---
kind: "section"
citation: "42 U.S.C. § 1395i–3a"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1395i–3a"
heading: "Protecting residents of long-term care facilities"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1395i-3a"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XVIII — Health Insurance for Aged and Disabled"
  - "Part A — Hospital Insurance Benefits for Aged and Disabled"
---

# §1395i–3a. Protecting residents of long-term care facilities

- (1) **National Training Institute for surveyors—**
  - (A) **In general—** The [Secretary](/usc/42/1301.md?p=a-6) of Health and Human Services shall enter into a contract with an entity for the purpose of establishing and operating a National Training Institute for Federal and [State](/usc/42/619.md?p=5) surveyors. Such Institute shall provide and improve the training of surveyors with respect to investigating allegations of [abuse](/usc/42/1397j.md?p=1), [neglect](/usc/42/1397j.md?p=16), and misappropriation of property in programs and [long-term care facilities](/usc/42/1397j.md?p=15) that receive payments under title XVIII or XIX of the [Social](/usc/42/1397j.md?p=20) Security Act [[42 U.S.C. 1395](/usc/42/1395.md) et seq., 1396 et seq.].
  - (B) **Activities carried out by the Institute—** The contract entered into under [subparagraph (A)](#1-A) shall require the Institute established and operated under such contract to carry out the following activities:
    - (i) Assess the extent to which [State agencies](/usc/42/629a.md?p=a-3) use specialized surveyors for the investigation of reported allegations of [abuse](/usc/42/1397j.md?p=1), [neglect](/usc/42/1397j.md?p=16), and misappropriation of property in such programs and [long-term care facilities](/usc/42/1397j.md?p=15).
    - (ii) Evaluate how the competencies of surveyors may be improved to more effectively investigate reported allegations of such [abuse](/usc/42/1397j.md?p=1), [neglect](/usc/42/1397j.md?p=16), and misappropriation of property, and provide feedback to Federal and [State agencies](/usc/42/629a.md?p=a-3) on the evaluations conducted.
    - (iii) Provide a national program of training, tools, and technical assistance to Federal and [State](/usc/42/619.md?p=5) surveyors on investigating reports of such [abuse](/usc/42/1397j.md?p=1), [neglect](/usc/42/1397j.md?p=16), and misappropriation of property.
    - (iv) Develop and disseminate information on best [practices](/usc/42/17061.md?p=19) for the investigation of such [abuse](/usc/42/1397j.md?p=1), [neglect](/usc/42/1397j.md?p=16), and misappropriation of property.
    - (v) Assess the performance of [State](/usc/42/619.md?p=5) complaint intake systems, in order to ensure that the intake of complaints occurs 24 hours per day, 7 days a week ([including](/usc/42/1301.md?p=b) holidays).
    - (vi) To the extent approved by the [Secretary](/usc/42/1301.md?p=a-6) of Health and Human Services, provide a national 24 hours per day, 7 days a week ([including](/usc/42/1301.md?p=b) holidays), back-up system to [State](/usc/42/619.md?p=5) complaint intake systems in order to ensure optimum national responsiveness to complaints of such [abuse](/usc/42/1397j.md?p=1), [neglect](/usc/42/1397j.md?p=16), and misappropriation of property.
    - (vii) Analyze and report annually on the following:
      - (I) The total number and sources of complaints of such [abuse](/usc/42/1397j.md?p=1), [neglect](/usc/42/1397j.md?p=16), and misappropriation of property.
      - (II) The extent to which such complaints are referred to [law enforcement](/usc/42/1397j.md?p=13) [agencies](/usc/42/1397n–12.md?p=1).
      - (III) General results of Federal and [State](/usc/42/619.md?p=5) investigations of such complaints.
    - (viii) Conduct a national study of the cost to [State agencies](/usc/42/629a.md?p=a-3) of conducting complaint investigations of skilled [nursing facilities](/usc/42/1397j.md?p=17-A) and [nursing facilities](/usc/42/1397j.md?p=17-A) under sections 1819 and 1919, respectively, of the [Social](/usc/42/1397j.md?p=20) Security Act ([42 U.S.C. 1395i–3](/usc/42/1395i–3.md); 1396r), and making recommendations to the [Secretary](/usc/42/1301.md?p=a-6) of Health and Human Services with respect to options to increase the efficiency and cost-effectiveness of such investigations.
  - (C) **Authorization—** There are authorized to be appropriated to carry out this paragraph, for the period of [fiscal years](/usc/42/619.md?p=3) 2011 through 2014, $12,000,000.
- (2) **Grants to State survey agencies—**
  - (A) **In general—** The [Secretary](/usc/42/1301.md?p=a-6) of Health and Human Services shall make [grants](/usc/42/1397j.md?p=10) to [State agencies](/usc/42/629a.md?p=a-3) that perform surveys of skilled [nursing facilities](/usc/42/1397j.md?p=17-A) or [nursing facilities](/usc/42/1397j.md?p=17-A) under sections 1819 or 1919, respectively, of the [Social](/usc/42/1397j.md?p=20) Security Act ([42 U.S.C. 1395i–3](/usc/42/1395i–3.md); 1395r [1396r]).
  - (B) **Use of funds—** A [grant](/usc/42/1397j.md?p=10) awarded under [subparagraph (A)](#2-A) shall be used for the purpose of designing and implementing complaint investigations systems that—
    - (i) promptly prioritize complaints in order to ensure a rapid response to the most serious and urgent complaints;
    - (ii) respond to complaints with optimum effectiveness and timeliness; and
    - (iii) optimize the collaboration between local authorities, consumers, and providers, [including](/usc/42/1301.md?p=b)—
      - (I) such [State agency](/usc/42/629a.md?p=a-3);
      - (II) the [State Long-Term Care Ombudsman](/usc/42/1397j.md?p=22);
      - (III) local [law enforcement](/usc/42/1397j.md?p=13) [agencies](/usc/42/1397n–12.md?p=1);
      - (IV) advocacy and consumer organizations;
      - (V) [State](/usc/42/619.md?p=5) aging units;
      - (VI) Area [Agencies](/usc/42/1397n–12.md?p=1) on Aging; and
      - (VII) other appropriate entities.
  - (C) **Authorization—** There are authorized to be appropriated to carry out this paragraph, for each of [fiscal years](/usc/42/619.md?p=3) 2011 through 2014, $5,000,000.

## Source credit

(Pub. L. 111–148, title VI, § 6703(b)(1), (2), Mar. 23, 2010, 124 Stat. 798, 799.)

## Notes

### Editorial Notes

### References in Text

The Social Security Act, referred to in par. (1)(A), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Titles XVIII and XIX of the Act are classified generally to this subchapter (§ 1395 et seq.) and subchapter XIX (§ 1396 et seq.), respectively, of this chapter. For complete classification of this Act to the Code, see section 1305 of this title and Tables.

### Codification

Section was enacted as part of the Elder Justice Act of 2009 and also as part of the Patient Protection and Affordable Care Act, and not as part of the Social Security Act which comprises this chapter.

### Statutory Notes and Related Subsidiaries

### Definitions

Pub. L. 111–148, title VI, § 6702, Mar. 23, 2010, 124 Stat. 782, provided that: “Except as otherwise specifically provided, any term that is defined in section 2011 of the Social Security Act [42 U.S.C. 1397j] (as added by section 6703(a)) and is used in this subtitle [subtitle H (§§ 6701–6703) of title VI of Pub. L. 111–148, enacting this section and sections 1320b–25, 1397j, 1397j–1, 1397k to 1397k–3, 1397l, and 1397m to 1397m–5 of this title, amending sections 602, 604, 622, 671 to 673, 1320a–7, 1320a–7a, 1397, 1397a, 1397c to 1397e, and 1397g of this title, and enacting provisions set out as notes under sections 602 and 1305 of this title] has the meaning given such term by such section.”