101 STAT. 1330-160
PUBLIC LAW 100-203—DEC. 22, 1987
benefits because of 1983 changes in actuarial reduction formula). "(D) Section 1634(c) of this Act (relating to individuals who loge eligibility for SSI benefits due to entitlement to child's insurance benefits under section 202(d) of this Act).". (10) Effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1986, section 9411(a)(2)(B) of such Act is amended by inserting "such" after "need for".
l-S!;? te a;?0l Qi«i. rs^spf'? Effective date. 42 USC 1396n.
Subtitle C—Nursing Home Reform i
PART 1—MEDICARE PROGRAM
SEC. 4201. REQUIREMENTS FOR SKILLED NURSING FACILITIES.
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(a) SPECIFICATION OF FACILITY REQUIREMENTS.—Title XVIII of the Social Security Act is amended— I (1) by amending subsection (j) of section 1861 (42 U.S.C. 1395x) to read as follows: "Skilled Nursing Facility
Contracts.
"(j) The term 'skilled nursing facility' has the meaning given such term in section 1819(a)."; (2) by adding at the end of section 1864 (42 U.S.C. 1395aa) the following new subsection: "(d) The Secretary may not enter an agreement under this section with a State with respect to determining whether an institution therein is a skilled nursing facility unless the State meets the requirements specified in section 1819(e)."; and (3) by adding at the end of part A the following new section: "REQUIREMENTS FOR, AND ASSURING QUAUTY OF CARE IN, SKILLED NURSING FACILITIES
42 USC 1395i-3. .^<^^i
1819. (a) SKILLED NURSING FACILITY DEFINED.—In this title, the term 'skilled nursing facility' means an institution (or a distinct part of an institution) which— ,,, V "(1) is primarily engaged in providing to residents— "(A) skilled nursing care and related services for resi£ dents who require medical or nursing care, or "(B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, and is not primarily for the care and treatment of mental .; diseases; f "(2) has in effect a transfer agreement (meeting the requirements of section 1861(1)) with one or more hospitals having agreements in effect under section 1866; and "(3) meets the requirements for a skilled nursing facility described in subsections (b), (c), and (d) of this section. "SEC.
"(b) REQUIREMENTS RELATING TO PROVISION OF SERVICES.— "(1) QUAUTY OF LIFE.—
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"(A) IN GENERAL.—A skilled nursing facility must care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident, ng • JM stih; > .a;
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