1450
PUBLIC LAW 92-603-OCT. 30, 1972
[86 STAT.
PROVISION OF MEDICAL SOCLVL SERVICES NOT MANDATORY FOR EXTENDED CARE FACILITIES
SEC. 265. Section 1861(j) (11) of the Social Security Act (as redesigAnte. pp. 1412, nated by section 234(d) of this Act) is amended by inserting before ^'*^'*' the semicolon at the end thereof the following: ", except that the Secretary shall not require as a condition of participation that medical social services be furnished in any such institution". R E F U N D o p EXCESS P R E M I U M S UNDER MEDICARE
42 USC i39sgg.
SEC. 266. Section 1870 of the Social Security Act is amended by adding at the end thereof the following new subsection: " (g) If an individual, who is enrolled under section 1818(c) of the Ante, p. 1374. Social Security Act or under section 1837, dies, and premiums with 42 USC i395p. respect; tx) such enrollment have been received with respect to such individual for any month after the month of his death, such premiums shall be refunded to the person or persons determined by the Secretary under regulations to have paid such premiums or if payment for such premiums was made by the deceased individual before his death, to the legal representative of the estate of such deceased individual, if any. If there is no person who meets the requirements of the preceding sentence such premiums shall be refunded to the person or persons in the priorities specified in paragraphs (2) through (7) of subsection (e)." WAIVER OF REGISTERED NURSE REQUIREMENT I N SKILLED N U R S I N G FACILITIES I N RURAL AREAS
SEC. 267. Section 1861(j) of the Social Security Act, as amended by Ante, pp. 1412, sectious 234(d) and 246(b) of this Act, is further amended by adding 1424 at the end thereof the following new sentence: "To the extent that paragraph (6) of this subsection may be deemed to require that any skilled nursing facility engage the services of a registered professional nurse for more than 40 hours a week, the Secretary is authorized to Avaive such requirement if he finds that— " (A) such facility is located in a rural area and the supply of skilled nursing facility services in such area is not sufficient to meet the needs of individuals residing therein, " (B) such facility has one full-time registered professional nurse who is regularly on duty at such facility 40 hours a week, and " (C) such facility (i) has only patients whose physicians have indicated (through physicians' orders or admission notes) that each such patient does not require the services of a registered nurse or a physician for a 48-hour period, or (ii) has made arrangements for a registered professional nurse or a physician to spend such time at such facility as may be indicated as necessary by the physician to provide necessary skilled nursing services on days when the regular full-time registered professional nurse is not on duty." EXEMPTION OF CHRISTIAN SCIENCE SANATORIUMS FROM CERTAIN N U R S I N G HOME REQUIREMENTS UNDER MEDICAID
42 USC 1396a. Ante, p. 1415.
gfic. 268. (a) Section 1902(a) of the Social Security Act is amended by adding at the end thereof the following new sentence: "For purposes of paragraphs (9)(A), (29), (31), and (33), and of section 1903 (1)(4), the terms 'skilled nursing home' and 'nursing home' do not
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