text>
<paragraph id="HA46A05F55DA74624BC7E896E78C1CCFC"><enum>(1)</enum><text>in clause (i)(II), by striking <quote>and (iv)</quote> and inserting <quote>(iv), and (v)(I)</quote>; and</text></paragraph>
<paragraph id="H3F86B9885E0C4710A1CEC4825165302B"><enum>(2)</enum><text>by adding at the end the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="HE5B11E0BFCBB4EBD8B5EBB7749D4158F" style="OLC">
<clause id="H1E5F565500C24673B300C2F284A662D1"><enum>(v)</enum><header>Exclusion of additional items and services determined appropriate by the Secretary</header>
<subclause id="H870E9B1DCDFF47CA9472AC51FA49EB26"><enum>(I)</enum><header>In general</header><text>Items and services described in this clause are any items and services not otherwise described in clauses (ii), (iii), or (iv), that the Secretary determines to be appropriate.</text></subclause>
<subclause id="H49B9EE958C9E4B2199252DB206149D50"><enum>(II)</enum><header>Annual update</header><text>The Secretary shall annually update the items and services described in subclause (I) to take into account changes in the practice of medicine.</text></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HD685F8CF58014338A1D5ED3C6250000"><enum>(b)</enum><header>Clarification</header><text>Items and services described in section 1888(e)(2)(A)(v)(I) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395yy">42 U.S.C. 1395yy(e)(2)(A)(v)(I)</external-xref>), as added by subsection (a), may include items and services furnished in a freestanding clinic to an individual who is a resident of a skilled nursing facility.</text></subsection>
<subsection id="H5C27D75220A94F16872B00B18F923316"><enum>(c)</enum><header>Effective date</header><text>The amendment made by subsection (a) shall take effect on October 1, 2007.</text></subsection></section>
<section id="HC1BFB7B37920477BAB9E07C5D6284C4C" section-type="subsequent-section"><enum>112.</enum><header>Elimination of Medicare 3-day post-hospital stay requirement for coverage of skilled nursing facility services</header>
<subsection id="H673D3C9CC73A418CBBEC0020421691BA"><enum>(a)</enum><header>In general</header><text>Section 1812(a)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395d">42 U.S.C. 1395d(a)(2)</external-xref>) is amended—</text>
<paragraph id="H154DD1B24FC34F85883203D6A86230DD"><enum>(1)</enum><text>by striking <quote>(A) post-hospital</quote> and</text></paragraph>
<paragraph id="H8DC1181069CA4ABD83C65D2B611079C2"><enum>(2)</enum><text>by striking <quote>, and (B)</quote> and all that follows up to the period at the end.</text></paragraph></subsection>
<subsection id="HD27113A27F724AC88F80E69C8DE24B79"><enum>(b)</enum><header>Conforming amendments</header>
<paragraph id="HCDA33F3CC2CE4905AEA55DEDF6B4729F"><enum>(1)</enum><text display-inline="yes-display-inline">Title XVIII of the Social Security Act are each amended by striking <quote>post-hospital</quote> before <quote>extended care services</quote> each place it appears.</text> </paragraph>
<paragraph id="HFE275E7B566B4E95954DD462274386E"><enum>(2)</enum><text>Section 1812(f) of such Act is repealed.</text></paragraph>
<paragraph id="HA4E8F79D49224655A8E72514AAB27EE6"><enum>(3)</enum><text>Section 1861(i) of such Act is repealed.</text></paragraph>
<paragraph id="H21EE7D77D0C04BD4A04EB919B593595F"><enum>(4)</enum><text>Section 1888(e)(2)(A)(i)(I) of such Act is amended by striking <quote>section 1861(i)</quote> and inserting <quote>section 1861(h)</quote>.</text></paragraph></subsection>
<subsection id="H15C16D08CCCB4821B69DBFCC32B19679"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall apply to extended care services furnished in periods of stay beginning on or after January 1, 2007. </text> </subsection></section>
<enum>II</enum><header>Workforce Support</header>
<section id="HD648EFA24F714022B7EB04A8B251B645"><enum>201.</enum><header>Nursing loan repayment program</header><text display-inline="no-display-inline">Section 846(a) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/297n">42 U.S.C. 297n(a)</external-xref>) is amended by striking the last sentence.</text></section>
<section id="HA7CA5D34EC9040CF88C5B25FDB14F2DC"><enum>202.</enum><header>National nursing database</header>
<subsection id="H3F7ADD40E8924E58B4E9E219C4FECC3F"><enum>(a)</enum><header>In general</header><text>The Secretary of Health and Human Services shall provide for the establishment of a national nursing database to be used to predict future nursing shortages.</text></subsection>
<subsection id="H3F91B7C8689C476F989BC2A900D69E33"><enum>(b)</enum><header>Information in database</header><text>The database established under subsection (a) shall be designed to include nursing workforce data across all healthcare provider settings, including nursing educators, as determined by the Secretary of Health and Human Services to be appropriate for use in the analysis of trends in the supply and demand of nurses and to create an educational model to predict future nursing workforce needs.</text></subsection>
<subsection id="H34F34FFC108B4BA5852120311D1B6271"><enum>(c)</enum><header>Funding</header><text>The Secretary of Health and Human Services may transfer, from amounts appropriated for the National Center for Health Workforce Analysis, such sums as may be necessary to carry out this section.</text></subsection></section>
<section id="H1E6D47B3741841119DC80053F060E6F0"><enum>203.</enum><header>Reports on nursing levels</header><text display-inline="no-display-inline">Section 806 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/296e">42 U.S.C. 296e</external-xref>), as amended by section 202, is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H9A9BFA6618A04EB492002E9B7C688400" style="OLC">
<subsection id="H5721F63092864AF300C258184D7E6EE8"><enum>(j)</enum><header>Reports concerning nursing levels</header>
<paragraph id="HBFDE79FBE59B48CFB8DF588607339397"><enum>(1)</enum><header>In general</header><text>The entities described in paragraph (2) shall annually submit to the Secretary a report concerning how assistance under this title is being used by such entities to increase the number of nurses, nursing educators, and nurse education enrollment slots.</text></paragraph>
<paragraph id="HA3930478DFB54AD2A17CF3F0E29C3748"><enum>(2)</enum><header>Entities described</header><text>An entity is described in this paragraph if such entity is—</text>
<subparagraph id="HE96FEDD4717F4BDE90E301A413601CCF"><enum>(A)</enum><text>an entity that receives a grant or contract under this title;</text></subparagraph>
<subparagraph id="H095C3FBF1C83488EB76919F1FBE6E62"><enum>(B)</enum><text>a school of nursing that receives student loan funds under this title;</text></subparagraph>
<subparagraph id="H704D2A2CFEAE4E44BC86D114FB47A1C9"><enum>(C)</enum><text>a school of nursing that receives nurse faculty student loan funds under this title; and</text></subparagraph>
<subparagraph id="HD07450A1776246659CAB5963E64CADC1"><enum>(D)</enum><text>any other entity that receives assistance under this title.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section>
<enum>III</enum><header>Tax Incentives</header>
<section id="H80B86185EF0A400BBCDA79BC6817D0DF"><enum>301.</enum><header>10-year recovery period for qualified long-term care improvement property</header>
<subsection id="HED59BB0EEE6C40CBB9B410AF9D17B2B2"><enum>(a)</enum><header>In general</header><text>Subparagraph (D) of <external-xref legal-doc="usc" parsable-cite="usc/26/168">section 168(e)(3)</external-xref> of the Internal Revenue Code of 1986 (relating to 10-year property) is amended by striking <quote>and</quote> at the end of clause (i), by striking the period at the end of clause (ii) and inserting <quote>, and</quote>, and by adding at the end the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="HB6CF6E955B9F43979D2EE2FB41A68EC0" style="OLC">
<clause id="H603D2A6C89754A5F8DE2678D1D29A5A0"><enum>(iii)</enum><text>any qualified long-term care improvement property.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H961316B81CE445B69B301CC2811DE95D"><enum>(b)</enum><header>Qualified long-term care improvement property</header><text><external-xref legal-doc="usc" parsable-cite="usc/26/168">Section 168(e)</external-xref> of the Internal Revenue Code of 1986 (relating to classification of property) is amended by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H4BE981902DDA4A17BB5F726436BA0784" style="OLC">
<paragraph id="HC097553A20FC45A1A845616B62447606"><enum>(8)</enum><header>Qualified long-term care improvement property</header><text>The term <term>qualified long-term care improvement property</term> means any section 1250 property which is an improvement to a building if—</text>
<subparagraph id="H04764D41931C49A9B62B15F9B3B4767"><enum>(A)</enum><text>such improvement is placed in service more than 3 years after the date such building was first placed in service, and</text></subparagraph>
<subparagraph id="HFE38FC2C87B54C4FA947EF03F2D8853B"><enum>(B)</enum><text>such building is, or is a part of, a nursing facility, assisted living facility, residential care facility, intermediate care facility for the mentally retarded, or similar facility designed to provide housing and healthcare for the elderly and disabled.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HA6C28473A795446594FB8D14D1E5F7B5"><enum>(c)</enum><header>Alternative system</header><text>The table contained in <external-xref legal-doc="usc" parsable-cite="usc/26/168">section 168(g)(3)(B)</external-xref> of the Internal Revenue Code of 1986 (relating to special rule for certain property assigned to classes) is amended by inserting after the item relating to subparagraph (D)(ii) the following:</text>
<quoted-block display-inline="no-display-inline" id="HC8ECB9E533354BC5B6E6C4C2311C9575" style="OLC">
<table align-to-level="subsection" blank-lines-before="1" frame="none" line-rules="no-gen" rule-weights="4.4.4.4.4.17" subformat="S6211" table-type="2-General">
<tgroup cols="2" grid-typeface="1.1" thead-tbody-ldg-size="10.10.10" ttitle-size="0"><colspec coldef="txt" colname="col1" colsep="0" colwidth="1*" min-data-value="50"/><colspec coldef="fig" colname="col2" colsep="0" colwidth="1.2*" min-data-value="10"/>
<tbody>
<row><entry align="left" colname="col1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">(D)(iii)</entry><entry align="right" colname="col2" entry-modify="fl-hang-hier-2" leader-modify="force-ldr" rowsep="0">10</entry></row></tbody></tgroup></table><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H0C6713D331344E76A1531C4995ECE160"><enum>(d)</enum><header>Effective date</header><text>The amendments made by this section shall apply to property placed in service after the date of the enactment of this Act.</text></subsection></section>