S.Amdt. 3261

SA 3261. Mrs. HAGAN submitted an amendment intended to be proposed to
amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr.
Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal
Revenue Code of 1986 to modify the first-time homebuyers credit in the
case of members of the Armed Forces and certain other Federal
employees, and for other purposes; which was ordered to lie on the
table; as follows:

On page 722, after line 20, insert the following:

SEC. 3016. CULTURE OF SAFETY HOSPITAL ACCOUNTABILITY STUDY
AND DEMONSTRATION PROGRAM.

(a) Study.--
(1) In general.--The Secretary shall conduct a study that--
(A) examines existing activities and programs in hospitals
for quality assurance, patient safety, and performance
improvement and provides an analysis regarding best practices
with respect to such activities and programs; and
(B) identifies best practices that should be replicated in
hospitals to improve patient safety and quality of care,
consistent with the provisions included under the quality
assessment and performance improvement program, as required
under the conditions of participation for hospitals under
Medicare.
(2) Report.--Not later than 2 years after the date of
enactment of this Act, the Secretary shall prepare a report
containing the results of the study conducted under paragraph
(1). Such report shall be made available on the Internet
website of the Centers for Medicare & Medicaid Services.
(b) Demonstration Program.--
(1) In general.--The Secretary shall establish the Culture
of Safety Hospital Accountability demonstration program to
provide support for establishing partnerships and other
cooperative approaches between hospitals, State health care
agencies, and the Department of Health and Human Services to
promote and implement the best practices identified under
subsection (a), with the goal of improving the safety and
quality of care provided to Medicare beneficiaries and
enhance compliance with the conditions of participation for
hospitals under Medicare.
(2) Duration.--The demonstration program shall operate
during a period of 3 years, beginning not later than 12
months after completion of the report described in subsection
(a)(2).
(3) Scope.--
(A) States.--The Secretary shall select not less than 4
States, but not more than 6 States, to participate in the
demonstration program.
(B) Hospitals.--The Secretary shall select not more than 24
hospitals, within the States

[[Page S13396]]

selected under subparagraph (A), to participate in the
demonstration program. The hospitals selected under this
subparagraph shall satisfy criteria, as developed by the
Secretary, indicating a need for substantial improvement in
quality of care and patient safety.
(4) Application.--A State or hospital that desires to
participate in the demonstration program shall submit to the
Secretary an application at such time, in such manner, and
containing such information as the Secretary may require.
(5) Implementation.--
(A) Technical assistance.--The Secretary shall provide
participating hospitals with technical assistance in
implementation of the best practices identified through the
study under subsection (a).
(B) Hospital surveyors.--For each State participating in
the demonstration program, the Secretary shall provide
training to State surveyors that is designed to--
(i) enhance knowledge of the disciplines of patient safety,
quality assessment, and performance improvement;
(ii) increase skill in evaluating compliance with quality
assessment and performance improvement programs required
under the conditions of participation for hospitals under
Medicare; and
(iii) focus investigations of complaints regarding hospital
care on the hospital's quality assessment and performance
improvement program.
(6) Evaluation.--For each State and hospital participating
in the demonstration program, the Secretary shall evaluate
the following:
(A) The level of implementation of the best practices
identified under subsection (a) by the participating
hospitals and whether adoption of such practices--
(i) improved quality and patient safety (including an
analysis of changes in quality measures and other indicators
of outcome and performance); and
(ii) resulted in a decrease in the seriousness or number of
citations for deficiencies under the conditions of
participation for hospitals under Medicare.
(B) The training provided to State surveyors and whether
such training resulted in enhanced proficiency in evaluations
of hospital quality assessment and performance improvement
programs.
(7) Report.--Not later than 12 months after completion of
the demonstration project, the Secretary shall submit to
Congress a report containing an evaluation of the
demonstration program, including--
(A) the findings of the evaluation under paragraph (6); and
(B) recommendations--
(i) in regard to whether the best practices identified
under the demonstration program should be adopted by other
hospitals, and how the Secretary can best promote adoption of
such best practices;
(ii) in regard to whether the training for State surveyors
developed under the demonstration program should be provided
to all State surveyors; and
(iii) for such legislation and administrative action as the
Secretary determines appropriate.
(8) Waiver authority.--The Secretary may waive such
requirements under titles XI and XVIII of the Social Security
Act as may be necessary to carry out the demonstration
program.
(c) Funding.--For purposes of carrying out this section,
the Secretary shall provide for the transfer from the Federal
Hospital Insurance Trust Fund under section 1817 of the
Social Security Act (42 U.S.C. 1395i) of $25,000,000, to the
Centers for Medicare & Medicaid Services Program Management
Account for the period of fiscal years 2010 through 2017.
Amounts transferred under the preceding sentence shall remain
available until expended.
(d) Alternative Remedies.--Section 1866(b) of the Social
Security Act (42 U.S.C. 1395cc(b)) is amended by adding at
the end the following new paragraph:
``(5)(A) The Secretary is authorized to promulgate
regulations that establish enforcement remedies that are in
addition to, or in lieu of, termination of an agreement under
this section for hospitals or critical access hospitals for
violations of health and safety requirements under this
title. Such remedies may include directed plans of correction
that are designed to--
``(i) ensure compliance with requirements under this title
(including conditions of participation for hospitals or
critical access hospitals);
``(ii) prevent recurrence of non-compliance with such
requirements; and
``(iii) improve the internal structures and processes
within the hospital or critical access hospital for provision
of continuous quality and safety enhancement.
``(B) The regulations described under subparagraph (A) may
be promulgated by the Secretary before, during, or after the
evaluation described under section 3016(b)(6) of the Patient
Protection and Affordable Care Act.''.
(e) Non-Application of Paperwork Reduction Act.--Chapter 35
of title 44, United States Code (commonly referred to as the
`Paperwork Reduction Act of 1995') shall not apply to this
section.
(f) Definitions.--In this section:
(1) Demonstration program.--The term ``demonstration
program'' means the Culture of Safety Hospital Accountability
demonstration program conducted under this section.
(2) Hospital.--The term ``hospital'' means--
(A) an institution described under section 1861(e) of the
Social Security Act (42 U.S.C. 1395x(e)); or
(B) a critical access hospital (as described under section
1861(mm)(1) of such Act (42 U.S.C. 1395x(mm)(1)).
(3) Medicare.--The term ``Medicare'' means the program
established under title XVIII of the Social Security Act (42
U.S.C. 1395 et seq.).
(4) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
______