(a) Medicare deeming authority

Section 1819 of the Social Security Act (42 U.S.C. 1395i–3) is amended by adding at the end the following new subsection:

(l) Special Rule for State Veterans Homes

(1) Deemed compliance

(A) In general

A State home (as defined in section 101 of title 38, United States Code) that is inspected and certified by the Department of Veterans Affairs (in this subsection referred to as the VA) in accordance with standards approved by the Secretary shall be deemed to meet the requirements of subsections (b) through (i) of this section if the Secretary determines that the following requirements are met:

(i)

The VA provides the Secretary with documentation of inspection and certification, which must include survey findings, statements of deficiencies, and related corrective actions.

(ii)

Not less than once every 2 years, the VA submits its State home survey standards and inspection procedures for joint review with the Centers for Medicare & Medicaid Services to confirm continued alignment with Medicare Conditions of Participation, including oversight methodologies.

(B) Requirements for approval of standards

In approving standards under subparagraph (A), the Secretary shall—

(i)

consult with the Secretary of Veterans Affairs; and

(ii)

ensure that the inspection and certification process used by the VA, including both standards and enforcement practices—

(I)

includes, as a minimum, the survey protocols and enforcement expectations of the Centers for Medicare & Medicaid Services; and

(II)

upholds, at a minimum, the same standards of resident care, safety, transparency, and accountability required under this section.

(2) Oversight and enforcement

Nothing in paragraph (1) shall preclude the Secretary from doing any of the following:

(A)

Conducting complaint investigations or targeted surveys of any State home.

(B)

Imposing remedies under subsection (h), including civil monetary penalties or termination of participation under this title.

(C)

Revoking deemed status under paragraph (1) if the VA certification process is found to be inconsistent with Federal standards of transparency, data quality, or enforcement.

(3) Public reporting

Survey and certification data from VA inspections deemed valid under this subsection shall be reported publicly through the Nursing Home Care Compare website under subsection (i) or another publicly accessible platform in a format determined by the Secretary, in consultation with the Secretary of Veterans Affairs.

(4) Congressional notice

Not later than 15 days after—

(A)

approving standards under paragraph (1);

(B)

revoking or suspending deemed status under paragraph (2); or

(C)

identifying material non-alignment between VA inspection practices and Medicare Conditions of Participation;

the Secretary shall submit written notice to the Committees on Veterans’ Affairs and Energy and Commerce of the House of Representatives and the Committees on Veterans’ Affairs and Finance of the Senate.

(b) Medicaid conforming amendment

Section 1919 of the Social Security Act (42 U.S.C. 1396r) is amended by adding at the end the following new subsection:

(l) Special rule for State veterans homes

The provisions of section 1819(l) shall apply with respect to a nursing facility that is a State home (as defined in section 101 of title 38, United States Code) and that is inspected and certified by the Department of Veterans Affairs in the same manner and to the same extent as such provisions apply under title XVIII.

(c) Effective date

The amendments made by this section shall take effect on the date that is 90 days after the date of enactment of this Act.

(d) Definition of enforcement expectations

The term Enforcement expectations means deficiency citations, corrective action plans, and remedies in response to individual deficiencies or repeat-deficiency rates that are as effective as or more effective than, and in lieu of, those resulting from surveys conducted directly by the Centers for Medicare & Medicaid Services.

(a) VA survey data on nursing home care compare

The Secretary of Health and Human Services shall coordinate with the Secretary of Veterans Affairs to ensure that inspection findings, deficiency statements, and quality metrics from Department of Veterans Affairs-certified State homes (as defined in section 101 of title 38, United States Code) are incorporated into the Nursing Home Care Compare website (or a successor website), to the extent feasible and consistent with section 1819(g)(5) of the Social Security Act (42 U.S.C. 1395i–3(g)(5)), and in a manner consistent with the risk-adjustment and case-mix methodologies otherwise used by the Centers for Medicare & Medicaid Services for public reporting of nursing facility quality measures.

(b) Harmonization of survey processes

Not later than 180 days after the date of enactment of this section, the Secretary of Health and Human Services, in consultation with the Secretary of Veterans Affairs, shall issue guidance to align certification and data reporting processes to ensure consistency and transparency in the public reporting of quality and compliance information for State homes (as so defined).

(1)

the impact of deeming authority on survey efficiency and costs;

(2)

comparative enforcement outcomes between VA-conducted and CMS-conducted surveys;

(3)

quality of care and safety outcomes for residents of State Veterans Homes; and

(4)

any recommendations for legislative or administrative action.