PUBLIC LAW 101-508 —NOV. 5, 1990 104 STAT. 1388-47 3(b)(5)(C)) is amended by striking "the State registry established under subsection (e)(2)(A) as to information in the registry" and inserting "any State registry established under subsection (e)(2)(A) that the facility believes will include information". (D) RETRAINING OF NURSE AIDES. —Section 1819(b)(5)(D) (42 U.S.C. 1395i-3(b)(5)(D)) is amended by striking the period at the end and inserting ", or a new competency evaluation program. ". (E) CLARIFICATION OF NURSE AIDES NOT SUBJECT TO CHARGES.— Section 1819(f)(2)(A)(iv) (42 U.S.C. 13951- 3(f)(2)(A)(iv)) is amended— (i) in subclause (I), by striking "and" at the end; (ii) in subclause (II), by inserting after "nurse aide" the following: "who is employed by (or who has received an offer of employment from) a facility on the date on which the aide begins either such program"; (iii) in subclause (II), by striking the period at the end and inserting ", and"; and (iv) by adding at the end the following new subclause: "(III) in the case of a nurse aide not described in subclause (II) who is employed by (or who has received an offer of employment from) a facility not later than 12 months after completing either such program, the State shall provide for the reimbursement of costs incurred in completing such program on a prorata basis during the period in which the nurse aide is so employed.". (F) MODIFICATION OF NURSING FACILITY DEFICIENCY STAND- ARDS.— (i) IN GENERAL.— Section 1819(f)(2)(B)(iii)(I) (42 U.S.C. 1395i-3(f)(2)(B)(iii)(I)) is amended to read as follows: "(I) offered Jt)y or in a skilled nursing facility which, within the previous 2 years— "(a) has operated under a waiver under subsection (b)(4)(C)(ii)(II); "(b) has been subject to an extended (or partial extended) survey under subsection (g)(2)(B)(i) or section 1919(g)(2)(B)(i); or "(c) has been assessed a civil money penalty described in subsection (h)(2)(B)(ii) or section 1919(h)(2)(A)(ii) of not less than $5,000, or has been subject to a remedy described in clauses (i) or (iii) of subsection (h)(2)(B), subsection (h)(4), section 1919(h)(l)(B)(i), or in clauses (i), (iii), or (iv) of section 1919(h)(2)(A), or", (ii) EFFECTIVE DATE. — The amendments made by 42 USC l395i-3 clause (i) shall take effect as if included in the enact- »^ote. ment of the Omnibus Budget Reconciliation Act of 1987, except that a State may not approve a training and competency evaluation program or a competency evaluation program offered by or in a nursing facility which, pursuant to any Federal or State law within the 2-year period beginning on October 1, 1988— (I) had its participation terminated under title XVIII of the Social Security Act or under the State plan under title XIX of such Act;
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