Medicare Skilled Nursing Home Quality Care Amendments of 1987

Medicare Skilled Nursing Home Quality Care Amendments of 1987 - Amends title XVIII (Medicare) of the Social Security Act to set forth requirements for skilled nursing facilities (other than facilities for the mentally retarded), including requirements that such facilities: (1) primarily engage in providing residents with nursing care or rehabilitation services directed toward residents' mental, psychosocial, and physical well-being; (2) provide such care in accordance with a written plan of care initially prepared and periodically reviewed and revised, by a team which includes the attending physician and a professional registered nurse, on the basis of assessments of a resident's functional capacity conducted upon the resident's admission and after a significant change in the resident's physical or mental condition, but in no case less often than annually; (3) provide, in addition to nursing and rehabilitative services, such physicians' services, medically-related social services, pharmaceutical services, dietician services, and dental services as are required to fulfill each resident's plan of care; (4) require nurse aides to complete a State-approved training or retraining program before participating in resident care, and have an ongoing program of nurse aide training and performance review; (5) require a physician's supervision of each resident's care, the maintenance of clinical records on all residents, and 24-hour nursing services; (6) protect specified resident rights, including the right to appeal an involuntary transfer or discharge from the facility; (7) safeguard a resident's funds upon the resident's authorization; (8) notify the State agency responsible for licensing the facility of changes in the ownership, control, or administration of the facility; (9) adopt certain measures to preserve facility safety and sanitation; (10) meet such other conditions which the Secretary of Health and Human Services deems necessary for resident's health and safety. Subjects nursing facilities which participate in the falsification of resident assessments to civil money penalties and the required use of independent assessors thereafter.

Requires States to: (1) specify, by September 1, 1988, State-approved nurse aide training and testing programs which meet minimum standards to be established by the Secretary by March 1, 1988; and (2) maintain a registry of nurse aides who have successfully completed such programs. Prohibits State approval of a training program offered by a facility that has been out of compliance with the Act's requirements within the preceding two years. Requires States to: (1) establish a fair mechanism which meets Federal guidelines to be established by October 1, 1988, for hearing appeals on involuntary transfers of residents from nursing facilities; and (2) implement and enforce standards which are to be developed by the Secretary by March 1, 1988, regarding the qualifications of nursing facility administrators.

Reimburses nursing facilities for the reasonable costs of complying with this Act's requirements. Directs the Secretary to report to the Congress by January 1, 1992, on the implementation of the nursing facility resident assessment process.

Requires States to conduct periodic educational programs for the staff and residents of nursing facilities on current regulations, procedures, and policies concerning the quality of care provided at such facilities. Makes the Secretary responsible for certifying that State nursing facilities comply, and States responsible for certifying that other nursing facilities comply, with Medicare nursing facility requirements. Bases such certifications on standard surveys to be conducted within two months of any change in the ownership or administration of such a facility and, on an unannounced basis, at least every 15 months. Prohibits the Statewide average interval between surveys from exceeding one year. Subjects facilities with poor compliance records to extended surveys.

Requires that surveys be conducted by a multidisciplinary team of professionals who receive preservice and continuing training from the State. Directs States to use specialized survey teams to survey and carry out enforcement actions against chronically substandard facilities. Directs the Secretary to: (1) develop and test a protocol for conducting surveys; (2) establish minimum qualifications for surveyors; and (3) conduct sample surveys of nursing facilities, within two months of State surveys, to test the adequacy of State surveys, and, if the State surveys prove inadequate, train the State survey team or designate another State to perform such survey and certification activities. Authorizes the Secretary to conduct a special survey of a facility when there is reason to question its compliance with this Act.

Requires States to investigate complaints against, and monitor the compliance of, a facility with this Act's requirements if the facility was previously found to be out of compliance with such requirements or the State has reason to question its compliance.

Requires that certain information regarding nursing facilities and their compliance with this Act's requirements be made available to the public. Provides residents' physicians and the State board which licenses facility administrators with notice of a facility's poor quality of care. Gives State Medicaid (title XIX of the Act) fraud and abuse control units access to facility survey and certification information. Requires that survey results be posted in a place which is readily accessible to residents and their representatives.

Requires the Secretary or a State, upon determining that a nursing facility's deficiencies immediately jeopardize residents' health and safety, to terminate such facility's Medicare participation or take immediate action to remove the jeopardy and correct the deficiencies. Authorizes the Secretary and States to apply certain other remedies, which States must establish by October 1, 1989, where the health and safety of facility residents is not immediately jeopardized. Provides that if a facility is out of compliance with any of this Act's requirements six months after having been found out of compliance with such requirements, Medicare payments for newly admitted residents shall be denied. Sets forth special rules which are to be applied where a State and the Secretary disagree on a finding of noncompliance or the remedies which should be prescribed.