PUBLIC LAW 100-203—DEC. 22, 1987
101 STAT. 1330-213
(C) in paragraph (6)— (i) by striking subparagraph (B), (ii) in subparagraph (C), by striking "intermediate care facility services" and inserting "services in an intermediate care facility for the mentally retarded", and \ (iii) by redesignating subparagraphs (C) and (D) as subparagraphs (B) and (C), respectively; and (D) by striking paragraph (7). (2) Section 1902(a)(31) of such Act (42 U.S.C. 1396a(a)(31)) is amended— (A) in the matter before subparagraph (A), by striking "skilled nursing facility services" and all that follows through "where" and inserting "services in an intermediate care facility for the mentally retarded (where", and (B) in subparagraph (B), by striking "skilled nursing or intermediate care facility" and inserting "intermediate care facility for the mentally retarded". (3) Section 1902(a)(33)(B) of such Act (42 U.S.C. 1396a(a)(33)(B)) is amended by inserting ", except as provided in section 1919(d)," after "(B) that". (4) The amendments made by this subsection shall not apply to a Effective date. State until such date (not earlier than October 1, 1990) as of which 42 USC I396a the Secretary determines that— "°*® (A) the State has specified the resident assessment instrument under section 1919(e)(5) of the Social Security Act, and (B) the State has begun conducting surveys under section 1919(g)(2)ofsuchAct. (e)
MISCELLANEOUS
CONFORMING
AMENDMENTS.—(1)
Section
1902(a)(44) of such Act (42 U.S.C. 1396a(a)(44)) is amended— (A) in the matter before subparagraph (A), by striking "skilled nursing facility services, intermediate care facility services" and inserting "services in an intermediate care facility for the mentally retarded", and (B) in subparagraph (A), by striking "that are intermediate care facility services in an institution for the mentally retarded" and inserting "that are services in an intermediate care facility for the mentally retarded". (2) Section 1903(a)(7) of such Act (42 U.S.C. 1396b(a)(7)) is amended by inserting "subject to section 1919(g)(3)(B)," after "(7)". (3) Section 1910 of such Act (42 U.S.C. 13961) is amended— (A) by striking "SKILLED NURSING FACILITIES AND" in the
heading, (B) by striking subsection (a), and (C) by redesignating subsections (b) and (c) as subsections (a) and (b) resoectivelv. (4) Section 1866(c) of such Act (42 U.S.C. 1395cc(c)) is amended by striking paragraph (2) and by redesignating paragraph (3) as paragraph (2). SEC. 4213. ENFORCEMENT PROCESS.
(a) IN GENERAL.—Section 1919 of the Social Security Act, as inserted by section 4201 and amended by section 4202, is further amended by adding at the end the following new subsection: "(h) ENFORCEMENT PROCESS.—
"(1) IN GENERAL.—If a State finds, on the basis of a standard, extended, or partial extended survey under subsection (g)(2) or otherwise, that a nursing facility no longer meets a requirement
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