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1 ners of such owners in facilitating compliance by fa-
2 cilities of the chain with State and Federal laws and
3 regulations applicable to the facilities;
4 (3) analyze the management structure, distribu-
5 tion of expenditures, and nurse staffing levels of fa-
6 cilities of the chain in relation to resident census,
7 staff turnover rates, and tenure;
8 (4) report findings and recommendations with
9 respect to such reviews, analyses, and oversight to
10 the chain and facilities of the chain, to the Secretary
11 and to relevant States; and
12 (5) publish the results of such reviews, anal-
13 yses, and oversight.
14 (d) IMPLEMENTATION OF RECOMMENDATIONS.—
15 (1) RECEIPT OF FINDING BY CHAIN.—Not later
16 than 10 days after receipt of a finding of an inde-
17 pendent monitor under subsection (c)(4), a chain
18 participating in the pilot program shall submit to
19 the independent monitor a report—
20 (A) outlining corrective actions the chain
21 will take to implement the recommendations in
22 such report; or
23 (B) indicating that the chain will not im-
24 plement such recommendations and why it will
25 not do so.

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1 (2) RECEIPT OF REPORT BY INDEPENDENT

2 MONITOR.—Not later than 10 days after the date of

3 receipt of a report submitted by a chain under para-
4 graph (1), an independent monitor shall finalize its
5 recommendations and submit a report to the chain
6 and facilities of the chain, the Secretary, and the
7 State (or States) involved, as appropriate, containing
8 such final recommendations.
9 (e) COST OF APPOINTMENT.—A chain shall be re-
10 sponsible for a portion of the costs associated with the
11 appointment of independent monitors under the pilot pro-
12 gram. The chain shall pay such portion to the Secretary
13 (in an amount and in accordance with procedures estab-
14 lished by the Secretary).
15 (f) WAIVER AUTHORITY.—The Secretary may waive
16 such requirements of titles XVIII and XIX of the Social
17 Security Act (42 U.S.C. 1395 et seq.; 1396 et seq.) as
18 may be necessary for the purpose of carrying out the pilot
19 program.
20 (g) AUTHORIZATION OF APPROPRIATIONS.—There
21 are authorized to be appropriated such sums as may be
22 necessary to carry out this section.
23 (h) DEFINITIONS.—In this section:
24 (1) FACILITY.—The term ‘‘facility’’ means a
25 skilled nursing facility or a nursing facility.

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1 (2) NURSING FACILITY.—The term ‘‘nursing
2 facility’’ has the meaning given such term in section
3 1919(a) of the Social Security Act (42 U.S.C.
4 1396r(a)).
5 (3) SECRETARY.—The term ‘‘Secretary’’ means
6 the Secretary of Health and Human Services, acting
7 through the Assistant Secretary for Planning and
8 Evaluation.
9 (4) SKILLED NURSING FACILITY.—The term
10 ‘‘skilled nursing facility’’ has the meaning given such
11 term in section 1819(a) of the Social Security Act
12 (42 U.S.C. 1395(a)).
13 (i) EVALUATION AND REPORT.—
14 (1) EVALUATION.—The Inspector General of
15 the Department of Health and Human Services shall
16 evaluate the pilot program. Such evaluation shall—
17 (A) determine whether the independent
18 monitor program should be established on a
19 permanent basis; and
20 (B) if the Inspector General determines
21 that the independent monitor program should
22 be established on a permanent basis, rec-
23 ommend appropriate procedures and mecha-
24 nisms for such establishment.

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1 (2) REPORT.—Not later than 180 days after
2 the completion of the pilot program, the Inspector
3 General shall submit to Congress and the Secretary
4 a report containing the results of the evaluation con-
5 ducted under paragraph (1), together with rec-
6 ommendations for such legislation and administra-
7 tive action as the Inspector General determines ap-
8 propriate.
9 SEC. 1423. NOTIFICATION OF FACILITY CLOSURE.

10 (a) SKILLED NURSING FACILITIES.—

11 (1) IN GENERAL.—Section 1819(c) of the So-
12 cial Security Act (42 U.S.C. 1395i–3(c)) is amended
13 by adding at the end the following new paragraph:
14 ‘‘(7) NOTIFICATION OF FACILITY CLOSURE.—

15 ‘‘(A) IN GENERAL.—Any individual who is

16 the administrator of a skilled nursing facility
17 must—
18 ‘‘(i) submit to the Secretary, the State
19 long-term care ombudsman, residents of
20 the facility, and the legal representatives of
21 such residents or other responsible parties,
22 written notification of an impending clo-
23 sure—

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1 ‘‘(I) subject to subclause (II), not
2 later than the date that is 60 days
3 prior to the date of such closure; and
4 ‘‘(II) in the case of a facility
5 where the Secretary terminates the fa-
6 cility’s participation under this title,
7 not later than the date that the Sec-
8 retary determines appropriate;
9 ‘‘(ii) ensure that the facility does not
10 admit any new residents on or after the
11 date on which such written notification is
12 submitted; and
13 ‘‘(iii) include in the notice a plan for
14 the transfer and adequate relocation of the
15 residents of the facility by a specified date
16 prior to closure that has been approved by
17 the State, including assurances that the
18 residents will be transferred to the most
19 appropriate facility or other setting in
20 terms of quality, services, and location,
21 taking into consideration the needs and
22 best interests of each resident.
23 ‘‘(B) RELOCATION.—
24 ‘‘(i) IN GENERAL.—The State shall
25 ensure that, before a facility closes, all

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1 residents of the facility have been success-
2 fully relocated to another facility or an al-
3 ternative home and community-based set-
4 ting.
5 ‘‘(ii) CONTINUATION OF PAYMENTS

6 UNTIL RESIDENTS RELOCATED.—The Sec-

7 retary may, as the Secretary determines
8 appropriate, continue to make payments
9 under this title with respect to residents of
10 a facility that has submitted a notification
11 under subparagraph (A) during the period
12 beginning on the date such notification is
13 submitted and ending on the date on which
14 the resident is successfully relocated.’’.
15 (2) CONFORMING AMENDMENTS.—Section

16 1819(h)(4) of the Social Security Act (42 U.S.C.

17 1395i–3(h)(4)) is amended—
18 (A) in the first sentence, by striking ‘‘the
19 Secretary shall terminate’’ and inserting ‘‘the
20 Secretary, subject to subsection (c)(7), shall
21 terminate’’; and
22 (B) in the second sentence, by striking
23 ‘‘subsection (c)(2)’’ and inserting ‘‘paragraphs
24 (2) and (7) of subsection (c)’’.
25 (b) NURSING FACILITIES.—

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1 (1) IN GENERAL.—Section 1919(c) of the So-
2 cial Security Act (42 U.S.C. 1396r(c)) is amended
3 by adding at the end the following new paragraph:
4 ‘‘(9) NOTIFICATION OF FACILITY CLOSURE.—

5 ‘‘(A) IN GENERAL.—Any individual who is

6 an administrator of a nursing facility must—
7 ‘‘(i) submit to the Secretary, the State
8 long-term care ombudsman, residents of
9 the facility, and the legal representatives of
10 such residents or other responsible parties,
11 written notification of an impending clo-
12 sure—
13 ‘‘(I) subject to subclause (II), not
14 later than the date that is 60 days
15 prior to the date of such closure; and
16 ‘‘(II) in the case of a facility
17 where the Secretary terminates the fa-
18 cility’s participation under this title,
19 not later than the date that the Sec-
20 retary determines appropriate;
21 ‘‘(ii) ensure that the facility does not
22 admit any new residents on or after the
23 date on which such written notification is
24 submitted; and

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1 ‘‘(iii) include in the notice a plan for
2 the transfer and adequate relocation of the
3 residents of the facility by a specified date
4 prior to closure that has been approved by
5 the State, including assurances that the
6 residents will be transferred to the most
7 appropriate facility or other setting in
8 terms of quality, services, and location,
9 taking into consideration the needs and
10 best interests of each resident.
11 ‘‘(B) RELOCATION.—
12 ‘‘(i) IN GENERAL.—The State shall
13 ensure that, before a facility closes, all
14 residents of the facility have been success-
15 fully relocated to another facility or an al-
16 ternative home and community-based set-
17 ting.
18 ‘‘(ii) CONTINUATION OF PAYMENTS

19 UNTIL RESIDENTS RELOCATED.—The Sec-

20 retary may, as the Secretary determines
21 appropriate, continue to make payments
22 under this title with respect to residents of
23 a facility that has submitted a notification
24 under subparagraph (A) during the period
25 beginning on the date such notification is

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