S.Amdt. 2182

1. Adds SEC. 1422. ADMINISTRATION AND OVERSIGHT OF THE ARMED FORCES RETIREMENT HOME at the end of subtitle C of title XIV

   Adds a section

   Inserted: SEC. 1422. ADMINISTRATION AND OVERSIGHT OF THE ARMED FORCES RETIREMENT HOME.

   Inserted: (a) Independence and Purpose of Retirement Home.--Section 1511 of the Armed Forces Retirement Home Act of 1991 (24 U.S.C. 411) is amended--

   Inserted: (1) in subsection (a), by adding at the end the following: "However, the Retirement Home shall be treated as a military facility of the Department of Defense, and may not be privatized. The administration of the Retirement Home (including administration for the provision of health care and medical care for residents) shall remain under the direct authority, control, and administration of the Secretary of Defense."; and

   Inserted: (2) by striking subsection (g) and inserting the following new subsection (g):

   Inserted: "(g) Accreditation.--The Chief Executive Officer shall secure and maintain accreditation by a nationally recognized civilian accrediting organization for each aspect of each facility of the Retirement Home, including medical and dental care, pharmacy, independent living, and assisted living and nursing care.".

   Inserted: (b) Spectrum of Care.--Section 1513(b) of the Armed Forces Retirement Home Act of 1991 (24 U.S.C. 413(b)) is amended by inserting after the first sentence the following new sentence: "The services provided residents of the Retirement Home shall include nonacute medical and dental services, pharmaceutical services, and transportation of residents, at no cost to residents, to acute medical and dental services and after-hours routine medical care".

   Inserted: (c) Administration Through Chief Executive Officer.--

   Inserted: (1) In general.--Section 1515 of the Armed Forces Retirement Home Act of 1991 (24 U.S.C. 415) is amended--

   Inserted: (A) by striking "Chief Operating Officer" each place it appears and inserting "Chief Executive Officer"; and

   Inserted: (B) in subsection (e)(1), by striking "Chief Operating Officer's" and inserting "Chief Executive Officer's".

   Inserted: (2) Heading amendment.--The heading of such section is amended to read as follows:

   Inserted: "SEC. 1515. CHIEF EXECUTIVE OFFICER.".

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   Inserted: (3) Other conforming amendments.--The Armed Forces Retirement Home Act of 1991 is further amended by striking "Chief Operating Officer" each place it appears (other than section 1531 (24 U.S.C. 431)) and inserting "Chief Executive Officer".

   Inserted: (d) Modification of Authorities Applicable to Chief Executive Officer.--

   Inserted: (1) Term of office; eligibility for reappointment.--Paragraph (2) of subsection (a) of section 1515 of such Act is amended to read as follows:

   Inserted: "(2) The Chief Executive Officer shall serve a term of four years, but is removable from office during such term at the pleasure of the Secretary. An individual may be reappointed as Chief Executive Officer for a single additional term of four years.".

   Inserted: (2) Evaluation of performance.--Subsection (a)(3) of such section is amended by adding at the end the following new sentence: "In evaluating the performance of the Chief Executive Officer, the Secretary shall take into account the views of the Local Board for each facility of the Retirement Home and of the residents of each facility of the Retirement Home.".

   Inserted: (3) Qualifications.--Subsection (b) of such section is amended to read as follows:

   Inserted: "(b) Qualifications.--To qualify for appointment as the Chief Executive Officer, a person shall have--

   Inserted: "(1) not less than 10 years of civilian or military experience as a medical doctor, nurse, nurse practitioner, or other public health care professional;

   Inserted: "(2) experience managing a medical care facility or continuing care facility, including experience--

   Inserted: "(A) managing a military installation, military medical treatment facility or veterans medical care facility, public health care facility, or retirement home; or

   Inserted: "(B) providing long-term medical care to the elderly; and

   Inserted: "(3) proven senior leadership and management skills as an administrator of a military installation, residential or medical facility, or public health care facility.".

   Inserted: (4) Responsibilities.--Subsection (c) of such section is amended--

   Inserted: (A) in paragraph (1)--

   Inserted: (i) by striking ", operation, and management" and inserting "and financial management"; and

   Inserted: (ii) by striking "to the Secretary" and inserting "directly to the Secretary (or the designee of the Secretary)";

   Inserted: (B) in paragraph (2)--

   Inserted: (i) by striking "supervise the operation and administration" and inserting "advise the Secretary on the long-term financial and administrative management"; and

   Inserted: (ii) by striking ", including the Local Boards of those facilities"; and

   Inserted: (C) in paragraph (3)(C), by inserting before the period at the end the following "and submit to the Secretary and the Under Secretary of Defense for Personnel and Readiness on a quarterly basis reports on such examinations and audits".

   Inserted: (5) Compensation.--Subsection (d)(2) of such section is amended by striking the second sentence and inserting the following new sentence: "In determining the amount of the bonus each year, the Secretary shall take into account the views of the Local Board for each facility of the Retirement Home, and the resident advisory committee or council of each facility, regarding the performance of the Chief Executive Officer.".

   Inserted: (e) Chief Medical Officer.--The Armed Forces Retirement Home Act of 1991 is further amended by inserting after section 1515 the following new section:

   Inserted: "SEC. 1515A. CHIEF MEDICAL OFFICER.

   Inserted: "(a) Appointment.--(1) The Secretary of Defense shall appoint the Chief Medical Officer of the Retirement Home. The Secretary of Defense shall make the appointment in consultation with the Secretary of Homeland Security.

   Inserted: "(2) The Chief Medical Officer shall serve a term of two years, but is removable from office during such term at the pleasure of the Secretary.

   Inserted: "(3) The Secretary (or the designee of the Secretary) shall evaluate the performance of the Chief Medical Officer not less frequently than once each year. The Secretary shall carry out such evaluation in consultation with the Chief Executive Officer and the Local Board for each facility of the Retirement Home.

   Inserted: "(4) An officer appointed as Chief Medical Officer of the Retirement Home shall serve as Chief Medical Officer without vacating any other military duties and responsibilities assigned to that officer whether at the time of appointment or afterward.

   Inserted: "(b) Qualifications.--(1) To qualify for appointment as the Chief Medical Officer, a person shall be a member of the Medical, Dental, Nurse, or Medical Services Corps of the Armed Forces, including the Health and Safety Directorate of the Coast Guard, serving on active duty in the grade of brigadier general, or in the case of the Navy or the Coast Guard rear admiral (lower half), or higher.

   Inserted: "(2) In making appointments of the Chief Medical Officer, the Secretary of Defense shall, to the extent practicable, provide for the rotation of the appointments among the various Armed Forces and the Health and Safety Directorate of the Coast Guard.

   Inserted: "(c) Responsibilities.--(1) The Chief Medical Officer shall be responsible to the Secretary, the Under Secretary of Defense for Personnel and Readiness, and the Chief Executive Officer for the direction and oversight of the provision of medical, mental health, and dental care at each facility of the Retirement Home.

   Inserted: "(2) The Chief Medical Officer shall advise the Secretary, the Under Secretary of Defense for Personnel and Readiness, the Chief Executive Officer, and the Local Board for each facility of the Retirement Home on all medical and medical administrative matters of the Retirement Home.

   Inserted: "(d) Duties.--In carrying out the responsibilities set forth in subsection (c), the Chief Medical Officer shall perform the following duties:

   Inserted: "(1) Ensure the timely availability to residents of the Retirement Home, at locations other than the Retirement Home, of such acute medical, mental health, and dental care as such resident may require that is not available at the applicable facility of the Retirement Home.

   Inserted: "(2) Ensure compliance by the facilities of the Retirement Home with accreditation standards, applicable health care standards of the Department of Veterans Affairs, and any other applicable health card standards and requirements (including requirements identified in applicable reports of the Inspectors General for the Retirement Home and the Inspector General of the Department of Defense).

   Inserted: "(3) Periodically visit and inspect the medical facilities and medical operations of each facility of the Retirement Home.

   Inserted: "(4) Periodically examine and audit the medical records and administration of the Retirement Home.

   Inserted: "(5) Consult with the Local Board for each facility of the Retirement Home not less frequently than once each year.

   Inserted: "(e) Advisory Bodies.--In carrying out the responsibilities set forth in subsection (c) and the duties set forth in subsection (d), the Chief Medical Officer may establish and seek the advice of such advisory bodies as the Chief Medical Officer considers appropriate.".

   Inserted: (f) Local Boards of Trustees.--

   Inserted: (1) Duties.--Subsection (b) of section 1516 of the Armed Forces Retirement Home Act of 1991 (24 U.S.C. 416) is amended to read as follows:

   Inserted: "(b) Duties.--(1) The Local Board for a facility shall serve in an advisory capacity to the Director of the facility and to the Chief Executive Officer.

   Inserted: "(2) The Local Board for a facility shall provide to the Chief Executive Officer and the Director of the facility such guidance and recommendations on the administration of the facility as the Local Board considers appropriate.

   Inserted: "(3) The Local Board for a facility shall provide to the Under Secretary of Defense for Personnel and Readiness not less often than annually an assessment of all aspects of the facility, including the quality of care at the facility.

   Inserted: "(4) Not less frequently than one each year, the Local Board for a facility shall submit to Congress a report that includes an assessment of all aspects of the facility, including the quality of care at the facility.".

   Inserted: (2) Composition.--Subparagraph (K) of subsection (c) of such section is amended to read as follows:

   Inserted: "(K) One senior representative of one of the chief personnel officers of the Armed Forces, who shall be a member of the Armed Forces serving on active duty in the grade of brigadier general, or in the case of the Navy or Coast Guard, rear admiral (lower half).".

   Inserted: (g) Directors, Deputy Directors, Associate Directors, and Staff of Facilities.--

   Inserted: (1) Directors.--

   Inserted: (A) Qualifications for appointment, term, and supervision.--Subsection (b) of section 1517 of the Armed Forces Retirement Home Act of 1991 (24 U.S.C. 417) is amended to read as follows:

   Inserted: "(b) Director.--(1) The Director of a facility shall--

   Inserted: "(A) be a member of the Armed Forces serving on active duty in the grade of colonel or, in the case of the Navy, captain;

   Inserted: "(B) either--

   Inserted: "(i) have proven leadership and management skills, including at least one tour of duty as a commanding officer or executive officer of a military installation or similar facility; or

   Inserted: "(ii) have served as a director, deputy director, or commanding officer of a military hospital or military medical or dental treatment facility; and

   Inserted: "(C) possess certification as a retirement facilities director from an appropriate civilian certifying organization, or obtain such certification within the time otherwise applicable to civilian achievement of such certification unless the requirement for such certification is waived by the Secretary of Defense.

   Inserted: "(2) The Director of a facility shall serve at the pleasure of the Secretary.

   Inserted: "(3) The Director of a facility shall be under the direction of the Under Secretary of Defense for Personnel and Readiness. The Director of a facility shall also keep the Chief Executive Officer and the Chief Medical Officer apprised of matters relating to the facility.

   Inserted: "(4) The Secretary or the Under Secretary shall evaluate the performance of the Director of a facility not less frequently than once each year, in consultation with the Local Board for the facility and the residents of the facility.".

   Inserted: (B) Additional duties.--Subsection (c) of such section is amended by adding at the end the following new paragraph:

   Inserted: "(3) The Director of a facility shall work with the Chief Executive Officer and the Chief Medical Officer to ensure that sufficient resources are available to manage the facility properly.".

   Inserted: (2) Deputy directors.--Subsection (d) of such section is amended to read as follows:

   Inserted: "(d) Deputy Director.--(1) The Deputy Director of a facility shall--

   Inserted: "(A) either--

   Inserted: "(i) be a civilian with not less than 5 years of experience as a continuing care retirement community professional; or

   Inserted: "(ii) be a member of the Armed Forces serving on active duty in a grade of or below lieutenant colonel or, in the case of the Navy, commander; and

   Inserted: "(B) have proven appropriate leadership and management skills.

   Inserted: "(2) The Deputy Director of a facility shall serve at the pleasure of the Secretary of Defense.

   Inserted: "(3) The Deputy Director of a facility shall be under the direction of the Director of the facility.".

   Inserted: (3) Associate directors.--

   Inserted: (A) Qualifications for appointment and supervision.--Subsection (f) of such section is amended--

   Inserted: (i) in paragraph (1)--

   Inserted: (I) in subparagraph (A), by striking "and" at the end;

   Inserted: (II) by redesignating subparagraph (B) as subparagraph (C); and

   Inserted: (III) by inserting after subparagraph (A) the following new subparagraph (B):

   Inserted: "(B) have served as Command Master Chief or Command Senior Enlisted Advisor at a major military command; and"; and

   Inserted: (ii) by adding at the end the following new paragraph:

   Inserted: "(3) The Associate Director of a facility shall be under the direction of the Director and Deputy Director of the facility.".

   Inserted: (B) Additional duties.--Subsection (g) of such section is amended to read as follows:

   Inserted: "(g) Duties of Associate Director.--The Associate Director of a facility shall--

   Inserted: "(1) serve as ombudsman for the residents of the facility;

   Inserted: "(2) report to the Director of the facility on any issues the Associate Director determines to be important for ensuring proper medical care for the residents of the facility;

   Inserted: "(3) advise the Under Secretary of Defense for Personnel and Readiness and the Local Board for the facility on matters relating to the care of the residents of the facility; and

   Inserted: "(4) perform such other duties as the Director of the facility may specify.".

   Inserted: (h) Inspection of Retirement Home.--Section 1518 of such Act (24 U.S.C. 418) is amended to read as follows:

   Inserted: "SEC. 1518. INSPECTION OF RETIREMENT HOME.

   Inserted: "(a) Inspectors General for the Retirement Home.--(1) The Inspectors General of the military departments shall have the duty to inspect the Retirement Home. The duty to inspect shall alternate among the Inspector General of the Army, the Naval Inspector General, and the Inspector General of the Air Force on such schedule as the Secretary of Defense shall direct.

   Inserted: "(2) On matters relating to the inspection of the Retirement Home the Inspectors General for the Retirement Home under paragraph (1) shall report directly to the Under Secretary of Defense for Personnel and Readiness.

   Inserted: "(3) The Inspectors General for the Retirement Home under paragraph (1) shall advise the Inspector General of the Department of Defense and the Director of each facility of the Retirement Home on matters relating to waste, fraud, abuse, and mismanagement of the Retirement Home.

   Inserted: "(b) Inspections by Inspector General.--(1) Every two years, the current Inspector General for the Retirement Home under subsection (a) shall perform a comprehensive inspection of all aspects of each facility of the Retirement Home, including independent living, assisted living, medical and dental care, pharmacy, financial and contracting records, and any aspect of either facility on which the Local Board for the facility or the resident advisory committee or council of the facility recommends inspection.

   Inserted: "(2) The Inspector General shall be assisted in inspections under this subsection by the medical inspector general of a military department designated for purposes of this subsection by the Secretary of Defense. In making such designations, the Secretary shall designate such medical inspectors general on a rotating basis from among the various military departments.

   Inserted: "(3) In conducting the inspection of a facility of the Retirement Home under this subsection, the Inspector General shall solicit concerns, observations, and recommendations from the Local Board for the facility, the resident advisory committee or council of the facility, and the residents of the facility. Any concerns, observations, and recommendations solicited from residents shall be solicited on a not-for-attribution basis.

   Inserted: "(4) The Chief Executive Officer and the Director of each facility of the Retirement Home shall make all staff, other personnel, and records of each facility available to the Inspector General in a timely manner for purposes of inspections under this subsection.

   Inserted: "(c) Reports on Inspections by Inspector General.--(1) Not later than 45 days after completing an inspection of a facility of the Retirement Home under subsection (b), the current Inspector General for the Retirement Home under subsection (a) shall submit to the Secretary of Defense, the Under Secretary of Defense for Personnel and Readiness, the Chief Executive Officer, the Director of the facility, and the Local Board for the facility, and to Congress, a report describing the results of the inspection and containing such recommendations as the Inspector General considers appropriate in light of the inspection.

   Inserted: "(2) Not later than 45 days after receiving a report of the Inspector General under paragraph (1), the Director of the facility concerned shall submit the Secretary of Defense, the Under Secretary of Defense for Personnel and Readiness, the Chief Executive Officer, and the Local Board for the facility, and to Congress, a plan to address the recommendations and other matters set forth in the report.

   Inserted: "(d) Additional Inspections.--(1) Every two years, in a year in which the Inspector General does not perform an inspection under subsection (b), the Chief Executive Officer shall request the inspection of each facility of the Retirement Home by the Joint Commission with respect to matters of facilities that are within the purview of the Joint Commission.

   Inserted: "(2) In the event an inspection under paragraph (1) does not address all matters at the facilities of the Retirement Home, the Chief Executive Officer shall request the inspection of the facilities by one or more appropriate civilian accrediting organizations for any matters at such facilities that are not addressed by the inspection under paragraph (1), including independent living, assisted living, and pharmacy (if applicable).

   Inserted: "(3) The Chief Executive Officer and the Director of a facility being inspected under this subsection shall make all staff, other personnel, and records of the facility available to the Joint Commission or other civilian accrediting organization in a timely manner for purposes of inspections under this subsection.

   Inserted: "(e) Reports on Additional Inspections.--(1) Not later than 45 days after receiving a report of an inspection from the Joint Commission or other civilian accrediting organization under subsection (d), the Director of the facility concerned shall submit to the Under Secretary of Defense for Personnel and Readiness, the Chief Executive Officer, and the Local Board for the facility a report containing--

   Inserted: "(A) the results of the inspection; and

   Inserted: "(B) a plan to address any recommendations and other matters set forth in the report.

   Inserted: "(2) Not later than 45 days after receiving a report and plan under paragraph (1), the Secretary of Defense shall submit the report and plan to Congress.".

   Inserted: (i) Armed Forces Retirement Home Trust Fund.--Section 1519 of the Armed Forces Retirement Home Act of 1991 (24 U.S.C. 419) is amended by adding at the end the following new subsection:

   Inserted: "(d) Reporting Requirements.--The Chief Financial Officer of the Armed Forces Retirement Home shall comply with the reporting requirements of subchapter II of chapter 35 of title 31, United States Code.".

   Original wording

   At the end of subtitle C of title XIV, add the following:

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As printed