12 2 STA T . 2 5 1 3PUBLIC LA W 11 0– 2 7 5 —J UL Y 15 , 200 8(b)USEOFFUND SFO R FEDER ALA D MI NIS T RATI V E EXP ENSES .—Section1820 ( g )( 5 )o f t h e Soci al Sec ur it y Act ( 4 2 U.S. C . 1 39 5i – 4(g)(5)) i s a m en d ed— (1) by stri k ing ‘ ‘beginning w ith fiscal year 2005 ’ ’ and inserting ‘‘for each of fiscal years 2005 through 2008’’
and (2) by inserting ‘‘and , of the total amount a p propriated for grants under paragraphs (1), (2), and ( 6 ) for a fiscal year (beginning with fiscal year 2009)’’ after ‘‘2005)’’. (c) EXTENSION OF AUT H ORI Z ATION FOR F L E XG RANTS.—Section 1820( j ) of the Social Security Act (42 U.S.C. 1395i–4(j)) is amended— (1) by striking ‘‘and for’’ and inserting ‘‘for’’; and (2) by inserting ‘‘, for making grants to all States under paragraphs (1) and (2) of subsection (g), $ 55,000,000 in each of fiscal years 2009 and 2010, and for making grants to all States under paragraph (6) of subsection (g), $50,000,000 in each of fiscal years 2009 and 2010, to remain a v ailable until e x pended’’ before the period at the end. (d) M EDI C ARE R URAL H OSPITAL FLEXI B ILIT YP RO G RAM.—Section 1820(g)(1) of the Social Security Act (42 U.S.C. 1395i–4(g)(1)) is amended— (1) in subparagraph ( B ), by striking ‘‘and’’ at the end; (2) in subparagraph (C), by striking the period at the end and inserting ‘‘; and’’; and (3) by adding at the end the following new subparagraph
‘‘( D ) providing support for critical access hospitals for q uality improvement, quality reporting, performance improvements, and benchmarking.’’. (e) ASSISTANCE TO SMALL CRITICAL ACCESS HOSPITALS T RANSITIONING TO S K ILLED N URSING FACILITIES AND ASSISTED LIVING FACILITIES.—Section 1820(g) of the Social Security Act (42 U.S.C. 1395i–4(g)), as amended by subsection (a), is amended by adding at the end the following new paragraph: ‘‘( 7 ) CRITICAL ACCESS HOSPITALS TRANSITIONING TO SKILLED NURSING FACILITIES AND ASSISTED LIVING FACILITIES.— ‘‘(A) GRANTS.—The Secretary may award grants to eligible critical access hospitals that have submitted applications in accordance with subparagraph (B) for assisting such hospitals in the transition to skilled nursing facilities and assisted living facilities. ‘‘(B) APPLICATION.—An applicable critical access hos - pital seeking a grant under this paragraph shall submit an application to the Secretary on or before such date and in such form and manner as the Secretary specifies. ‘‘(C) ADDITIONAL RE Q UIREMENTS.—The Secretary may not award a grant under this paragraph to an eligible critical access hospital unless— ‘‘(i) local organi z ations or the State in which the hospital is located provides matching funds; and ‘‘(ii) the hospital provides assurances that it will surrender critical access hospital status under this title within 180 days of receiving the grant. ‘‘(D) AMOUNT OF GRANT.—A grant to an eligible critical access hospital under this paragraph may not exceed $1,000,000. ‘‘(E) FUNDING.—There are appropriated from the Fed- eral Hospital I nsurance Trust Fund under section 1817 Ap p ro pr iat io n a u t h ori z ation .
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