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. Update of the Medicare skilled nursing facility
market basket index .
Sec. 110. 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. 111. Exclusion of all ambulance services from the Medicare
prospective payment system for skilled nursing facilities.
Sec. 112. Authority to exclude additional items and services
from the Medicare prospective payment system for skilled nursing
facilities.
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.
Sec. 302. Investment tax credit for long-term care facility
information technology.
Sec. 303. Long-Term Care Trust Accounts.
Sec. 304. Refundable credit for contributions to Long-Term Care
Trust Accounts.
TITLE IV—Disaster preparedness and response
Sec. 401. Disaster preparedness and response.
<enum>I</enum><header>Medicare and
Medicaid Modernization</header>
<section id="idD3A1CF3A53794C35922FBB7082058D37"><enum>101.</enum><header>Joint training
of surveyors and providers</header>
<subsection id="H5A33D0B318064AA6B53C91195FB0F9C1"><enum>(a)</enum><header>Medicare
program</header><text>Section 1819(e) of the Social Security Act (42 U.S.C.
1395i–3(e)) is amended by adding at the end the following new paragraph:</text>
<quoted-block id="H49262AAA3C1E4999B7006568D62DA2D" style="OLC">
<paragraph id="H9E4A63CE8FD24FACBE5BBC404C4869EC"><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="H518ABDF60AFD4765AFD0CAC7D6AE3148"><enum>(b)</enum><header>Medicaid
program</header><text>Section 1919(e) of the Social Security Act (42 U.S.C.
1396r(e)) is amended by adding at the end the following new paragraph:</text>
<quoted-block id="HBBF2095C28234B06ABC1A6EF88FEA274" style="OLC">
<paragraph id="H6161763D43E241B291F77E259BE35361"><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="H17833D52D05644968B45D9005D8BF00"><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="H0899AE5BD23E4D6AA341632C273200C1"><enum>102.</enum><header>Facility-based
training for new surveyors</header>
<subsection id="H53836936EC354E729E9FDF3328EE4B7B"><enum>(a)</enum><header>Medicare
program</header><text>Section 1819(e) of the Social Security Act (42 U.S.C.
1395i–3(e)), as amended by section 101(a), is amended by adding at the end the
following new paragraph:</text>
<quoted-block id="HEB2062C97C334D5FA87504AFCB052666" style="OLC">
<paragraph id="H3228BAF250CC4A159B05392EFA5BDE65"><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="HF6FD9541A1014EF0AA46CECFE1BDAD1"><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="HA8386C550351480800E1DE32068C5606"><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="HF27C84B1179746ACB8F103AFE0E2FD60"><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="HAD7D0429C0434FF4B79EF941FE3064C5"><enum>(b)</enum><header>Medicaid
program</header><text display-inline="yes-display-inline">Section 1919(e) of
the Social Security Act (42 U.S.C. 1396r(e)), 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="HB7C2498D14F34C7C8C8EBBC12F37E8D2" style="OLC">
<paragraph id="HB634D10D3AF3405994A3D0CED0ADAB6E"><enum>(9)</enum><header>Facility-based
training for new surveyors</header><text>The State shall establish a process
for assuring that—</text>
<subparagraph id="HC313394E0ACE4014BD02008823B3AF3"><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="H1A370C5C13744D288F095D6814C9D588"><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="HFFECA084178F45D488EC6FDCA7BAAA2F"><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="id0C3AE18EA1F4497580173A0BBBA925EE"><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="idC6C1B9F80509453FB803A39B862A1BB2"><enum>103.</enum><header>Resumption of
nurse aide training program after correction of deficiencies</header>
<subsection id="idC4152B3DB35B4A679BE9247A0CAC6C0B"><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 (42
U.S.C. 1395i–3(f)(2)) is amended—</text>
<paragraph id="id8875091E708C4B5C94968AF10A269695"><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="id7990B0C21D9542B9AE679791526EE51E"><enum>(2)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="id74507DC86888418888D2878F8D5DCCF3" style="OLC">
<subparagraph id="id8AE2F359884C4733916BE6E4620B45FE"><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="id205979B8548C4A959274EAFDFE27A6A4"><enum>(i)</enum><text>corrected any
deficiencies that resulted in the prohibition of approval of such program;
and</text>
</clause><clause id="id065C7EA95B804456ACBCCF6F73526E8D"><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="id6E52CA85ABB14A2C93B6D08A510556BE"><enum>(b)</enum><header>Resumption of
nurse aide training program for nursing facilities</header><text>Section
1919(f)(2) of the Social Security Act (42 U.S.C. 1396r(f)(2)) is
amended—</text>
<paragraph id="id8406CC20E1974CE1968352707CECE8B9"><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="id502831F478A1462BAD37AD2595BE8653"><enum>(2)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="id11D28A3339D843A58C15A6434C565EF3" style="OLC">
<subparagraph id="id5BF309B6B44B47909ECC8917B8F42993"><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="id6089FF46E1D74CA4BA81238C60537367"><enum>(i)</enum><text>corrected any
deficiencies that resulted in the prohibition of approval of such program;
and</text>
</clause><clause id="id252384ED733A410CAD966F02BBC7537B"><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="id4975A98AE3A241838E609EF3BDDA749D"><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="id868B57B0D77F488CA72EDD0585A97419"><enum>104.</enum><header>Clarifying and
eliminating the distinction between physician supervision requirements for
skilled nursing facilities and nursing facilities</header>
<subsection id="id8F7A093C3109431E85084B0C0F7A98CE"><enum>(a)</enum><header>Physician
supervision requirements for skilled nursing facilities</header><text>Section
1819(b)(6)(A) of the Social Security Act (42 U.S.C. 1395i–3(b)(6)(A)) 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="idCAC9D3C9BCA940F0B3444B5CB466AE64"><enum>(b)</enum><header>Clarifying
physician supervision requirements for nursing facilities</header><text>Section
1919(b)(6)(A) of the Social Security Act (42 U.S.C. 1396r(b)(6)(A)) is amended
by striking <quote>who is not an employee of the facility but</quote>.</text>
</subsection><subsection id="id2B17E5FC5A9B4D7D83A0CD38818A1EA3"><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="id9BE11605F5474CDEB2A8FB9D57D2A5A4"><enum>105.</enum><header>Permitting
split or shared billing by physicians and nurse practitioners in skilled
nursing facilities</header>
<subsection id="id0FC3799A7B0F4B46B767556919687165"><enum>(a)</enum><header>In
general</header><text>Section 1888(e) of the Social Security Act (42 U.S.C.
1395yy(e)) is amended by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="id332A9DAD03274DB6BD2734DDA7269581" style="OLC">
<paragraph id="id016EC30A2AEA4CD09B5BD005AA6C6B38"><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="id9141AC1BAB5C4525AD223AA7DD4EFC68"><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="id1A691F3364254ADAAAD4F69AA4A59B06"><enum>106.</enum><header>Permitting
nurse practitioners employed by skilled nursing facilities to certify skilled
care</header>
<subsection id="id7E239B401EEB4B49863EA5DE8D39856A"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 1814(a)(2) of
the Social Security Act (42 U.S.C. 1395f(a)(2)) is amended by striking
<quote>or a nurse practitioner or</quote> and inserting <quote>a nurse
practitioner, or a</quote>.</text>
</subsection><subsection id="id27779590C844462B9B07C97710DE7124"><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="id8818C40821104E26A1438D4253A64FC5"><enum>107.</enum><header>Modernization
of therapy caps</header><text display-inline="no-display-inline">Section
1833(g) of the Social Security Act (42 U.S.C. 1395l(g)) is amended—</text>
<paragraph id="idEBF81B243D8D4656B026F272E2D6218E"><enum>(1)</enum><text>in paragraph
(4)—</text>
<subparagraph id="idAEE77853703B473E86B79C3DDA0FB364"><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="id714032ADCC654053A9A36E2ADE995649"><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="id7E44687C1E6A4D71A955B4DDACA92649"><enum>(2)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idD87D7CB65AD64896B5102EAECA955B99" style="OLC">
<paragraph id="id4D2F2F61E17842968033F01BF083FB16"><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="IDA16DCCBC8600426B89D1560458A8BC23"><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> (42 U.S.C.
1395yy(e)(4)(G)(ii)) 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="id458A8B6D52B74560B10C4DF735F54413"><enum>109.</enum><header>Update of the
Medicare skilled nursing facility market basket index </header><text display-inline="no-display-inline">Section 1888(e) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1395yy(e)) is amended by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idA20B4C00C6614C2DAAFECA86EBDF9641" style="OLC">
<paragraph id="idEA5FB5C19FFB456C848F19697A3A73E9"><enum>(13)</enum><header>Update of the
skilled nursing facility market basket index</header>
<subparagraph id="id74DDD9908E214496BF727EB3F93189CC"><enum>(A)</enum><header>In
general</header><text>Not later than October 1, 2007, the Secretary shall
develop and implement a process for updating the calculation of the skilled
nursing facility market basket index under paragraph (5)(A), including the
weights used in such index.</text>
</subparagraph><subparagraph id="id9DE9E063F8FE4B379049A7ADBB6C6292"><enum>(B)</enum><header>Requirement</header><text>Such
process shall ensure that such index—</text>
<clause id="id66A5DC3534504669AA6CFC45DCE0A72B"><enum>(i)</enum><text>includes a
separate weight for professional liability costs;</text>
</clause><clause id="idFFDDF1629369454BB01A951EBAC43367"><enum>(ii)</enum><text>is updated at
least as frequently as the hospital market basket is updated under section
1886(b)(3)(B)(iii); and</text>
</clause><clause id="id495E4D0106074D8F8C0044707F04F20B"><enum>(iii)</enum><text>reflects the
most current data available.</text>
</clause></subparagraph><subparagraph id="id46B0BF52300847349B89059FCFCE9A57"><enum>(C)</enum><header>Consideration</header><text>In
developing and implementing the process under subparagraph (A), the Secretary
shall consider methodologies for measuring changes in the price of wages and
salaries other than the methodologies being used by the Secretary as of the
date of enactment of this paragraph.</text>
</subparagraph><subparagraph id="id84D9B2B65D80446DB88DA42C73C97684"><enum>(D)</enum><header>Study</header><text>The
Secretary shall conduct a study to determine the appropriate frequency for
updating the skilled nursing facility market basket index under the process
developed and implemented under subparagraph
(A).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="idAEDBDC4DB5494955B0FE1E620AB7D89F"><enum>110.</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="idDBBA8ADD663246A3B5A7545B87C5070C"><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> (42 U.S.C.
1395yy(e)(2)(A)(iii)) is amended—</text>
<paragraph id="idDDFC784E1EDE4D8AA87496C72B926778"><enum>(1)</enum><text>by redesignating
subclauses (IV) and (V) as subclauses (V) and (VI), respectively; and</text>
</paragraph><paragraph id="id6A75724ACA5747F9B57ADC12D603BC5B"><enum>(2)</enum><text>by inserting
after subclause (III) the following new subclause:</text>
<quoted-block display-inline="no-display-inline" id="idBED0027D7AEB4F4C97C3FEEF697DFF91" style="OLC">
<subclause id="idCCEE919849454B479AB1BB493AABA128"><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="id9DC6F1AB00FD4F4A9078503A36914D36"><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="id2B3F2479D8CE46BFA015562EC79C87FD"><enum>111.</enum><header>Exclusion of
all ambulance services from the Medicare prospective payment system for skilled
nursing facilities</header>
<subsection id="id0AD65A4CE1804D83A9752D6E3765788B"><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> (42 U.S.C.
1395yy(e)(2)(A)(iii)(I)) is amended by striking <quote>furnished to</quote> and
all that follows before the period.</text>
</subsection><subsection id="idF90F11685B6B461FA2BB1A2A1D91B001"><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="idD65B13E5A7304A8FB8887D8816125FF1"><enum>112.</enum><header>Authority to
exclude additional items and services from the Medicare prospective payment
system for skilled nursing facilities</header>
<subsection id="id1FAA43C1C8CA48D1BBAE474B17486FDA"><enum>(a)</enum><header>Authority</header><text>Section
1888(e)(2)(A) of the <act-name parsable-cite="SSA">Social Security
Act</act-name> (42 U.S.C. 1395yy(e)(2)(A)) is amended—</text>
<paragraph id="id0AC6F7B7193B4C7EB0898F0C888B7FC9"><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="idF3DADE9C3B9A4A2096F636C10573176C"><enum>(2)</enum><text>by adding at the
end the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="id452CE604250D4B8C90944CF2936D6129" style="OLC">
<clause id="id92AFB43B5D114F91BCED374A23A504EA"><enum>(v)</enum><header>Exclusion of
additional items and services determined appropriate by the Secretary</header>
<subclause id="id5127E7E202544A6FAAC2428F95BF8CBF"><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="id54DF4EAE52D245A39C4DD2D4FE7FD7C0"><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="id4999DC68533F4865986ADFCC3E343998"><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> (42 U.S.C.
1395yy(e)(2)(A)(v)(I)), 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="idE52446AF65D445529A44C97BEDF90DC6"><enum>(c)</enum><header>Effective
date</header><text>The amendment made by subsection (a) shall take effect on
October 1, 2007.</text>
</subsection></section><enum>II</enum><header>Workforce
support</header>
<section id="id8A03A8F72B654DA8AFFF0B29D9F56950"><enum>201.</enum><header>Nursing loan
repayment program</header><text display-inline="no-display-inline">Section
846(a) of the Public Health Service Act (42 U.S.C. 297n(a)) is amended by
striking the last sentence.</text>
</section><section id="id50B0B5DD1BB04CB2BAFBBB869880FA04"><enum>202.</enum><header>National
nursing database</header>
<subsection id="id71CAB0278E764A8C9CFC72CB5A684C6D"><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="idB88897E14A99436BB963EE00117857A7"><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="id964F36F14E2D4B7CA55796CDBA8B4C8C"><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="id05148BBCD0344DD38677B9F5F16D52C9"><enum>203.</enum><header>Reports on
nursing levels</header><text display-inline="no-display-inline">Section 806 of
the Public Health Service Act (42 U.S.C. 296e), as amended by section 202, is
further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="idCC3D312747B7493DA975A97A550D1A6B" style="OLC">
<subsection id="id0F52A9C6A75B40E1873EADD492D018EF"><enum>(j)</enum><header>Reports
concerning nursing levels</header>
<paragraph id="id721399CDB88D4E929C5DD0CA133EF9EE"><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="idC4CE1EE006F94DEA977E2F64F8772140"><enum>(2)</enum><header>Entities
described</header><text>An entity is described in this paragraph if such entity
is—</text>
<subparagraph id="id5AE51A6B219E496CA339A89F4AF7D904"><enum>(A)</enum><text>an entity that
receives a grant or contract under this title;</text>
</subparagraph><subparagraph id="idAEB17330968A44E59AE7447891ACF039"><enum>(B)</enum><text>a school of
nursing that receives student loan funds under this title;</text>
</subparagraph><subparagraph id="id28D819C23DFE4EA0BF41A363A600EFA1"><enum>(C)</enum><text>a school of
nursing that receives nurse faculty student loan funds under this title;
and</text>
</subparagraph><subparagraph id="id784931AC95AE479996C20C330CD9CD07"><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="idB76EF128DFC34B488CB91047AEF06233"><enum>301.</enum><header>10-year
recovery period for qualified long-term care improvement property</header>
<subsection id="idE1BEB204DCCF4E09AAA8B7546A7E7085"><enum>(a)</enum><header>In
general</header><text>Subparagraph (D) of section 168(e)(3) 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="id26F9E9ED6606461FB59407FB86FE7D69" style="OLC">
<clause id="id7D16B551B92F4F31A82083D2A659CDA9"><enum>(iii)</enum><text>any qualified
long-term care improvement
property.</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id1CA65D3C71D94CE8A11AFB35366028B7"><enum>(b)</enum><header>Qualified
long-term care improvement property</header><text>Section 168(e) 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="id8C2D70643E054A85A787304DED3970DA" style="OLC">
<paragraph id="id3D97205943B34891A39722080E283098"><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="id6A882AF60F894BFC8950F69255FAEC9C"><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="idFA6DE2820BD348F4B3C862A435969510"><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="idA64E7B4B221E49A3AE33D46C707ED5CD"><enum>(c)</enum><header>Alternative
system</header><text>The table contained in section 168(g)(3)(B) 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="id2054361B2B4A4BAA96CF60263A1B2B91" 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><colspec coldef="fig" colname="col2" colsep="0" colwidth="1.2*" min-data-value="10"></colspec>
<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="id0F6E567798444DF0B51BA21300FFCE9C"><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><section commented="no" display-inline="no-display-inline" id="id1B9264F290544162A791C193963AEB96"><enum>302.</enum><header>Investment tax
credit for long-term care facility information technology</header>
<subsection id="ID5D8DEB6CB74F4CD3AFF04E9703DBD13E"><enum>(a)</enum><header>In
general</header><text>Section 46 of the Internal Revenue Code of 1986 (relating
to amount of credit) is amended by striking <quote>and</quote> at the end of
paragraph (3), by striking the period at the end of paragraph (4) and inserting
<quote>, and</quote>, and by adding at the end the following new
paragraph:</text>
<quoted-block id="ID656BF78FB8A64EA3B8DDE0ED47EFA5A0">
<paragraph id="IDC9F87479671B4F19939D2DE683FBE2BF"><enum>(5)</enum><text>the qualifying
long-term care facility information technology
credit.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" display-inline="no-display-inline" id="IDB01ABF716E8348A8AF52742953EC2A99"><enum>(b)</enum><header>Amount of
credit</header><text>Subpart E of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to rules for computing investment
credit) is amended by inserting after section 48B the following new
section:</text>
<quoted-block display-inline="no-display-inline" id="ID95FBEFD9E8984BE9A775FD252FB88FAA" style="OLC">
<section id="ID36FFB5BD05E04EF2AE15B68C384CD706"><enum>48C.</enum><header>Qualifying
long-term care facility technology credit</header>
<subsection id="ID606F7BE560DE4D6C805F3848922E7F4D"><enum>(a)</enum><header>In
general</header><text>For purposes of section 46, the qualifying long-term care
facility technology credit for any taxable year is an amount equal to 20
percent of the qualified investment for such taxable year.</text>
</subsection><subsection id="IDBFB7624E237544928FA110EEA66BB3EF"><enum>(b)</enum><header>Qualified
investment</header>
<paragraph id="ID0C2BF98C4B364BF1B25405F09C21BA53"><enum>(1)</enum><header>In
general</header><text>For purposes of subsection (a), the qualified investment
for any taxable year is the basis of property placed in service by the taxpayer
during such taxable year which is part of a qualifying long-term care facility
technology system—</text>
<subparagraph id="ID851308FF0D2F4649A0921502E9635207"><enum>(A)</enum><clause commented="no" display-inline="yes-display-inline" id="IDA509DB22276C47CB8DC97B7376C861C0"><enum>(i)</enum><text>the construction,
reconstruction, or erection of which is completed by the taxpayer, or</text>
</clause><clause id="ID5F8BDCA7CC9148189CE03F2F72DC3AA0" indent="up1"><enum>(ii)</enum><text>which is acquired by the taxpayer
if the original use of such property commences with the taxpayer, and</text>
</clause></subparagraph><subparagraph id="ID600413CE8AA9488C90016704A1CD94E6"><enum>(B)</enum><text>with respect to
which depreciation (or amortization in lieu of depreciation) is
allowable.</text>
</subparagraph></paragraph><paragraph id="IDD6454BFA25134F78A77DE95B7C651752"><enum>(2)</enum><header>Applicable
rules</header><text>For purposes of this section, rules similar to the rules of
subsection (a)(4) and (b) of section 48 shall apply.</text>
</paragraph></subsection><subsection id="ID7798E3ADB46144F0BC387933ABABA0FA"><enum>(c)</enum><header>Qualifying
long-term care facility technology system</header><text>For purposes of this
section, the term <term>qualifying long-term care facility technology
system</term> means any computers, related equipment, and software for a
healthcare information system 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>
</subsection><subsection id="id1CE8A43610054F2FAB35872E7AF4538D"><enum>(d)</enum><header>Denial of
double benefit</header><text>No deduction or other credit shall be allowed with
respect to the basis of any property taken into account in determining the
credit allowed under this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="IDAB71C8ADC32143E98F1A9458B9B02383"><enum>(c)</enum><header>Conforming
amendments</header>
<paragraph id="ID5D01D28D62AB48CF9BCCC60CB633A9F1"><enum>(1)</enum><text>Section
49(a)(1)(C) of the Internal Revenue Code of 1986 is amended by striking
<quote>and</quote> at the end of clause (iii), by striking the period at the
end of clause (iv) and inserting <quote>, and</quote>, and by adding after
clause (iv) the following new clause:</text>
<quoted-block id="IDA4E7D1AEDFA341EB839B7D860A7F0E93">
<clause id="IDA925C342133E4060BE1F0B3A10DB4BC9"><enum>(v)</enum><text>the basis of any
property which is part of a qualifying long-term care facility technology
system under section
48C.</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="ID16AFF10EF0314AAAA647A66ACEFC4675"><enum>(2)</enum><text>The table of
sections for subpart E of part IV of subchapter A of chapter 1 of such Code is
amended by inserting after the item relating to section 48B the following new
item:</text>
<quoted-block id="IDC496565B18144917B7B688291C895819" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">48C. Qualifying long-term care facility
technology
credit.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="ID89B52528DF5D4413906FC33FAFC78DD4"><enum>(d)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to periods
after the date of the enactment of this Act, under rules similar to the rules
of section 48(m) of the Internal Revenue Code of 1986 (as in effect on the day
before the date of the enactment of the Revenue Reconciliation Act of
1990).</text>
</subsection></section><section id="H167824B07F664E4E8E18437164201752" section-type="subsequent-section"><enum>303.</enum><header>Long-Term Care Trust
Accounts</header>
<subsection id="HBC1C7B52E5B84B57AAFA77D5F7077D00"><enum>(a)</enum><header>In
general</header><text>Subchapter F of chapter 1 of the Internal Revenue Code of
1986 (relating to exempt organizations) is amended by adding at the end the
following new part:</text>
<quoted-block id="HB3A82A47E9A742D19C705257009C00E8">
<part id="HC67829DE55674AB9A6A3E7FDB05FAF72"><enum>IX</enum><header>Long-Term Care
Trust Accounts</header>
<section id="H39E384AE92A440A6A3A48098E46DCEA4"><enum>530A.</enum><header>Long-Term Care
Trust Accounts</header>
<subsection id="HE4883B74614A42B79600002D23EBD244"><enum>(a)</enum><header>General
rule</header><text>A Long-Term Care Trust Account shall be exempt from taxation
under this subtitle. Notwithstanding the preceding sentence, such account shall
be subject to the taxes imposed by section 511 (relating to imposition of tax
on unrelated business income of charitable organizations).</text>
</subsection><subsection id="H9BBC99F9B3FF45C48C28624EC9BC9358"><enum>(b)</enum><header>Long-Term Care
Trust Account</header><text>For purposes of this section, the term
<term>Long-Term Care Trust Account</term> means a trust created or organized in
the United States for the exclusive benefit of an individual who is the
designated beneficiary of the trust and which is designated (in such manner as
the Secretary shall prescribe) at the time of the establishment of the trust as
a Long-Term Care Trust Account, but only if the written governing instrument
creating the trust meets the following requirements:</text>
<paragraph id="HEBBE95C5E999415299A2275FD8B9EDA9"><enum>(1)</enum><text>Except in the case
of a qualified rollover contribution described in subsection (d)—</text>
<subparagraph id="HA1916436F085419DAAE5071468E05BBD"><enum>(A)</enum><text>no contribution
will be accepted unless it is in cash, and</text>
</subparagraph><subparagraph id="HAC45AEB6E1CD4234BE36383B3C3CDCCE"><enum>(B)</enum><text>contributions will
not be accepted for the calendar year in excess of the contribution limit
specified in subsection (c)(1).</text>
</subparagraph></paragraph><paragraph id="H62A241F5EB8944209138E74F91793113"><enum>(2)</enum><text>The trustee is a
bank (as defined in section 408(n)), an insurance company (as defined in
section 816), or another person who demonstrates to the satisfaction of the
Secretary that the manner in which that person will administer the trust will
be consistent with the requirements of this section or who has so demonstrated
with respect to any individual retirement plan.</text>
</paragraph><paragraph id="H23DC91E5D21C4745BDAD084BA11758D8"><enum>(3)</enum><text>No part of the
trust assets will be invested in life insurance contracts.</text>
</paragraph><paragraph id="H6927F5894E4848449918BD0500334603"><enum>(4)</enum><text>The interest of an
individual in the balance of his account is nonforfeitable.</text>
</paragraph><paragraph id="HCF7F73C5AD0B4677957BED675BF3CEEB"><enum>(5)</enum><text>The assets of the
trust shall not be commingled with other property except in a common trust fund
or common investment fund.</text>
</paragraph><paragraph id="id39A7DAE887F244D1818923F832C7E6BC"><enum>(6)</enum><text>Except as
provided in subsection (e)(2), no distribution will be allowed if at the time
of such distribution the designated beneficiary is not a chronically ill
individual (as defined in section 7702B(c)(2)).</text>
</paragraph></subsection><subsection id="H44F24D32A94048E8A8A37E75E770C8A3"><enum>(c)</enum><header>Tax treatment of
contributions</header>
<paragraph id="HDFD289FDD8FB4201A8FF9843B413F408"><enum>(1)</enum><header>Contribution
limit</header>
<subparagraph id="idCB65AB4B86A54D518C224D80E7490E37"><enum>(A)</enum><header>In
general</header><text>The aggregate amount of contributions (other than
qualified rollover contributions described in subsection (d)) for any taxable
year to all Long-Term Care Trust Accounts maintained for the benefit of the
designated beneficiary shall not exceed $5,000.</text>
</subparagraph><subparagraph id="idCCA3C35D7FBC4FCD8CC59E2A6D1E6410"><enum>(B)</enum><header>Inflation
adjustment</header><text>In the case of any taxable year beginning in a
calendar year after 2006, the dollar amount under subparagraph (A) shall be
increased by an amount equal to—</text>
<clause id="id8198F730A6384402A4D2224083694DB1"><enum>(i)</enum><text>such dollar
amount, multiplied by</text>
</clause><clause id="id0122B4E181444215A21D9C25A96446D0"><enum>(ii)</enum><text>the medical care
cost adjustment determined under section 213(d)(10)(B)(ii) for the calendar
year in which the taxable year begins, determined by substituting
<quote>2005</quote> for <quote>1996</quote> in subclause (II) thereof.</text>
</clause><continuation-text continuation-text-level="subparagraph">If any
amount as adjusted under the preceding sentence is not a multiple of $10, such
amount shall be rounded to the next lowest multiple of $10.</continuation-text></subparagraph></paragraph><paragraph id="ID1e13bd1f4a4f4b679ab3393d1a117a47"><enum>(2)</enum><header>Gift tax
treatment of contributions</header><text>For purposes of chapters 12 and
13—</text>
<subparagraph id="IDfda64e5ae93b4d58afc9a25888f9ee21"><enum>(A)</enum><header>In
general</header><text>Any contribution to a Long-Term Care Trust Account on
behalf of any designated beneficiary—</text>
<clause id="ID2e207d10986049aa919039098f09f9c6"><enum>(i)</enum><text>shall be treated
as a completed gift to such beneficiary which is not a future interest in
property, and</text>
</clause><clause id="IDbc8ac62216d74779a2074a8f4260e8ef"><enum>(ii)</enum><text>shall not be
treated as a qualified transfer under section 2503(e).</text>
</clause></subparagraph><subparagraph id="IDcc581b4abe2f4daf9da67bf7464098df"><enum>(B)</enum><header>Treatment of
excess contributions</header><text>If the aggregate amount of contributions
described in subparagraph (A) during the calendar year by a donor exceeds the
limitation for such year under section 2503(b), such aggregate amount shall, at
the election of the donor, be taken into account for purposes of such section
ratably over the 5-year period beginning with such calendar year.</text>
</subparagraph></paragraph></subsection><subsection id="HB5D09CAE659B41E6B177BBAF5FB8D"><enum>(d)</enum><header>Qualified rollover
contribution</header><text>For purposes of this section, the term
<term>qualified rollover contribution</term> means a contribution to a
Long-Term Care Trust Account—</text>
<paragraph id="HF228375DCC8F471E94CFFC3204D975D2"><enum>(1)</enum><text>from another such
account of the same beneficiary, but only if such amount is contributed not
later than the 60th day after the distribution from such other account,
and</text>
</paragraph><paragraph id="H9313C13AC5EA47CEAACAF5AA45468CDF"><enum>(2)</enum><text>from a Long-Term
Care Trust Account of a spouse of the beneficiary of the account to which the
contribution is made, but only if such amount is contributed not later than the
60th day after the distribution from such other account.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idC9005ACC4AB74E96AB6852A9B6E2AB35"><enum>(e)</enum><header>Tax treatment
of distributions</header>
<paragraph id="ID6411ea68082744e7931e4069b4548b44"><enum>(1)</enum><header>In
general</header><text>Any distribution from a Long-Term Care Trust Account
shall be includible in the gross income of the distributee in the manner as
provided under section 72 to the extent not excluded from gross income under
any other provision of this subsection.</text>
</paragraph><paragraph id="idDA28ADDBDE6B48C5A0EA7179879B8B26"><enum>(2)</enum><header>Long-term care
insurance premiums</header><text>If at the time of any distribution, the
designated beneficiary is not a chronically ill individual (as defined in
section 7702B(c)(2)), no amount shall be includible in gross income under
paragraph (1) if the aggregate premiums for any qualified long-term care
insurance contract for such beneficiary during the taxable year are not less
than the aggregate distributions during the taxable year.</text>
</paragraph><paragraph id="IDf5732c68c5c645cab978c6bb780dbc0c"><enum>(3)</enum><header>Distributions
for qualified long-term care services</header><text>For purposes of this
subsection, if at the time of any distribution, the designated beneficiary is a
chronically ill individual (as so defined)—</text>
<subparagraph id="ID8636897289bf495a84a37a92d06acc18"><enum>(A)</enum><header>In-kind
distributions</header><text>No amount shall be includible in gross income under
paragraph (1) by reason of a distribution which consists of providing a benefit
to the distributee which, if paid for by the distributee, would constitute
expenses for any qualified long-term care services (as defined in section
7702B(c)).</text>
</subparagraph><subparagraph id="IDc67e7724713e4e89bf013841fa5c5561"><enum>(B)</enum><header>Cash
distributions</header><text>In the case of distributions not described in
subparagraph (A), if—</text>
<clause id="ID5b75bd9c6e3f40e9b0799e4c723e1249"><enum>(i)</enum><text>such
distributions do not exceed the expenses for qualified long-term care services
(as so defined), reduced by expenses described in subparagraph (A), no amount
shall be includible in gross income, and</text>
</clause><clause id="IDf70bb34a9b644230b9f8a9530c08b62a"><enum>(ii)</enum><text>in any other
case, the amount otherwise includible in gross income shall be reduced by an
amount which bears the same ratio to such amount as such expenses bear to such
distributions.</text>
</clause></subparagraph></paragraph><paragraph id="ID3e0e3d7846d64d8dbbde3e49e10db1f2"><enum>(4)</enum><header>Change in
beneficiaries or accounts</header><text>Paragraph (1) shall not apply to that
portion of any distribution which, within 60 days of such distribution, is
transferred—</text>
<subparagraph id="ID944bf67c00bf430490cbacbfcb4c0574"><enum>(A)</enum><text>to another
Long-Term Care Trust Account for the benefit of the designated beneficiary,
or</text>
</subparagraph><subparagraph id="IDce3e4da8153a4070924d0f917a303a2c"><enum>(B)</enum><text>to the credit of
another designated beneficiary under a Long-Term Care Trust Account who is a
spouse of the designated beneficiary with respect to which the distribution was
made.</text>
</subparagraph></paragraph><paragraph id="IDd5f825ab971a4b9ab4ba935adb73a57a"><enum>(5)</enum><header>Operating
rules</header><text>For purposes of applying section 72—</text>
<subparagraph id="IDb1751b87c5c34142a9f5c1486933eabd"><enum>(A)</enum><text>to the extent
provided by the Secretary, all Long-Term Care Trust Accounts of which an
individual is a designated beneficiary shall be treated as one account,</text>
</subparagraph><subparagraph id="ID4e911c1a3ff44a129a4dcc7dfc9d38ac"><enum>(B)</enum><text>except to the
extent provided by the Secretary, all distributions during a taxable year shall
be treated as one distribution, and</text>
</subparagraph><subparagraph id="ID0dde9e1cc2ce40138d8ae98766c3e9ba"><enum>(C)</enum><text>except to the
extent provided by the Secretary, the value of the contract, income on the
contract, and investment in the contract shall be computed as of the close of
the calendar year in which the taxable year begins.</text>
</subparagraph></paragraph><paragraph id="idA9423F916AC243EFB57DACB7109823B0"><enum>(6)</enum><header>Special rules
for death and divorce</header>
<subparagraph id="ID1e52ab850fe948ba8ace63cb0ceca207"><enum>(A)</enum><header>In
general</header><text>Rules similar to the rules of paragraphs (7) and (8) of
section 220(f) shall apply.</text>
</subparagraph><subparagraph id="ID6dcc343e42134eb089160fdeb811d2aa"><enum>(B)</enum><header>Amounts
includible in estate of donor making excess contributions</header><text>In the
case of a donor who makes the election described in subsection (c)(2)(B) and
who dies before the close of the 5-year period referred to in such subsection,
the gross estate of the donor shall include the portion of such contributions
properly allocable to periods after the date of death of the donor.</text>
</subparagraph></paragraph><paragraph id="ID785fa2ee2ad64a53b6dd01dd97333b1e"><enum>(7)</enum><header>Additional
tax</header><text>The tax imposed by this chapter for any taxable year on any
taxpayer who receives a payment or distribution from a Long-Term Care Trust
Account which is includible in gross income shall be increased by 25 percent of
the amount which is so includible under rules similar to the rules of section
530(d)(4).</text>
</paragraph><paragraph id="id327EF1A77AAA44EA92D1CBA7A77DC51E"><enum>(8)</enum><header>Denial of
double benefit</header><text>For purposes of determining the amount of any
deduction under this chapter, any payment or distribution out of a Long-Term
Care Trust Account shall not be treated as an expense paid for medical
care.</text>
</paragraph></subsection><subsection id="ID09a002d138ff440cadd0b9dd34912c41"><enum>(f)</enum><header>Designated
beneficiary</header><text>For purposes of this section, the term
<term>designated beneficiary</term> means the individual designated at the
commencement of participation in the Long-Term Care Trust Account as the
beneficiary of amounts paid (or to be paid) to the account.</text>
</subsection><subsection id="H82BE570A69AC49ACB092872BB600B06D"><enum>(g)</enum><header>Loss of taxation
exemption of account where beneficiary engages in prohibited
transaction</header><text>Rules similar to the rules of paragraph (2) of
section 408(e) shall apply to any Long-Term Care Trust Account.</text>
</subsection><subsection id="H649F0AA974B54D859645781870A57C4C"><enum>(h)</enum><header>Custodial
accounts</header><text>For purposes of this section, a custodial account or an
annuity contract issued by an insurance company qualified to do business in a
State shall be treated as a trust under this section if—</text>
<paragraph id="H480F14CF0D6A4D9FB03F2666CB007816"><enum>(1)</enum><text>the custodial
account or annuity contract would, except for the fact that it is not a trust,
constitute a trust which meets the requirements of subsection (b), and</text>
</paragraph><paragraph id="HFDDA7F7293234B9D96B546408900FC7D"><enum>(2)</enum><text>in the case of a
custodial account, the assets of such account are held by a bank (as defined in
section 408(n)) or another person who demonstrates, to the satisfaction of the
Secretary, that the manner in which he will administer the account will be
consistent with the requirements of this section.</text>
</paragraph><continuation-text continuation-text-level="subsection">For
purposes of this title, in the case of a custodial account or annuity contract
treated as a trust by reason of the preceding sentence, the person holding the
assets of such account or holding such annuity contract shall be treated as the
trustee thereof.</continuation-text></subsection><subsection id="HA40AE552EC0F4258988F01497E63353D"><enum>(i)</enum><header>Reports</header><text>The
trustee of a Long-Term Care Trust Account shall make such reports regarding
such account to the Secretary and to the beneficiary of the account with
respect to contributions, distributions, and such other matters as the
Secretary may require. The reports required by this subsection shall be filed
at such time and in such manner and furnished to such individuals at such time
and in such manner as may be
required.</text>
</subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HC6D80C926FD648A8BE9CE26C7F003DFC"><enum>(b)</enum><header>Tax on excess
contributions</header>
<paragraph id="H2054213435BC4AD085D57E5F34590428"><enum>(1)</enum><header>In
general</header><text>Subsection (a) of section 4973 of the Internal Revenue
Code of 1986 (relating to tax on excess contributions to certain tax-favored
accounts and annuities) is amended by striking <quote>or</quote> at the end of
paragraph (4), by inserting <quote>or</quote> at the end of paragraph (5), and
by inserting after paragraph (5) the following new paragraph:</text>
<quoted-block id="HD032DCB7016A40B0A5F0F21631CB356B">
<paragraph id="HCFCD26FFEA1F45718507006F2676CCA6"><enum>(6)</enum><text>a Long-Term Care
Trust Account (as defined in section
530A),</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H96A200FC73FC42FCB242E88EB323763F"><enum>(2)</enum><header>Excess
contribution</header><text>Section 4973 of such Code is amended by adding at
the end the following new subsection:</text>
<quoted-block id="H31A583370C0145438D2FE600CF1DE945">
<subsection id="H260D95624FC44E90824F0092C0A7E647"><enum>(h)</enum><header>Excess
contributions to Long-Term Care Trust Accounts</header><text>For purposes of
this section—</text>
<paragraph id="H3CE51121D5B94AA5BE305125D4205E51"><enum>(1)</enum><header>In
general</header><text>In the case of Long-Term Care Trust Accounts (within the
meaning of section 530A), the term <term>excess contributions</term> means the
sum of—</text>
<subparagraph id="H1B9CC3C8F6E2422B930000BCEBC48043"><enum>(A)</enum><text>the amount by
which the amount contributed for the calendar year to such accounts (other than
qualified rollover contributions (as defined in section 530A(d))) exceeds the
contribution limit under section 530A(c)(1), and</text>
</subparagraph><subparagraph id="HFFC86D6BA384417580006077A5D94CB8"><enum>(B)</enum><text>the amount
determined under this subsection for the preceding calendar year, reduced by
the excess (if any) of the maximum amount allowable as a contribution under
section 530A(c)(1) for the calendar year over the amount contributed to the
accounts for the calendar year.</text>
</subparagraph></paragraph><paragraph id="H0AA5F8E36891470F8C85ECE8CD4D759E"><enum>(2)</enum><header>Special
rule</header><text>A contribution shall not be taken into account under
paragraph (1) if such contribution (together with the amount of net income
attributable to such contribution) is returned to the beneficiary before June 1
of the year following the year in which the contribution is
made.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H40CEE3F03D1A4F35B7786B84834061E2"><enum>(c)</enum><header>Failure To
provide reports on Long-Term Care Trust Accounts</header><text>Paragraph (2) of
section 6693(a) of the Internal Revenue Code of 1986 (relating to failure to
provide reports on individual retirement accounts or annuities) is amended by
striking <quote>and</quote> at the end of subparagraph (D), by striking the
period at the end of subparagraph (E) and inserting <quote>, and</quote>, and
by adding at the end the following new subparagraph:</text>
<quoted-block id="H2EC8554FA2964DD48EA128AFA3662E91">
<subparagraph id="HB4EABDE120AF48378C60F0B575E2F75"><enum>(F)</enum><text>section 530A(i)
(relating to Long-Term Care Trust
Accounts).</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HA6402D84DD834F068CA053BDD8B200F7"><enum>(d)</enum><header>Conforming
amendment</header><text>The table of parts for subchapter F of chapter 1 of the
Internal Revenue Code of 1986 is amended by adding at the end the following new
item:</text>
<quoted-block id="HB13E153EE10B43579E5D8FA85D6FA17B" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="part">Part IX. Long-Term Care Trust
Accounts</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H9870A41BEF6E434894F283B6ED4FAB3"><enum>(e)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2005.</text>
</subsection></section><section id="H0DD2A74AB8F34DFCBABCB2DB917D9783" section-type="subsequent-section"><enum>304.</enum><header>Refundable credit
for contributions to Long-Term Care Trust Accounts</header>
<subsection id="H4A3EC960F1D446F18D1C44D9C79087D3"><enum>(a)</enum><header>In
general</header><text>Subpart C of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to refundable credits) is amended by
inserting after section 35 the following new section:</text>
<quoted-block display-inline="no-display-inline" id="idD03E3DE668654142B00158BA0C5C4EF8" style="OLC">
<section id="H39DF7428B39A4FBD006E3186CEEAFBFF"><enum>35A.</enum><header>Contributions
to Long-Term Care Trust Accounts</header>
<subsection id="ID3B66E7F691E244EA93E863A9F5F3B0E3"><enum>(a)</enum><header>General
rule</header><text>In the case of an individual, there shall be allowed as a
credit against the tax imposed by this subtitle for the taxable year an amount
equal to 10 percent of the contributions to any Long-Term Care Trust Account
allowed under section 530A for such taxable year.</text>
</subsection><subsection id="id86254C6E944548DA9AF0056FD55CD920"><enum>(b)</enum><header>Reduction based
on adjusted gross income</header>
<paragraph id="id915A321385A44EFFBFF0FF0B063F1FFF"><enum>(1)</enum><header>In
general</header><text>The percentage which would (but for this subsection) be
taken into account under subsection (a) for the taxable year shall be reduced
(but not below zero) by the percentage determined under paragraph (2).</text>
</paragraph><paragraph id="id192A531BC3074CDBAD83A09E399449F1"><enum>(2)</enum><header>Amount of
reduction</header><text>The percentage determined under this paragraph is the
percentage which bears the same ratio to the percentage which would be so taken
into account as—</text>
<subparagraph id="id9612891DC93F41ED8451197783B67905"><enum>(A)</enum><text>the excess
of—</text>
<clause id="id0877DD9D8BC74A0889B4C1FEBED5672A"><enum>(i)</enum><text>the taxpayer's
adjusted gross income for such taxable year, over</text>
</clause><clause id="idB22FEA187BF24133A0BCF4845C9EFB11"><enum>(ii)</enum><text>$95,000
($190,000 in the case of a joint return), bears to</text>
</clause></subparagraph><subparagraph id="id3A24C9F58E0D479FADCCCBB37317973C"><enum>(B)</enum><text>$10,000 ($20,000
in the case of a joint return).</text>
</subparagraph></paragraph><paragraph id="idAE6F9E1E901E490CB10D59AAC9C0FBC3"><enum>(3)</enum><header>Adjusted gross
income</header><text>For purposes of this subsection, adjusted gross income
shall be determined without regard to sections 911, 931, and 933.</text>
</paragraph></subsection><subsection id="HB67A289CE75B4764A22D9FA4A867FA5"><enum>(c)</enum><header>Denial of double
benefit</header><text display-inline="yes-display-inline">No deduction shall be
allowed under this chapter for any amount taken into account in determining the
credit under this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="IDD2E46A74F7C041F9B5B0454186D9C202"><enum>(b)</enum><header>Conforming
amendments</header>
<paragraph commented="no" display-inline="no-display-inline" id="ID83AEE40534414249B157B480786C412C"><enum>(1)</enum><text>Paragraph (2) of
section 1324(b) of title 31, United States Code, is amended by inserting before
the period <quote>, or from section 35A of such Code</quote>.</text>
</paragraph><paragraph id="H1C7F39A468CD4182B27F92AFCDDB772"><enum>(2)</enum><text>The table of
sections of subpart C of part IV of subchapter A of chapter 1 of the Internal
Revenue Code of 1986 is amended by inserting after the item relating to section
35 the following new item:</text>
<quoted-block display-inline="no-display-inline" id="H9D04497958D84AA794D95FFBAA1BA45" style="OLC">
<toc container-level="quoted-block-container" lowest-bolded-level="division-lowest-bolded" lowest-level="section" quoted-block="no-quoted-block" regeneration="yes-regeneration">
<toc-entry idref="H39DF7428B39A4FBD006E3186CEEAFBFF" level="section">Sec. 35A. Contributions to Long-Term Care Trust
Accounts.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HBD19BBACE23B4E56BF3DED3B3C62C200"><enum>(c)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to amounts
paid or incurred in taxable years beginning after December 31, 2005.</text>
</subsection></section><enum>IV</enum><header>Disaster
preparedness and response</header>
<section id="idCF58521CD7274DF09C60E701865B30FD"><enum>401.</enum><header>Disaster
preparedness and response</header>
<subsection id="idFAFCE3A544AB4D28A683D0BD9BB942A5"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 406(a) of the
Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C.
5172(a)) is amended—</text>
<paragraph id="id57FECC65656843A9B1818E4A14BAE2A6"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1)—</text>
<subparagraph id="id9AA2AB592B1A430EAADE25D743B7F093"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (A), by striking
<quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="idA29A1CAEDFE24C7BB5F8BB371B46F8C4"><enum>(B)</enum><text>in subparagraph
(B), by striking the period and inserting <quote>; and</quote>; and</text>
</subparagraph><subparagraph id="idCCDC4A1A8BBB46A388DB3AEA581C274A"><enum>(C)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="idCC7AE37BF0134CC8853A36ED1E5B9CBF" style="OLC">
<subparagraph id="idA8F4DFCBE78A4CC68F6F0F6424E06343"><enum>(C)</enum><text>subject to
paragraph (5), to a person that owns or operates a long-term care facility
damaged or destroyed by a major disaster for the repair, restoration,
reconstruction, or replacement of the facility and for associated expenses
incurred by the person.</text>
</subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="idA143C84A93C941EBBEF64641AA2F6D59"><enum>(2)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="id33D860D198BE4D1EBC7B890BF9035296" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="ID0FFDA98D1269420D86C137A7B1070843"><enum>(5)</enum><header>Conditions for
assistance to long-term care facilities</header><text>The President may make
contributions to a long-term care facility under paragraph (1)(C) only if the
owner or operator of the facility—</text>
<subparagraph id="ID90B7D3DB44B64426A086907357B5193D"><enum>(A)</enum><text>has applied for a
disaster loan under section 7(b) of the Small Business Act (15 U.S.C. 636(b));
and</text>
</subparagraph><subparagraph id="ID71F858498CDB43FA9912BEBCA05BFC96"><enum>(B)</enum><text>either—</text>
<clause id="idD8E39AAAE09841E68CAE2FA646148CD8"><enum>(i)</enum><text>has been
determined to be ineligible for such a loan; or</text>
</clause><clause id="IDBC6ECCEB91B5426BAC57C6AA17E362F5"><enum>(ii)</enum><text>has obtained
such a loan in the maximum amount for which the Small Business Administration
determines the facility is
eligible.</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="id49AD21BF9ACC4A94B737DC9D2E4CC6C9"><enum>(b)</enum><header>Definition</header><text>Section
102 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42
U.S.C. 5122) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="id3EBD7341EA9C4751A5C3F53F0F7E2CED" style="OLC">
<paragraph id="id51BB69B3FE77455F9054C694FCFC2CA5"><enum>(10)</enum><header>Long-term care
facility</header><text>The term <term>long-term care facility</term> means the
following facilities or providers which receive payment for services under
title XVIII or XIX of the Social Security Act:</text>
<subparagraph id="id0A5D7C9204074474A4AD6A7D584B8A61"><enum>(A)</enum><text>A skilled nursing
facility (as defined in section 1819(a) of the Social Security Act (42 U.S.C.
1395i–3(a))).</text>
</subparagraph><subparagraph id="id4E7CAB5CF4B142339F164044C5A4DB21"><enum>(B)</enum><text>A nursing
facility (as defined in section 1919(a) of the Social Security Act (42 U.S.C.
1396r(a))).</text>
</subparagraph><subparagraph id="id7B1D1614E1D549209E303C9E3E8FD933"><enum>(C)</enum><text>A home health
agency (as defined in section 1861(o) of the Social Security Act (42 U.S.C.
1395x(o))).</text>
</subparagraph><subparagraph id="id1B79BB4466BF4891A166049A93080DC8"><enum>(D)</enum><text>A provider of
hospice care (as defined in section 1861(dd)(1) of the Social Security Act (42
U.S.C. 1395x(dd)(1))).</text>
</subparagraph><subparagraph id="id217073D86C334450A512F643AB34DB7A"><enum>(E)</enum><text>A long-term care
hospital (as described in section 1886(d)(1)(B)(iv) of the Social Security Act
(42 U.S.C. 1395ww(d)(1)(B)(iv))).</text>
</subparagraph><subparagraph id="idEF3AD83B47FE4753A40000912519BBD7"><enum>(F)</enum><text>A provider of
personal care services.</text>
</subparagraph><subparagraph id="id3A25963A78DE4F3EBCAD1A443C2662C8"><enum>(G)</enum><text>A residential
care provider that arranges for, or directly provides, long-term care
services.</text>
</subparagraph><subparagraph id="id30745775AAA84906A53B0F9E9A90BC62"><enum>(H)</enum><text>An intermediate
care facility for the mentally retarded (as defined in section 1905(d) of the
Social Security Act (42 U.S.C. 1396d(d))).</text>
</subparagraph><subparagraph id="idBC332AB115844B74A9FD6808EB75415B"><enum>(I)</enum><text>An assisted
living facility or a resident care program facility (as defined by the
Secretary of Health and Human Services).</text>
</subparagraph><subparagraph id="idC489178EF30A47E6BBB4A5A9CF11D0B8"><enum>(J)</enum><text>A board and care
facility (as defined in section 1903(q)(4)(B) of the Social Security Act (42
U.S.C. 1396b(q)(4)(B))).</text>
</subparagraph><subparagraph id="idBF1394B958374E6CA97A3964B6B488F9"><enum>(K)</enum><text>Any other
licensed facility determined appropriate by the Secretary of Health and Human
Services, including a psychiatric health facility, a mental health
rehabilitation center, and a mental retardation developmental disability
facility.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section>