[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9067 Introduced in House (IH)]

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118th CONGRESS
  2d Session
                                H. R. 9067

To amend titles XVIII and XIX of the Social Security Act to establish a 
waiver of certain training and certification requirements for specified 
           skilled nursing facilities and nursing facilities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 18, 2024

 Mr. Guthrie introduced the following bill; which was referred to the 
Committee on Ways and Means, and in addition to the Committee on Energy 
    and Commerce, 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 amend titles XVIII and XIX of the Social Security Act to establish a 
waiver of certain training and certification requirements for specified 
           skilled nursing facilities and nursing facilities.

    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 ``Building America's Health Care 
Workforce Act''.

SEC. 2. ESTABLISHING A WAIVER OF CERTAIN TRAINING AND CERTIFICATION 
              REQUIREMENTS FOR SPECIFIED SKILLED NURSING FACILITIES AND 
              NURSING FACILITIES.

    (a) Medicare.--Section 1819 of the Social Security Act (42 U.S.C. 
1395i-3) is amended by adding at the end the following new subsection:
    ``(l) Waiver of Certain Training and Certification Requirements for 
Specified Skilled Nursing Facilities.--
            ``(1) Election.--
                    ``(A) States.--A State may elect, in a form and 
                manner specified by the Secretary, for the provisions 
                of subsections (b) and (f) to be applied in accordance 
                with paragraph (2) with respect to specified skilled 
                nursing facilities (as defined in paragraph (3)) 
                located in such State.
                    ``(B) Specified skilled nursing facilities.--In the 
                case of a specified skilled nursing facility located in 
                a State that has not made the election described in 
                subparagraph (A), such facility may make such election 
                with respect to such facility in a form and manner 
                specified by the Secretary.
            ``(2) Waivers.--In the case of a specified skilled nursing 
        facility located in a State that has made the election 
        described in paragraph (1) (or, with respect to a specified 
        skilled nursing facility located in a State that has not made 
        such election, in the case of such a facility that has made 
        such election), the Secretary shall--
                    ``(A) apply subsection (b)(5)(A) as if the 
                reference to `4 months' in such subsection were instead 
                a reference to `12 months', except that such reference 
                shall continue to be treated as a reference to `4 
                months' for purposes of applying the requirement 
                specified in clause (i)(II) of such subsection;
                    ``(B) for purposes of determining whether a nurse 
                aide training and competency evaluation program offered 
                by or in such facility complies with the requirements 
                for such program specified pursuant to subsection 
                (f)(2)(A)(i), allow such program to count any hours 
                worked by a nurse aide in a skilled nursing facility or 
                nursing facility (as defined in section 1919(a)) toward 
                the 75 hours of initial training described in subclause 
                (II) of such subsection; and
                    ``(C) in the case such facility is a facility 
                described in subparagraph (B)(iii)(I) of subsection 
                (f)(2), apply subparagraph (A)(iv)(I) of such 
                subsection as if such facility were not a facility so 
                described, but only if the State in which the facility 
                is located does not offer a nurse aide competency 
                evaluation (in person or online) at least once per week 
                or if availability is limited.
            ``(3) Specified skilled nursing facility defined.--For 
        purposes of this subsection, the term `specified skilled 
        nursing facility' means a skilled nursing facility that--
                    ``(A) is located in an area of a State that the 
                State has designated as being a nurse aide shortage 
                area; and
                    ``(B) has not received a citation for a deficiency 
                for providing a substandard quality of care relating to 
                direct patient care during the preceding 2 years.''.
    (b) Medicaid.--Section 1919 of the Social Security Act (42 U.S.C. 
1396r) is amended by adding at the end the following new subsection:
    ``(l) Waiver of Certain Training and Certification Requirements for 
Specified Nursing Facilities.--
            ``(1) Election.--
                    ``(A) States.--A State may elect, in a form and 
                manner specified by the Secretary, for the provisions 
                of subsections (b) and (f) to be applied in accordance 
                with paragraph (2) with respect to specified nursing 
                facilities (as defined in paragraph (3)) located in 
                such State.
                    ``(B) Specified nursing facilities.--In the case of 
                a specified nursing facility located in a State that 
                has not made the election described in subparagraph 
                (A), such facility may make such election with respect 
                to such facility in a form and manner specified by the 
                Secretary.
            ``(2) Waivers.--In the case of a specified nursing facility 
        located in a State that has made the election described in 
        paragraph (1) (or, with respect to a specified nursing facility 
        located in a State that has not made such election, in the case 
        of such a facility that has made such election), the Secretary 
        shall--
                    ``(A) apply subsection (b)(5)(A) as if the 
                reference to `4 months' in such subsection were instead 
                a reference to `12 months', except that such reference 
                shall continue to be treated as a reference to `4 
                months' for purposes of applying the requirement 
                specified in clause (i)(II) of such subsection;
                    ``(B) for purposes of determining whether a nurse 
                aide training and competency evaluation program offered 
                by or in such facility complies with the requirements 
                for such program specified pursuant to subsection 
                (f)(2)(A)(i), allow such program to count any hours 
                worked by a nurse aide in a nursing facility or skilled 
                nursing facility (as defined in section 1819(a)) toward 
                the 75 hours of initial training described in subclause 
                (II) of such subsection; and
                    ``(C) in the case such facility is a facility 
                described in subparagraph (B)(iii)(I) of subsection 
                (f)(2), apply subparagraph (A)(iv)(I) of such 
                subsection as if such facility were not a facility so 
                described, but only if the State in which the facility 
                is located does not offer a nurse aide competency 
                evaluation (in person or online) at least once per week 
                or if availability is limited.
            ``(3) Specified nursing facility defined.--For purposes of 
        this subsection, the term `specified nursing facility' means a 
        nursing facility that--
                    ``(A) is located in an area of a State that the 
                State has designated as being a nurse aide shortage 
                area; and
                    ``(B) has not received a citation for a deficiency 
                for providing a substandard quality of care relating to 
                direct patient care during the preceding 2 years.''.
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