text: 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.
target: 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.
feat_title: A bill to establish the Culture of Safety Hospital Accountability Study and Demonstration Program.