[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4082 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 4082

       To improve the quality of, and access to, long-term care.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 6, 2007

 Mr. Pomeroy (for himself, Mrs. Capito, and Mr. Allen) introduced the 
   following bill; which was referred to the Committee on Energy and 
  Commerce, and in addition to the Committee on Ways and Means, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
       To improve the quality of, and access to, long-term care.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Long-term Care 
Quality and Modernization Act of 2007''.
    (b) Table of Contents.--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. Demonstration program for joint training of surveyors and 
                            providers in nursing facilities.
Sec. 102. Resumption of nurse aide training program after correction of 
                            deficiencies.
Sec. 103. 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. 104. Exclusion of all ambulance services from the Medicare 
                            prospective payment system for skilled 
                            nursing facilities.
Sec. 105. Authority to exclude additional items and services from the 
                            Medicare prospective payment system for 
                            skilled nursing facilities.
Sec. 106. Payment for blood glucose tests administered as part of a 
                            physician, nurse practitioner, or clinical 
                            nurse specialist prescribed protocol of 
                            blood glucose monitoring.
Sec. 107. Counting of observation days for purposes of applying the 
                            Medicare post-hospital requirement for 
                            coverage of skilled nursing facility care.
Sec. 108. Payment for therapy services.
Sec. 109. Expansion of telehealth services to skilled nursing 
                            facilities.
Sec. 110. Physical therapy grant program.
Sec. 111. Long-Term Care Quality Advisory Commission and demonstration 
                            projects.
                      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. 15-year recovery period for qualified long-term care 
                            improvement property.

              TITLE I--MEDICARE AND MEDICAID MODERNIZATION

SEC. 101. DEMONSTRATION PROGRAM FOR JOINT TRAINING OF SURVEYORS AND 
              PROVIDERS IN NURSING FACILITIES.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall conduct a 
demonstration program under which the Secretary, under sections 1819(e) 
and 1919(e) of the Social Security Act (42 U.S.C. 1395i-3(e), 
1396r(e)), shall require a State to establish a process for joint 
training and education of surveyors and providers for skilled nursing 
facilities and nursing facilities 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.
    (b) Demonstration States.--The demonstration program under this 
section shall be conducted in 5 States. In selecting the States in 
which to conduct the demonstration program, the Secretary shall ensure 
that the States vary in geographic location and include States with 
high levels of deficiencies as well as States with low levels of 
deficiencies.
    (c) Duration.--The Secretary shall conduct the demonstration 
program under this section for a 2-year period.
    (d) Waiver Authority.--The Secretary may waiver such requirements 
of titles XI, XVIII, and XIX of the Social Security Act as may be 
necessary for purposes of carrying out the demonstration program under 
this section.
    (e) Report.--
            (1) In general.--Not later than 6 months after the 
        completion of the demonstration program under this section, the 
        Secretary shall submit a report to Congress on the project.
            (2) Requirements.--The report submitted under paragraph (1) 
        shall include--
                    (A) the results of the demonstration program as 
                they relate to the rate and type of deficiencies in 
                skilled nursing facilities and nursing facilities in 
                the States selected under subsection (b) compared to 
                those States not so selected;
                    (B) an evaluation of added efficiencies or 
                deficiencies in care for patients in skilled nursing 
                facilities and nursing facilities that directly 
                resulted from the demonstration program; and
                    (C) recommendations for such legislation and 
                administrative action as the Secretary determines 
                appropriate.
        The results and evaluation under subparagraphs (A) and (B) 
        shall include an examination of the current baseline.

SEC. 102. RESUMPTION OF NURSE AIDE TRAINING PROGRAM AFTER CORRECTION OF 
              DEFICIENCIES.

    (a) Resumption of Nurse Aide Training Program for Skilled Nursing 
Facilities.--Section 1819(f)(2) of the Social Security Act (42 U.S.C. 
1395i-3(f)(2)) is amended--
            (1) in subparagraph (B)(iii), in the matter preceding 
        subclause (I), by striking ``(C) and (D)'' and inserting ``(C), 
        (D), and (E)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(E) Resumption of nurse aide training program 
                after correction of deficiencies.--Clause (iii)(I) of 
                subparagraph (B) shall not apply to a program offered 
                by or in a skilled nursing facility if the facility 
                has--
                            ``(i) corrected any deficiencies that 
                        resulted in the prohibition of approval of such 
                        program; and
                            ``(ii) demonstrated compliance with the 
                        requirements of subsections (b), (c), and (d) 
                        of this section.''.
    (b) Resumption of Nurse Aide Training Program for Nursing 
Facilities.--Section 1919(f)(2) of the Social Security Act (42 U.S.C. 
1396r(f)(2)) is amended--
            (1) in subparagraph (B)(iii), in the matter preceding 
        subclause (I), by striking ``(C) and (D)'' and inserting ``(C), 
        (D), and (E)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(E) Resumption of nurse aide training program 
                after correction of deficiencies.--Clause (iii)(I) of 
                subparagraph (B) shall not apply to a program offered 
                by or in a nursing facility if the facility has--
                            ``(i) corrected any deficiencies that 
                        resulted in the prohibition of approval of such 
                        program; and
                            ``(ii) demonstrated compliance with the 
                        requirements of subsections (b), (c), and (d) 
                        of this section.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on January 1, 2008.

SEC. 103. 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.

    (a) In General.--Section 1888(e)(2)(A)(iii) of the Social Security 
Act (42 U.S.C. 1395yy(e)(2)(A)(iii)) is amended--
            (1) by redesignating subclauses (IV) and (V) as subclauses 
        (V) and (VI), respectively; and
            (2) by inserting after subclause (III) the following new 
        subclause:
                                    ``(IV) 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.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to drugs furnished on or after October 1, 2008.

SEC. 104. EXCLUSION OF ALL AMBULANCE SERVICES FROM THE MEDICARE 
              PROSPECTIVE PAYMENT SYSTEM FOR SKILLED NURSING 
              FACILITIES.

    (a) In General.--Section 1888(e)(2)(A)(iii)(I) of the Social 
Security Act (42 U.S.C. 1395yy(e)(2)(A)(iii)(I)) is amended by striking 
``furnished to'' and all that follows before the period.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to services furnished on or after October 1, 2008.

SEC. 105. AUTHORITY TO EXCLUDE ADDITIONAL ITEMS AND SERVICES FROM THE 
              MEDICARE PROSPECTIVE PAYMENT SYSTEM FOR SKILLED NURSING 
              FACILITIES.

    (a) Authority.--Section 1888(e)(2)(A) of the Social Security Act 
(42 U.S.C. 1395yy(e)(2)(A)) is amended--
            (1) in clause (i)(II), by striking ``and (iv)'' and 
        inserting ``(iv), and (v)(I)''; and
            (2) by adding at the end the following new clause:
                            ``(v) Exclusion of additional items and 
                        services determined appropriate by the 
                        secretary.--
                                    ``(I) In general.--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.
                                    ``(II) Annual update.--The 
                                Secretary shall annually update the 
                                items and services described in 
                                subclause (I) to take into account 
                                changes in the practice of medicine.''.
    (b) Clarification.--Items and services described in section 
1888(e)(2)(A)(v)(I) of the Social Security Act (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.
    (c) Effective Date.--The amendment made by subsection (a) shall 
take effect on October 1, 2008.

SEC. 106. PAYMENT FOR BLOOD GLUCOSE TESTS ADMINISTERED AS PART OF A 
              PHYSICIAN, NURSE PRACTITIONER, OR CLINICAL NURSE 
              SPECIALIST PRESCRIBED PROTOCOL OF BLOOD GLUCOSE 
              MONITORING.

    Section 1835(a) of the Social Security Act (42 U.S.C. 1395n(a)) is 
amended--
            (1) in paragraph (2), in the matter preceding subparagraph 
        (A), by inserting ``, or, as provided in the last 2 sentences 
        of this subsection with respect to blood glucose tests, a 
        physician, a nurse practitioner, or a clinical nurse 
        specialist,'' after ``physician''; and
            (2) by adding at the end the following new sentences: 
        ``With respect to paragraph (2)(B), a physician, or a nurse 
        practitioner or a clinical nurse specialist in accordance with 
        State law, may certify that a prescribed series of blood 
        glucose tests, furnished over a specified and limited period of 
        time to monitor an individual's blood glucose levels, are 
        medically required. For purposes of the preceding sentence, 
        neither a physician's, a nurse practitioner's, or a clinical 
        nurse specialist's order for a prescribed series of blood 
        glucose tests nor a physician's, a nurse practitioner's, or a 
        clinical nurse specialist's certification that such tests are 
        medically required constitutes a standing order.''.

SEC. 107. COUNTING OF OBSERVATION DAYS FOR PURPOSES OF APPLYING THE 
              MEDICARE POST-HOSPITAL REQUIREMENT FOR COVERAGE OF 
              SKILLED NURSING FACILITY CARE.

    (a) In General.--Section 1861(i) of the Social Security Act (42 
U.S.C. 1395x(i)) is amended by adding at the end the following: ``For 
purposes of this subsection, an individual shall be treated as an 
inpatient of a hospital for a day if the individual is staying as an 
inpatient in the hospital overnight for observation for that day.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to observation days occurring on or after the first day of the 
month beginning more than 60 days after the date of the enactment of 
this Act.

SEC. 108. PAYMENT FOR THERAPY SERVICES.

    (a) Extension of Exceptions Process for Medicare Therapy Caps.--
Section 1833(g)(5) of the Social Security Act (42 U.S.C. 1395l(g)(5)), 
as amended by section 201 of the Medicare Improvements and Extension 
Act of 2006 (division B of Public Law 109-432), is amended by striking 
``2007'' and inserting ``2009''.
    (b) Study and Report.--
            (1) Study.--The Secretary of Health and Human Services, in 
        consultation with appropriate stakeholders, including the 
        national professional associations representing long-term care 
        providers and each therapy discipline (including physical 
        therapy, speech-language pathology, and occupational therapy), 
        shall conduct a study or studies to develop utilization 
        management alternatives to the Medicare payment cap under 
        section 1833(g) of the Social Security Act (42 U.S.C. 1395l(g)) 
        for physical therapy services and speech-language pathology 
        services, described in paragraph (1) of such section and 
        occupational therapy services described in paragraph (3) of 
        such section.
            (2) Considerations.--Such study or studies shall--
                    (A) identify, test, and utilize standardized 
                patient assessment instruments that can collect general 
                and discipline-specific data elements, including 
                rehabilitation diagnosis, age, illness, caregiver 
                support, setting, co-morbidities, and functional 
                status;
                    (B) assure that assessment instruments are 
                compatible with a uniform electronic health record to 
                collect the data and keep discipline-specific data; and
                    (C) utilize such assessment instruments and 
                resulting data to develop a utilization management 
                system that--
                            (i) assures appropriate access to medically 
                        necessary services;
                            (ii) employs the use of practice 
                        guidelines,
                            (iii) outcomes tracking and other 
                        appropriate quality measurement mechanisms;
                            (iv) includes, with respect to Medicare 
                        reimbursement for outpatient therapy services, 
                        the development of the systems described in 
                        paragraph (3); and
                            (v) applies the extension and the 
                        refinement of an exceptions process and other 
                        methods of utilization control, such as the 
                        creation of multiple payment classifications 
                        based on the clinical diagnosis (including 
                        comorbidities), setting, rehabilitation 
                        potential, functional status and other patient 
                        characteristics; and
                    (D) include a variety of geographic sites and 
                practice settings, including all settings or facilities 
                in which the therapy disciplines furnish services under 
                part B of the Medicare program.
            (3) Systems.--The systems described in this paragraph are 
        the following:
                    (A) A utilization management system based on 
                classifying the individual beneficiary's need for 
                therapy.
                    (B) A prospective payment system, including an 
                episode-based utilization management system, for 
                services described in paragraph (1).
            (4) Report.--Not later than January 1, 2009, the Secretary 
        shall submit to Congress a report on the study conducted under 
        paragraph (1).

SEC. 109. EXPANSION OF TELEHEALTH SERVICES TO SKILLED NURSING 
              FACILITIES.

    (a) In General.--Section 1834(m)(4)(C)(ii) of the Social Security 
Act (42 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the end the 
following new subclause:
                                    ``(IV) A skilled nursing facility 
                                (as defined in section 1819(a)).''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to telehealth services furnished on or after January 1, 2009.

SEC. 110. PHYSICAL THERAPY GRANT PROGRAM.

    Subpart 2 of part E of title VII of the Public Health Service Act 
(42 U.S.C. 295 et seq.) is amended by inserting after section 769, the 
following:

``SEC. 769A. PHYSICAL THERAPY.

    ``(a) In General.--The Secretary may make grants to, and enter into 
contracts with, programs of physical therapy for the purpose of 
planning and implementing projects to recruit and retain faculty and 
students, develop curriculum, support the distribution of physical 
therapy practitioners in underserved areas, or support the continuing 
development of these professions.
    ``(b) Preference in Making Grants.--In making grants under 
subsection (a), the Secretary shall give preference to qualified 
applicants that seek to educate physical therapists in rural or urban 
medically underserved communities, or to expand post-professional 
programs for the advanced education of physical therapist 
practitioners.
    ``(c) Peer Review.--Each peer review group under section 799(f) 
that is reviewing proposals for grants or contracts under subsection 
(a) shall include not fewer than 2 physical therapists.
    ``(d) Report to Congress.--
            ``(1) In general.--The Secretary shall prepare a report 
        that--
                    ``(A) summarizes the applications submitted to the 
                Secretary for grants or contracts under subsection (a);
                    ``(B) specifies the identity of entities receiving 
                the grants or contracts; and
                    ``(C) evaluates the effectiveness of the program 
                based upon the objectives established by the entities 
                receiving the grants or contracts.
            ``(2) Date certain for submission.--Not later than February 
        1, 2009, the Secretary shall submit the report prepared under 
        paragraph (1) to the Committee on Energy and Commerce and the 
        Committee on Appropriations of the House of Representatives, 
        the Committee on Health, Education, Labor, and Pensions and the 
        Committee on Appropriations of the Senate.''.

SEC. 111. LONG-TERM CARE QUALITY ADVISORY COMMISSION AND DEMONSTRATION 
              PROJECTS.

    (a) Long-Term Care Quality Advisory Commission.--
            (1) Establishment.--Not later than 6 months after the date 
        of the enactment of this section, the Secretary of Health and 
        Human Services (in this section referred to as the 
        ``Secretary'') shall establish a commission to be known as the 
        Long Term Care Quality Advisory Commission (in this section 
        referred to as the ``Commission'').
            (2) Duties of commission.--
                    (A) National plan.--The Commission shall develop, 
                coordinate, and facilitate implementation of a national 
                plan for long-term care quality improvement. The 
                national plan shall--
                            (i) identify objectives for long-term care 
                        quality improvement;
                            (ii) identify strategies to eliminate known 
                        gaps in long-term care health system capacity 
                        and improve long-term care quality; and
                            (iii) provide for Federal programs to 
                        identify opportunities for strengthening and 
                        aligning policies and programs to improve long-
                        term care quality.
                    (B) Demonstration projects.--The Commission shall 
                design demonstration projects to test alternative 
                models for long-term care quality improvement, 
                including with respect to both personal and population 
                health.
                    (C) Monitoring.--The Commission shall monitor 
                progress toward the objectives identified pursuant to 
                paragraph (1)(A).
            (3) Membership.--
                    (A) Number.--The Commission shall be composed of 11 
                members appointed by the Secretary.
                    (B) Selection.--The Secretary shall select the 
                members of the Commission from among individuals with 
                significant long-term care and health care quality 
                expertise, including expertise in clinical health care, 
                health care quality research, population or public 
                health, rehabilitation care, or consumer organizations.
            (4) Contracting authority.--Subject to the availability of 
        funds, the Commission may enter into contracts and make other 
        arrangements, as may be necessary to carry out the duties 
        described in paragraph (2).
            (5) Staff.--Upon the request of the Commission, the 
        Secretary may detail, on a reimbursable basis, any of the 
        personnel of the Administration on Aging, the Agency for Health 
        Care Quality and Research, or the Centers for Medicare & 
        Medicaid Services to the Commission to assist in carrying out 
        this subsection.
            (6) Reports to congress.--Not later than 1 year after the 
        establishment of the Commission, and annually thereafter, the 
        Commission shall submit a report to the Congress on long-term 
        care quality. Each such report shall include the following:
                    (A) An inventory of relevant programs and 
                recommendations for improved coordination and 
                integration of policy and programs.
                    (B) An assessment of achievement of the objectives 
                identified in the national plan developed under 
                paragraph (2) and recommendations for realizing such 
                objectives.
                    (C) Recommendations on Federal legislation, 
                regulations, or administrative policies to enhance 
                long-term care quality and outcomes.
    (b) Long-Term Care Quality Demonstration Projects.--
            (1) In general.--Not later than 270 days after the date of 
        the enactment of this Act, the Secretary, in consultation with 
        the Administration on Aging, the Agency for Healthcare Research 
        and Quality, and the Centers for Medicare & Medicaid Services, 
        shall make grants to eligible entities for 5 demonstration 
        projects to implement and evaluate methods for improving the 
        quality of health care in long-term care settings. Each such 
        demonstration project shall include--
                    (A) alternative community models that--
                            (i) will achieve greater integration of 
                        personal and population health services; and
                            (ii) address safety, effectiveness, 
                        patient- or community-centeredness, timeliness, 
                        efficiency, and equity (the six aims identified 
                        by the Institute of Medicine of the National 
                        Academies in its report entitled ``Crossing the 
                        Quality Chasm: A New Health System for the 21st 
                        Century'' released on March 1, 2001);
                    (B) innovative approaches to the financing and 
                delivery of health services to achieve long-term care 
                quality goals; and
                    (C) development of quality improvement support 
                structures to assist long-term care systems and 
                professionals (such as workforce support structures, 
                quality monitoring and reporting, clinical care 
                protocols, and information technology applications).
            (2) Eligible entities.--In this subsection, the term 
        ``eligible entity'' means a consortium that--
                    (A) shall include--
                            (i) at least one health care provider or 
                        health care delivery system; and
                            (ii) at least one organization representing 
                        multiple community stakeholders; and
            (3) Consultation.--In developing the program for awarding 
        grants under this subsection, the Secretary shall consult with 
        the Administrator of the Agency for Healthcare Research and 
        Quality, long-term care providers, long-term care researchers, 
        and private and non-profit groups (including national 
        associations) which are undertaking similar efforts.
            (4) Expedited waivers.--The Secretary shall expedite the 
        processing of any waiver that--
                    (A) is authorized under title XVIII or XIX of the 
                Social Security Act (42 U.S.C. 1395 et seq.); and
                    (B) is necessary to carry out a demonstration 
                project under this subsection.
            (5) Demonstration project sites.--The Secretary shall 
        ensure that the 5 demonstration projects funded under this 
        subsection are conducted at a variety of sites representing the 
        diversity of geographic locations in the Nation.
            (6) Duration.--Each demonstration project under this 
        subsection shall be for a period of 4 years.
            (7) Independent evaluation.--The Secretary shall enter into 
        an arrangement with an entity that has experience working 
        directly with long-term care systems for the conduct of an 
        independent evaluation of the program carried out under this 
        subsection.
            (8) Report.--Not later than one year after the conclusion 
        of all of the demonstration projects funded under this 
        subsection, the Secretary shall submit a report to the Congress 
        on the results of such projects. The report shall include--
                    (A) an evaluation of patient access to care, 
                patient outcomes, and an analysis of the cost 
                effectiveness of each such project; and
                    (B) recommendations on Federal legislation, 
                regulations, or administrative policies to enhance 
                long-term care quality and outcomes.
    (c) Appropriation.--For the purpose of carrying out this section, 
there is authorized to be appropriated such sums as may be necessary.

                      TITLE II--WORKFORCE SUPPORT

SEC. 201. NURSING LOAN REPAYMENT PROGRAM.

    Section 846(a) of the Public Health Service Act (42 U.S.C. 297n(a)) 
is amended by striking the last sentence.

SEC. 202. NATIONAL NURSING DATABASE.

    (a) In General.--The Secretary of Health and Human Services shall 
provide for the establishment of a national nursing database (including 
geriatric nursing) to be used to predict future nursing shortages.
    (b) Information in Database.--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.
    (c) Funding.--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.

SEC. 203. REPORTS ON NURSING LEVELS.

    Section 806 of the Public Health Service Act (42 U.S.C. 296e) is 
amended by adding at the end the following:
    ``(i) Reports Concerning Nursing Levels.--
            ``(1) In general.--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 (including with respect to geriatric 
        nursing).
            ``(2) Entities described.--An entity is described in this 
        paragraph if such entity is--
                    ``(A) an entity that receives a grant or contract 
                under this title;
                    ``(B) a school of nursing that receives student 
                loan funds under this title;
                    ``(C) a school of nursing that receives nurse 
                faculty student loan funds under this title; and
                    ``(D) any other entity that receives assistance 
                under this title.''.

                       TITLE III--TAX INCENTIVES

SEC. 301. 15-YEAR RECOVERY PERIOD FOR QUALIFIED LONG-TERM CARE 
              IMPROVEMENT PROPERTY.

    (a) In General.--Subparagraph (E) of section 168(e)(3) of the 
Internal Revenue Code of 1986 (relating to 15-year property) is amended 
by striking ``and'' at the end of clause (vii), by striking the period 
at the end of clause (viii) and inserting ``, and'', and by adding at 
the end the following new clause:
                            ``(ix) any qualified long-term care 
                        improvement property.''.
    (b) Qualified Long-Term Care Improvement Property.--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:
            ``(8) Qualified long-term care improvement property.--The 
        term `qualified long-term care improvement property' means any 
        section 1250 property which is an improvement to a building 
        if--
                    ``(A) such improvement is placed in service more 
                than 3 years after the date such building was first 
                placed in service, and
                    ``(B) such building is, or is a part of, a nursing 
                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.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to property placed in service after the date of the enactment of 
this Act.
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