Page:United States Statutes at Large Volume 104 Part 2.djvu/458

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104 STAT. 1388-50 PUBLIC LAW 101-508 —NOV. 5, 1990 (i) in subparagraph (A), by striking the period and inserting the following: ", or any individual described in subsection (f)(2)(B)(ii) or in subparagraph (B), (C), or (D) of section 6901(b)(4) of the Omnibus Budget Reconciliation Act of 1989."; and (ii) by adding at the end the following new subparagraph: "(C) PROHIBITION AGAINST CHARGES.— A State may not impose any charges on a nurse aide relating to the registry established and maintained under subparagraph (A).". (L) CLARIFICATION ON FINDINGS OF NEGLECT. —Section 1819(g)(1)(C) (42 U.S.C. 1395i-3(g)(l)(C)) is amended by adding at the end the following: "A State shall not make a finding that an individual has neglected a resident if the individual demonstrates that such neglect was caused by factors beyond the control of the individual.". (M) TIMING OF PUBLIC DISCLOSURE OF SURVEY RESULTS. — Section 1819(g)(5)(A)(i) (42 U.S.C. 1395i-3(g)(5)(A)(i)) is amended by striking "deficiencies and plans" and inserting "deficiencies, within 14 calendar days after such information is made available to those facilities, and approved plans". (N) OMBUDSMAN PROGRAM COORDINATION WITH STATE SURVEY AND CERTIFICATION AGENCIES. — Section 1819(g)(5)(B) (42 U.S.C. 1395i-3(g)(5)(B)) is amended by striking "with respect" and inserting "or of any adverse action taken against a skilled nursing facility under paragraphs (1), (2), or (4) of subsection (h), with respect". 42 USC 1395i-3 (O) MAINTAINING REGULATORY STANDARDS FOR CERTAIN

SERVICES. —Any regulations promulgated and applied by the Secretary of Health and Human Services after the date of the enactment of the Omnibus Budget Reconciliation Act of 1987 with respect to services described in clauses (ii), (iv), and (v) of section 1819(b)(4)(A) of the Social Security Act shall include requirements for providers of such services that are at least as strict as the requirements applicable to providers of such services prior to the enactment of the Omnibus Budget Reconciliation Act of 1987. 42 USC 1395i-3 (P) EFFECTIVE DATES.— The amendments made by this ^°*®- pargigraph shall take effect as if they were included in the enactment of the Omnibus Budget Reconciliation Act of 1987. (i) CLARIFICATION OF SECRETARIAL WAIVER AUTHORITY. — 42 USC I395b-1 (1) RURAL HOSPITAL DEMONSTRATION.— The Secretary of Health and Human Services is authorized to waive such provisions of title XVIII of the Social Security Act as are necessary to conduct any demonstration project for limited-service rural hospitals with respect to which the Secretary has entered into an agreement before the date of the enactment of the Omnibus Budget Reconciliation Act of 1989. (2) NURSING HOME DEMONSTRATIONS.— Section 6901(d)(3)(B) of the Omnibus Budget Reconciliation Act of 1989 is amended— (A) by striking "Wisconsin" and inserting "Wisconsin and nursing home case-mix demonstration projects in other States"; and (B) by striking the second sentence. note.