A bill to amend title XIX of the Social Security Act to require the States to regulate nursing homes more effectively under their medicaid programs and to improve the enforcement of such regulation.

Requires, under Title XIX (Medicaid) of the Social Security Act, that the States must provide for periodic inspections of nursing homes to determine compliance with sanitation, environmental, patient care, medical care, dietary and fire safety standards, without advance notice.

Specifies that the States must create an ombudsman-ombudswoman system to receive and consider complaints and reports concerning the operation of long-term care facilities.

Directs the States to appoint a trustee manager for long term care facilities which fail to meet the specified standards.