article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Culture of Safety Hospital Accountability Act of 2010''. SEC. 2. 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 selected under subparagraph (A), to participate in the demonstration program. The hospitals selected under this subparagraph shall satisfy criteria, as developed by the Secretary, relating to compliance with the conditions of participation for hospitals under Medicare. (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 program, the Secretary shall submit to Congress a report containing an evaluation of such 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 Act, 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 2(b)(6) of the Culture of Safety Hospital Accountability Act of 2010.''. (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 Act. (f) Definitions.--In this Act: (1) Demonstration program.--The term ``demonstration program'' means the Culture of Safety Hospital Accountability demonstration program conducted under this Act. (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.
summary: Culture of Safety Hospital Accountability Act of 2010 - Directs the Secretary of Heatlh and Human Services (HHS) to study for a report made available on the Internet website of the Centers for Medicare and Medicaid Services: (1) existing activities and programs in hospitals for quality assurance, patient safety, and performance improvement; and (2) any best practices that should be replicated in hospitals to improve patient safety and quality of care, consistent with the quality assessment and performance improvement program, as required by the conditions of participation for hospitals under title XVIII (Medicare) of the Social Security Act. Directs the Secretary to establish the Culture of Safety Hospital Accountability demonstration program to support establishing partnerships and other cooperative approaches among hospitals, state health care agencies, and HHS to promote and implement the best practices.