Medicaid Frail Elderly Community Care Amendments of 1990

Medicaid Frail Elderly Community Care Amendments of 1990 - Amends title XIX (Medicaid) of the Social Security Act to permit States to provide Medicaid coverage of community care for functionally disabled elderly individuals. Considers individuals who are unable to perform at least two daily living activities or who have Alzheimer's disease and require substantial assistance or supervision as functionally disabled individuals. Defines a covered community care setting as a nonresidential setting or a residential setting in which more than two unrelated adults reside and personal services are provided.

Requires that community care be provided to each client in accordance with an individual community care plan (ICCP) prepared and periodically reviewed and revised by a community care case manager on the basis of the manager's consultation with the client and a comprehensive functional assessment of a client's needs conducted by an interdisciplinary team before his or her receipt of care and at least annually thereafter.

Sets a ceiling on Medicaid payments to States for community care. Reduces Federal Medicaid payments to States that reduce their Medicaid community care expenditures below their FY 1990 expenditures for such care.

Requires that community care and community care settings meet requirements, to be developed by the Secretary of Health and Human Services, concerning client rights, the quality of such care, and safety and sanitation. Imposes specified minimum requirements on such care and settings, including certain Medicaid requirements currently applicable to nursing facilities. Requires that community care settings: (1) disclose persons having an ownership or control interest in the setting; and (2) exclude a person from such interest if he or she has been excluded from the Medicaid program or had an interest in a community care setting repeatedly found to have provided substandard care.

Makes: (1) the Secretary responsible for certifying that State community care providers and settings comply with Medicaid requirements; and (2) States responsible for certifying that other community care providers and settings comply with Medicaid requirements. Requires that providers and settings be certified annually. Bases community care setting certification on an annual, unannounced survey. Directs the Secretary to: (1) develop a protocol for conducting surveys; and (2) conduct sample surveys of community care settings, within two months of State surveys, to test the adequacy of State surveys. Authorizes the Secretary to conduct a special survey of a setting or a review of a provider when there is reason to question its compliance with this Act. Prohibits the use of surveyors who have an interest in the provider or setting being surveyed.

Requires States and the Secretary to investigate complaints against providers or settings concerning violations of this Act's requirements. Requires each State to provide, through the State agency responsible for the certification of such providers and settings, for the receipt, review, and investigation of allegations of client neglect and abuse, and of misappropriation of client property by providers.

Requires that: (1) certain information regarding providers and settings and their compliance with this Act's requirements be made available to the public; and (2) State Medicaid fraud and abuse control units be given access to provider or setting survey and certification information.

Requires that when the Secretary or State determines that a provider's or setting's deficiencies immediately jeopardize the client's health and safety, immediate action be taken to remove the jeopardy and correct the deficiencies or the provider's or setting's participation in Medicaid be terminated. Authorizes the Secretary or States to terminate a community care provider's participation in the Medicaid program and to impose a civil monetary penalty for failure to meet this Act's requirements.

Sets forth the Secretary's responsibilities relating to community care requirements.

Requires that State Medicaid payment rates for community care be reasonable and adequate to meet the costs of providing such care efficiently, economically, and in accordance with applicable laws, regulations, and standards.

Prohibits the coverage of substandard community care, penalties imposed for such care, and community care furnished by family members.