104 STAT. 1388-48 PUBLIC LAW 101-508—NOV. 5, 1990 42 USC 1395i-3 note. 42 USC 1395yy. (II) was subject to a denial of payment under either such title; (III) was assessed a civil money penalty not less than $5,000 for deficiencies in nursing facility standards; (IV) operated under a temporary management appointed to oversee the operation of the facility and to ensure the health and safety of the facility's residents; or (V) pursuant to State action, was closed or had its residents transferred. (G) CLARIFICATION OF STATE RESPONSIBILITY TO DETERMINE COMPETENCY.— Section 1819(f)(2)(B) (42 U.S.C. 13951- 3(f)(2)(B)) is amended in the second sentence by inserting "(through subcontract or otherwise)" after "may not delegate". (H) EFFECTIVE DATE. —Except as provided in subparagraph (F), the amendments made by this subsection shall take effect as if they were included in the enactment of the Omnibus Budget Reconciliation Act of 1987. (2) OTHER AMENDMENTS.— (A) ASSURANCE OF APPROPRIATE PAYMENT AMOUNTS.—(i) Section 1861(v)(l)(E) (42 U.S.C. 1395x(v)(l)(E)) is amended in the second sentence by striking "the costs of such facilities" and inserting "the costs (including the costs of services required to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident eligible for benefits under this title) of such facilities". (ii) Section 1888(d)(1) (42 U.S.C. 1395xx(d)(l)) is amended in the first sentence by striking "(and capital-related costs)" and inserting "(including the costs of services required to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident eligible for benefits under this title) and capital-related costs". (B) DISCLOSURE OF INFORMATION OF QUALITY ASSESSMENT AND ASSURANCE COMMITTEES.— Section 1819(b)(1)(B) (42 U.S.C. 1395i-3(b)(l)(B)) is amended by adding at the end the following new sentence: "A State or the Secretary may not require disclosure of the records of such committee except insofar as such disclosure is related to the compliance of such committee with the requirements of this subparagraph.". (C) PERIOD FOR RESIDENT ASSESSMENT. —Section 1819(b)(3)(C)(i)(I) (42 U.S.C. 1395i-3(b)(3)(C)(i)(I)) is amended by striking "4 days" and inserting "not later than 14 days". (D) CLARIFICATION OF RESPONSIBILITY FOR SERVICES FOR MENTALLY ILL AND MENTALLY RETARDED RESIDENTS.— Section 1819(b)(4)(A) (42 U.S.C. 1395i-3(b)(4)(A)) is amended— (i) by striking "and" at the end of clause (v), (ii) by striking the period at the end of clause (vi) and inserting "; and", and (iii) by inserting after clause (vi) the following new clause: "(vii) treatment and services required by mentally ill and mentally retarded residents not otherwise provided or arranged for (or required to be provided or arranged for) by the State.".
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