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1 (C) by adding at the end the following new
2 subparagraph:
3 ‘‘(D) that the State maintain a consumer-
4 oriented website providing useful information to
5 consumers regarding all skilled nursing facili-
6 ties and all nursing facilities in the State, in-
7 cluding for each facility, Form 2567 State in-
8 spection reports (or a successor form), com-
9 plaint investigation reports, the facility’s plan of
10 correction, and such other information that the
11 State or the Secretary considers useful in as-
12 sisting the public to assess the quality of long
13 term care options and the quality of care pro-
14 vided by individual facilities;’’.
15 (3) DEFINITIONS.—In this subsection:
16 (A) NURSING FACILITY.—The term ‘‘nurs-
17 ing facility’’ has the meaning given such term
18 in section 1919(a) of the Social Security Act
19 (42 U.S.C. 1396r(a)).
20 (B) SECRETARY.—The term ‘‘Secretary’’
21 means the Secretary of Health and Human
22 Services.
23 (C) SKILLED NURSING FACILITY.—The

24 term ‘‘skilled nursing facility’’ has the meaning

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1 given such term in section 1819(a) of the Social
2 Security Act (42 U.S.C. 1395i–3(a)).
3 SEC. 1414. REPORTING OF EXPENDITURES.

4 Section 1888 of the Social Security Act (42 U.S.C.

5 1395yy) is amended by adding at the end the following
6 new subsection:
7 ‘‘(f) REPORTING OF DIRECT CARE EXPENDI-
8 TURES.—

9 ‘‘(1) IN GENERAL.—For cost reports submitted

10 under this title for cost reporting periods beginning
11 on or after the date that is 3 years after the date
12 of the enactment of this subsection, skilled nursing
13 facilities shall separately report expenditures for
14 wages and benefits for direct care staff (breaking
15 out (at a minimum) registered nurses, licensed pro-
16 fessional nurses, certified nurse assistants, and other
17 medical and therapy staff).
18 ‘‘(2) MODIFICATION OF FORM.—The Secretary,
19 in consultation with private sector accountants expe-
20 rienced with skilled nursing facility cost reports,
21 shall redesign such reports to meet the requirement
22 of paragraph (1) not later than 1 year after the date
23 of the enactment of this subsection.
24 ‘‘(3) CATEGORIZATION BY FUNCTIONAL AC-

25 COUNTS.—Not later than 30 months after the date

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1 of the enactment of this subsection, the Secretary,
2 working in consultation with the Medicare Payment
3 Advisory Commission, the Inspector General of the
4 Department of Health and Human Services, and
5 other expert parties the Secretary determines appro-
6 priate, shall take the expenditures listed on cost re-
7 ports, as modified under paragraph (1), submitted
8 by skilled nursing facilities and categorize such ex-
9 penditures, regardless of any source of payment for
10 such expenditures, for each skilled nursing facility
11 into the following functional accounts on an annual
12 basis:
13 ‘‘(A) Spending on direct care services (in-
14 cluding nursing, therapy, and medical services).
15 ‘‘(B) Spending on indirect care (including
16 housekeeping and dietary services).
17 ‘‘(C) Capital assets (including building and
18 land costs).
19 ‘‘(D) Administrative services costs.
20 ‘‘(4) AVAILABILITY OF INFORMATION SUB-

21 MITTED.—The Secretary shall establish procedures

22 to make information on expenditures submitted
23 under this subsection readily available to interested
24 parties upon request, subject to such requirements

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1 as the Secretary may specify under the procedures
2 established under this paragraph.’’.
3 SEC. 1415. STANDARDIZED COMPLAINT FORM.

4 (a) SKILLED NURSING FACILITIES.—

5 (1) DEVELOPMENT BY THE SECRETARY.—Sec-

6 tion 1819(f) of the Social Security Act (42 U.S.C.

7 1395i–3(f)), as amended by section 1413(a)(3), is
8 amended by adding at the end the following new
9 paragraph:
10 ‘‘(9) STANDARDIZED COMPLAINT FORM.—The

11 Secretary shall develop a standardized complaint

12 form for use by a resident (or a person acting on the
13 resident’s behalf) in filing a complaint with a State
14 survey and certification agency and a State long-
15 term care ombudsman program with respect to a
16 skilled nursing facility.’’.
17 (2) STATE REQUIREMENTS.—Section 1819(e)
18 of the Social Security Act (42 U.S.C. 1395i–3(e)) is
19 amended by adding at the end the following new
20 paragraph:
21 ‘‘(6) COMPLAINT PROCESSES AND WHISTLE-

22 BLOWER PROTECTION.—

23 ‘‘(A) COMPLAINT FORMS.—The State must

24 make the standardized complaint form devel-

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1 oped under subsection (f)(9) available upon re-
2 quest to—
3 ‘‘(i) a resident of a skilled nursing fa-
4 cility;
5 ‘‘(ii) any person acting on the resi-
6 dent’s behalf; and
7 ‘‘(iii) any person who works at a
8 skilled nursing facility or is a representa-
9 tive of such a worker.
10 ‘‘(B) COMPLAINT RESOLUTION PROCESS.—

11 The State must establish a complaint resolution

12 process in order to ensure that a resident, the
13 legal representative of a resident of a skilled
14 nursing facility, or other responsible party is
15 not retaliated against if the resident, legal rep-
16 resentative, or responsible party has com-
17 plained, in good faith, about the quality of care
18 or other issues relating to the skilled nursing
19 facility, that the legal representative of a resi-
20 dent of a skilled nursing facility or other re-
21 sponsible party is not denied access to such
22 resident or otherwise retaliated against if such
23 representative party has complained, in good
24 faith, about the quality of care provided by the
25 facility or other issues relating to the facility,

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1 and that a person who works at a skilled nurs-
2 ing facility is not retaliated against if the work-
3 er has complained, in good faith, about quality
4 of care or services or an issue relating to the
5 quality of care or services provided at the facil-
6 ity, whether the resident, legal representative,
7 other responsible party, or worker used the
8 form developed under subsection (f)(9) or some
9 other method for submitting the complaint.
10 Such complaint resolution process shall in-
11 clude—
12 ‘‘(i) procedures to assure accurate
13 tracking of complaints received, including
14 notification to the complainant that a com-
15 plaint has been received;
16 ‘‘(ii) procedures to determine the like-
17 ly severity of a complaint and for the in-
18 vestigation of the complaint;
19 ‘‘(iii) deadlines for responding to a
20 complaint and for notifying the complain-
21 ant of the outcome of the investigation;
22 and
23 ‘‘(iv) procedures to ensure that the
24 identity of the complainant will be kept
25 confidential.

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1 ‘‘(C) WHISTLEBLOWER PROTECTION.—

2 ‘‘(i) PROHIBITION AGAINST RETALIA-

3 TION.—No person who works at a skilled

4 nursing facility may be penalized, discrimi-
5 nated, or retaliated against with respect to
6 any aspect of employment, including dis-
7 charge, promotion, compensation, terms,
8 conditions, or privileges of employment, or
9 have a contract for services terminated, be-
10 cause the person (or anyone acting at the
11 person’s request) complained, in good
12 faith, about the quality of care or services
13 provided by a nursing facility or about
14 other issues relating to quality of care or
15 services, whether using the form developed
16 under subsection (f)(9) or some other
17 method for submitting the complaint.
18 ‘‘(ii) RETALIATORY REPORTING.—A

19 skilled nursing facility may not file a com-

20 plaint or a report against a person who
21 works (or has worked at the facility with
22 the appropriate State professional discipli-
23 nary agency because the person (or anyone
24 acting at the person’s request) complained
25 in good faith, as described in clause (i).

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1 ‘‘(iii) COMMENCEMENT OF ACTION.—

2 Any person who believes the person has

3 been penalized, discriminated , or retali-
4 ated against or had a contract for services
5 terminated in violation of clause (i) or
6 against whom a complaint has been filed in
7 violation of clause (ii) may bring an action
8 at law or equity in the appropriate district
9 court of the United States, which shall
10 have jurisdiction over such action without
11 regard to the amount in controversy or the
12 citizenship of the parties, and which shall
13 have jurisdiction to grant complete relief,
14 including, but not limited to, injunctive re-
15 lief (such as reinstatement, compensatory
16 damages (which may include reimburse-
17 ment of lost wages, compensation, and
18 benefits), costs of litigation (including rea-
19 sonable attorney and expert witness fees),
20 exemplary damages where appropriate, and
21 such other relief as the court deems just
22 and proper.
23 ‘‘(iv) RIGHTS NOT WAIVABLE.—The

24 rights protected by this paragraph may not

25 be diminished by contract or other agree-

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