[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 4184 Introduced in Senate (IS)]

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116th CONGRESS
  2d Session
                                S. 4184

     To require States to meet assisted living facility reporting 
      requirements to qualify for future COVID-19 response funds.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              July 2, 2020

Ms. Warren (for herself and Mr. Markey) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
     To require States to meet assisted living facility reporting 
      requirements to qualify for future COVID-19 response funds.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Assisted Living Facility Coronavirus 
Reporting Act''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Assisted living facility.--The term ``assisted living 
        facility'' means--
                    (A) an adult care facility that--
                            (i) is licensed and regulated by the State 
                        in which the facility is located (or, if there 
                        is no State law providing for such licensing 
                        and regulation by the State, by the 
                        municipality or other political subdivision in 
                        which the facility is located);
                            (ii) makes available to residents 
                        supportive services to assist the residents in 
                        carrying out activities of daily living, such 
                        as bathing, dressing, eating, getting in and 
                        out of bed or chairs, walking, going outdoors, 
                        using the toilet, laundry, home management, 
                        preparing meals, shopping for personal items, 
                        obtaining and taking medication, managing 
                        money, using the telephone, or performing light 
                        or heavy housework, and which may make 
                        available to residents home health care 
                        services, such as nursing and therapy; and
                            (iii) provides dwelling units for 
                        residents, each of which may contain a full 
                        kitchen and bathroom, and which includes common 
                        rooms and other facilities appropriate for the 
                        provision of supportive services to the 
                        residents of the facility;
                    (B) an adult care facility that--
                            (i) is--
                                    (I) licensed and regulated by the 
                                State in which the facility is located 
                                (or, if there is no State law providing 
                                for such licensing and regulation by 
                                the State, by the municipality or other 
                                political subdivision in which the 
                                facility is located); and
                                    (II) similar to a skilled nursing 
                                facility, (as defined in section 
                                1819(a) of the Social Security Act (42 
                                U.S.C. 1395i-3(a))), a nursing facility 
                                (as defined in section 1919(a) of the 
                                Social Security Act (42 U.S.C. 
                                1396r(a))), or a board and care 
                                facility (as defined in section 1616(e) 
                                of the Social Security Act (42 U.S.C. 
                                1382e(e))); or
                            (ii) is subject to the identification, 
                        investigation, and resolution of complaints by, 
                        or otherwise subject to the activities of, a 
                        State Long-Term Care Ombudsman program 
                        established under section 712 of the Older 
                        Americans Act of 1965 (42 U.S.C. 3058g); or
                    (C) an adult care facility receiving Federal funds 
                through a State Medicaid program under title XIX of the 
                Social Security Act (42 U.S.C. 1396 et seq.), including 
                through any waiver relating to such a program granted 
                under such title or title XI of such Act (42 U.S.C. 
                1301 et seq.).
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 3. STATE REPORTING REQUIREMENTS FOR ASSISTED LIVING FACILITIES AND 
              COVID-19.

    (a) In General.--As a condition of receiving funding to combat the 
coronavirus pandemic under Federal legislation enacted on or after the 
date of enactment of this Act which designates such funding as being 
for emergency requirements pursuant to section 251(b)(2)(A)(i) of the 
Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 
901(b)(2)(A)(i)), a State shall do the following:
            (1) Within 30 days of the passage of this Act, begin weekly 
        reporting of the following information for each assisted living 
        facility located in the State to the Centers for Disease 
        Control and Prevention, disaggregated by race, ethnicity, 
        primary language, sex, sexual orientation, gender identity, 
        age, and disability status:
                    (A) The number of suspected and confirmed active 
                cases of Coronavirus Disease 2019 (COVID-19) among 
                residents and the number of suspected and confirmed 
                active cases of COVID-19 among staff of the facility.
                    (B) The number of residents and staff of the 
                facility, respectively, who, since the last report 
                under this paragraph, contracted severe respiratory 
                infections related to COVID-19 that resulted in 
                hospitalization and the number that resulted in death, 
                including deaths that occurred outside of the facility.
                    (C) The number of COVID-19 diagnostic tests 
                conducted weekly on residents and staff of the 
                facility, respectively, and the percentage of those 
                tests that are positive among residents and staff of 
                the facility, respectively.
                    (D) The average time between testing a resident and 
                receiving the results of the test.
                    (E) The personal protective equipment, hand hygiene 
                supplies, ventilators, and medical supplies in the 
                facility.
                    (F) The total number of resident beds at, residents 
                living in, and staff employed by the facility.
                    (G) Other information specified by the Secretary.
            (2) Within 30 days of the passage of this Act, report for 
        each assisted living facility in the State to the Centers for 
        Disease Control and Prevention, the information specified in 
        subparagraphs (A) through (G) of paragraph (1) for the period 
        of time between January 1, 2020, and the passage of this Act, 
        disaggregated by race, ethnicity, primary language, sex, sexual 
        orientation, gender identity, age, and disability status.
            (3) Within 30 days of the passage of this Act, require each 
        assisted living facility in the State to inform the Centers for 
        Medicare & Medicaid Services, the Centers for Disease Control 
        and Prevention, State and local health officials, residents, 
        their representatives, and families of those residing in 
        facilities by 5 p.m. the next calendar day following the 
        occurrence of either a single confirmed infection of COVID-19 
        among the residents or staff of the facility or 3 or more 
        residents or staff of the facility presenting new-onset of 
        respiratory symptoms within 72 hours of each other. This 
        information shall--
                    (A) not include personally identifiable 
                information;
                    (B) include information on mitigating actions 
                implemented to prevent or reduce the risk of 
                transmission, including if normal operations of the 
                facility will be altered; and
                    (C) include any cumulative updates for residents, 
                their representatives, and families at least weekly or 
                by 5 p.m. the next calendar day following the 
                subsequent occurrence of--
                            (i) the identification of a confirmed 
                        infection of COVID-19 among the residents or 
                        staff of the facility; or
                            (ii) 3 or more residents or staff 
                        presenting new onset of respiratory symptoms 
                        within 72 hours of each other.
    (b) Sunset.--The requirements of subsection (a) shall terminate if 
and when the circumstances which led to the public health emergency 
period described in section 1135(g)(1)(B) of the Social Security Act 
(42 U.S.C. 1320b-5(g)(1)(B)) (relating to the coronavirus pandemic) 
cease to exist and are unlikely to recur.
    (c) Guidance.--Within 15 days of the date of enactment of this Act, 
the Secretary shall issue guidance to States to ensure the information 
reported in (a) is reported in an electronic, standardized format that 
matches, to the extent practicable, the format applicable to 
information reported to the Department of Health and Human Services by 
skilled nursing facilities and nursing facilities on COVID-19 under 
section 483.30(g) of title 42, Code of Federal Regulations (as amended 
by the interim final rule of the Centers for Medicare & Medicaid 
Services published on May 8, 2020 (85 Fed. Reg. 27550)), to enable the 
comparison of COVID-19 outbreaks across congregate care settings.
    (d) Publication of Information.--The Secretary shall publicly post 
on the website of the Department of Health and Human Services, the 
information received by the Department under section (a), and shall 
update such information on a weekly basis.
    (e) Extensions.--The Secretary may grant, at the request of a 
State, a 30-day extension for the State report the information required 
under paragraphs (1) and (2) of subsection (a) to allow the State to 
develop the reporting infrastructure necessary to gather such 
information from assisted living facilities.

SEC. 4. APPLICATION OF NURSING FACILITY REPORTING REQUIREMENTS TO 
              ASSISTED LIVING FACILITIES.

    The Secretary shall provide that any COVID-19 reporting requirement 
that applies to skilled nursing facilities (as defined in section 
1819(a) of the Social Security Act (42 U.S.C. 1395i-3(a))) or nursing 
facilities (as defined in section 1919(a) of the Social Security Act 
(42 U.S.C. 1396r(a))) and is imposed on or after the date of enactment 
of this Act under title XVIII or XIX of the Social Security Act (42 
U.S.C. 1395 et seq., 1396 et seq.) or under a regulation promulgated 
under such title shall apply in the same manner to assisted living 
facilities, which shall report such information through the States 
unless complying with such reporting requirement is not practicable in 
the assisted living facility setting.

SEC. 5. GAO REPORT.

    Not later than 2 years after the date of enactment of this Act, the 
Comptroller General of the United States shall conduct an evaluation, 
and submit to Congress, a report including--
            (1) what is known about how required reporting of COVID-19 
        data on residents in nursing homes during the pandemic was used 
        to prevent or control COVID-19 cases or deaths, and how this 
        compares to the experience of other congregate care facilities 
        without required reporting of this data; and
            (2) any lessons learned from required reporting of COVID-19 
        cases or deaths in nursing homes that could be applied to other 
        congregate care facilities during the COVID-19 pandemic, if it 
        continues, and similar public health emergencies in the future.
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