104 STAT. 1388-46 PUBLIC LAW 101-508—NOV. 5, 1990 "(7) an individual who meets the conditions of subsection (a) may enroll under this part during a special enrollment period that includes any month during any part of which the individual is enrolled under section 1876 with an eligible organization and ending with the last day of the 8th consecutive month in which the individual is at no time so enrolled; "(8) in the case of an individual who enrolls during a special enrollment period under paragraph (7)— "(A) in any month of the special enrollment period in which the individual is at any time enrolled under section 1876 with an eligible organization or in the first month following such a month, the coverage period shall begin on the first day of the month in which the individual so enrolls (or, at the option of the individual, on the first day of any of the following three months), or "(B) in any other month of the special enrollment period, the coverage period shall begin on the first day of the month following the month in which the individual so enrolls; and "(9) in applying the provisions of section 1839(b), there shall not be taken into account months for which the individual can demonstrate that the individual was enrolled under section 1876 with an eligible organization.". 42 USC 1395i-2 (2) EFFECTIVE DATE. — The amendment made by paragraph (1) note. shall take effect on February 1, 1991. (h) NURSING HOME REFORM.— (1) NURSE AIDE TRAINING AND COMPETENCY EVALUATION. — 42 USC 1395aa (A) No COMPLIANCE ACTIONS BEFORE EFFECTIVE DATE OF note. GUIDELINES. —The Secretary of Health and Human Services may not refuse to enter into an agreement or cancel an existing agreement with a State under section 1864 of the Social Security Act on the basis that the State failed to meet the requirement of section 1819(e)(1)(A) of such Act before the effective date of guidelines, issued by the Secretary, establishing requirements under section 1819(f)(2)(A) of such Act, if the State demonstrates to the satisfaction of the Secretary that it has made a good faith effort to meet such requirement before such effective date. (B) PART-TIME NURSE AIDES NOT ALLOWED DELAY IN TRAIN- 42 USC l395i-3. INC.—Section 1819(b)(5)(A) (42 U.S.C. 1396r(b)(5)(A)) is amended— (i) by striking "A skilled nursing facility" and inserting "(i) Except as provided in clause (ii), a skilled nursing facility"; (ii) by striking "(on a full-time, temporary, per diem, or other basis) and inserting "on a full-time basis"; (iii) by striking "(i)" and "(ii)" and inserting "(I)" and "(II)"; and (iv) by adding at the end the following: "(ii) A skilled nursing facility must not use on a temporary, per diem, leased, or on any basis other than as a permanent employee any individual as a nurse aide in the facility on or after January 1, 1991, unless the individual meets the requirements described in clause (i).". (C) REQUIREMENT TO OBTAIN INFORMATION FROM NURSE AIDE REGISTRY.—Section 1819(b)(5)(C) (42 U.S.C. 13951-
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