103 STAT. 2298 PUBLIC LAW 101-239—DEC. 19, 1989 individual for 1 or more persons maintaining the plan (includ- ing as an employee defined in section 401(c)(l) of the Internal Revenue Code of 1986)". 42 USC 300bb-8 (2) EFFECTIVS DATE. — The amendment made by paragraph (1) note. shall apply to plan years beginning after December 31, 1989. Subtitle F—Technical and Miscellaneous Provisions Relating to Nursing Home Reform SEC. 6901. MEDICARE AND MEDICAID TECHNICAL CORRECTIONS RELAT- ING TO NURSING HOME REFORM. (a) MORATORIUM ON IMPLEMENTATION OF FEBRUARY 2, 1989 REGU- LATION.—The regulations promulgated by the Secretary of Health and Human Services on February 2, 1989 (54 Federal Register 5315 et seq., relating to requirements for long-term care facilities) shall not be effective before October 1, 1990, insofar as such regulations apply to skilled nursing facilities and intermediate care facilities ,;. under title XVm or XIX of the Social Security Act. G)) NURSE AIDE TRAINING. — (1) DELAY IN REQUIREBIENT.— Sections 1819(b)(5) and 1919(b)(5) of the Social Security Act (42 U.S.C. 1395i-3(b)(5), 1396r(b)(5)) are each amended— (A) in subparagraph (A), by striking "January 1, 1990" and inserting "October 1, 1990", and (B) in subparagraph (B), by striking "July 1, 1989" and "January 1, 1990" and inserting "January 1, 1990" and "October 1, 1990". respectively. 42 USC i395i-3 (2) PUBLICATioN OP PROPOSED REGULATIONS. — The Secretary of note. Health and Human Services shall issue proposed regulations to i,^ establish the requirements described in sections 1819(f)(2) and ' 1919(f)(2) of the Social Security Act by not later than 90 days after the date of the enactment of this Act. (3) REQUIREMENTS FOR TRAINING AND EVALUATION PRO- GRAMS. — Sections 1819(f)(2)(A) and 1919(f)(2)(A) of the Social Security Act (42 U.S.C. 1395i-3(f)(2)(A), 1396r(f)(2)(A)) are each amended— (A) in clause (i)(D, by inserting "care of cognitively im- paired residents," after "social service needs."; (6) in clause (ii), by striking "cognitive, behavioral and social care" and inserting "recognition of mental health and social service needs, care of C(^nitively impaired resi- dents"; (Q by striking the period at the end of clause (iii) and inserting "; and; and (D) by adding at the end the following new clause: (iv) requirements, under both such programs, that—
"(I) provide procedures for determining com- petency that permit a nurse aide, at the nurse aide's option, to establish competency through procedures or methods other than the passing of a written examination and to have the competency evaluation conducted at the nursing facility at which the aide is (or will be) employed (unless the facility is described in subparagraph (B)(iiiXD), and
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