101 STAT. 1330-174
PUBLIC L A W 100-203—DEC. 22, 1987 "(A) REGULATIONS REQUIRED.—Pursuant to the require-
ment of section 21(b) of the Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977, the Secretary shall issue regulations, on or before the first day of the seventh month to begin after the date of enactment of this section, that define those costs which may be charged to the personal funds of patients in skilled nursing facilities who are individuals receiving benefits under this part and those costs which are to be included in the reasonable cost (or other payment amount) under this title for extended care services. "(B) RULE IF FAILURE TO PUBLISH REGULATIONS.—-If the
Secretary does not issue the regulations under subparagraph (A) on or before the date required in such subparagraph, in the case of a resident of a skilled nursing facility who is eligible to receive benefits under this part, the costs which may not be charged to the personal funds of such resident (and for which payment is considered to be made under this title) shall not include, at a minimum, the costs for routine personal hygiene items and services furnished by the facility.". 42 USC 1395x.
(b) COSTS OF MEETING REQUIREMENTS.— (1) UNDER REASONABLE COST.—Section 1861(v)(l)(E) of such Act
(42 U.S.C. 1395s(v)(l)(E)) is amended by adding at the end the following new sentence: "Notwithstanding the previous sentence, such regulations with respect to skilled nursing facilities shall take into account (in a manner consistent with subparagraph (A) and based on patient-days of services furnished) the costs of such facilities complying with the requirements of subsections (b), (c), and (d) of section 1819 (including the costs of conducting nurse aide training and competency evaluation programs and competency evaluation programs).". (2) ADJUSTMENT IN PROSPECTIVE PAYMENTS.—Section 1888(d) of
Reports. 42 USC 1395i-3 note.
such Act (42 U.S.C. 1395yy(d)) is amended by adding at the end the following new paragraph: "(7) In computing the rates of payment to be made under this subsection, there shall be taken into account the costs described in the last sentence of section 1861(v)(l)(E) (relating to compliance with nursing facility requirements and of conducting nurse aide training and competency evaluation programs and competency evaluation programs).". (c) EVALUATION.—The Secretary of Health and Human Services shall evaluate, and report to Congress by not later than January 1, 1992, on the implementation of the resident assessment process for residents of skilled nursing facilities under the amendments made by this section. (d) CONFORMING AMENDMENT.—Section 1861(a)(2) of the Social
Security Act (42 U.S.C. 1395x(a)(2)) is amended by striking "skilled nursing facility" and inserting "facility described in section 1919(a)(2) or subsection (y)(D". SEC. 4202. SURVEY AND CERTIFICATION PROCESS. (a) STATE REQUIREMENT FOR PROCESS.—Title XVIII of the Social
Security Act is amended— (1) in section 1864(d) (42 U.S.C. 1395aa(d)), as added by section 4201(a)(2) of this Act, by inserting before the period "and section 1819(g)", and
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