---
kind: "section"
citation: "42 U.S.C. § 1397m"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1397m"
heading: "Enhancement of long-term care"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1397m"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XX — Block Grants and Programs for Social Services and Elder Justice"
  - "Division B — Elder Justice"
  - "Part II — Programs To Promote Elder Justice"
---

# §1397m. Enhancement of long-term care

- (a) **Grants and incentives for long-term care staffing—**
  - (1) **In general—** The [Secretary](/usc/42/1301.md?p=a-6) shall carry out activities, [including](/usc/42/1301.md?p=b) activities described in paragraphs [(2)](#a-2) and [(3)](#a-3), to provide incentives for individuals to train for, seek, and maintain employment providing [direct care](/usc/42/1397j.md?p=4) in [long-term care](/usc/42/1397j.md?p=14-A).
  - (2) **Specific programs to enhance training, recruitment, and retention of staff—**
    - (A) **Coordination with Secretary of Labor to recruit and train long-term care staff—** The [Secretary](/usc/42/1301.md?p=a-6) shall coordinate activities under this subsection with the [Secretary](/usc/42/1301.md?p=a-6) of Labor in order to provide incentives for individuals to train for and seek employment providing [direct care](/usc/42/1397j.md?p=4) in [long-term care](/usc/42/1397j.md?p=14-A).
    - (B) **Career ladders and wage or benefit increases to increase staffing in long-term care—**
      - (i) **In general—** The [Secretary](/usc/42/1301.md?p=a-6) shall make [grants](/usc/42/1397j.md?p=10) to [eligible entities](/usc/42/1397j.md?p=7) to carry out programs through which the entities—
        - (I) offer, to employees who provide [direct care](/usc/42/1397j.md?p=4) to residents of an [eligible entity](/usc/42/1397j.md?p=7) or individuals receiving community-based [long-term care](/usc/42/1397j.md?p=14-A) from an [eligible entity](/usc/42/1397j.md?p=7), continuing training and varying levels of certification, based on observed clinical care [practices](/usc/42/17061.md?p=19) and the amount of time the employees spend providing [direct care](/usc/42/1397j.md?p=4); and
        - (II) provide, or make arrangements to provide, bonuses or other increased compensation or benefits to employees who achieve certification under such a program.
      - (ii) **Application—** To be eligible to receive a [grant](/usc/42/1397j.md?p=10) under this subparagraph, an [eligible entity](/usc/42/1397j.md?p=7) shall submit an application to the [Secretary](/usc/42/1301.md?p=a-6) at such time, in such manner, and containing such information as the [Secretary](/usc/42/1301.md?p=a-6) may require (which may include evidence of consultation with the [State](/usc/42/619.md?p=5) in which the [eligible entity](/usc/42/1397j.md?p=7) is located with respect to carrying out activities funded under the [grant](/usc/42/1397j.md?p=10)).
      - (iii) **Authority to limit number of applicants—** Nothing in this subparagraph shall be construed as prohibiting the [Secretary](/usc/42/1301.md?p=a-6) from limiting the number of applicants for a [grant](/usc/42/1397j.md?p=10) under this subparagraph.
  - (3) **Specific programs to improve management practices—**
    - (A) **In general—** The [Secretary](/usc/42/1301.md?p=a-6) shall make [grants](/usc/42/1397j.md?p=10) to [eligible entities](/usc/42/1397j.md?p=7) to enable the entities to provide training and technical assistance.
    - (B) **Authorized activities—** An [eligible entity](/usc/42/1397j.md?p=7) that receives a [grant](/usc/42/1397j.md?p=10) under [subparagraph (A)](#a-3-A) shall use funds made available through the [grant](/usc/42/1397j.md?p=10) to provide training and technical assistance regarding management [practices](/usc/42/17061.md?p=19) using methods that are demonstrated to promote retention of individuals who provide [direct care](/usc/42/1397j.md?p=4), such as—
      - (i) the establishment of [standard](/usc/42/1320d.md?p=7) human resource policies that reward high performance, [including](/usc/42/1301.md?p=b) policies that provide for improved [wages](/usc/42/409.md?p=a) and benefits on the basis of job reviews;
      - (ii) the establishment of motivational and thoughtful work organization [practices](/usc/42/17061.md?p=19);
      - (iii) the creation of a workplace culture that respects and values [caregivers](/usc/42/1397j.md?p=3) and their needs;
      - (iv) the promotion of a workplace culture that respects the rights of residents of an [eligible entity](/usc/42/1397j.md?p=7) or individuals receiving community-based [long-term care](/usc/42/1397j.md?p=14-A) from an [eligible entity](/usc/42/1397j.md?p=7) and results in improved care for the residents or the individuals; and
      - (v) the establishment of other programs that promote the provision of high quality care, such as a continuing education program that provides additional hours of training, [including](/usc/42/1301.md?p=b) on-the-job training, for employees who are certified nurse aides.
    - (C) **Application—** To be eligible to receive a [grant](/usc/42/1397j.md?p=10) under this paragraph, an [eligible entity](/usc/42/1397j.md?p=7) shall submit an application to the [Secretary](/usc/42/1301.md?p=a-6) at such time, in such manner, and containing such information as the [Secretary](/usc/42/1301.md?p=a-6) may require (which may include evidence of consultation with the [State](/usc/42/619.md?p=5) in which the [eligible entity](/usc/42/1397j.md?p=7) is located with respect to carrying out activities funded under the [grant](/usc/42/1397j.md?p=10)).
    - (D) **Authority to limit number of applicants—** Nothing in this paragraph shall be construed as prohibiting the [Secretary](/usc/42/1301.md?p=a-6) from limiting the number of applicants for a [grant](/usc/42/1397j.md?p=10) under this paragraph.
  - (4) **Accountability measures—** The [Secretary](/usc/42/1301.md?p=a-6) shall develop accountability measures to ensure that the activities conducted using funds made available under this subsection benefit individuals who provide [direct care](/usc/42/1397j.md?p=4) and increase the stability of the [long-term care](/usc/42/1397j.md?p=14-A) workforce.
  - (5) **Definitions—** In this subsection:
    - (A) **Community-based long-term care—** The term “community-based [long-term care](/usc/42/1397j.md?p=14-A)” has the meaning given such term by the [Secretary](/usc/42/1301.md?p=a-6).
    - (B) **Eligible entity—** The term “[eligible entity](/usc/42/1397j.md?p=7)” means the following:
      - (i) A [long-term care facility](/usc/42/1397j.md?p=15).
      - (ii) A community-based [long-term care](/usc/42/1397j.md?p=14-A) entity (as defined by the [Secretary](/usc/42/1301.md?p=a-6)).
- (b) **Certified EHR technology grant program—**
  - (1) **Grants authorized—** The [Secretary](/usc/42/1301.md?p=a-6) is authorized to make [grants](/usc/42/1397j.md?p=10) to [long-term care facilities](/usc/42/1397j.md?p=15) for the purpose of assisting such entities in offsetting the costs related to purchasing, leasing, developing, and implementing certified EHR technology (as defined in [section 1395w–4(o)(4)](/usc/42/1395w–4.md?p=o-4) of this title) designed to improve patient safety and reduce adverse events and health care complications resulting from medication errors.
  - (2) **Use of grant funds—** Funds provided under [grants](/usc/42/1397j.md?p=10) under this subsection may be used for any of the following:
    - (A) Purchasing, leasing, and installing computer software and hardware, [including](/usc/42/1301.md?p=b) handheld computer technologies.
    - (B) Making improvements to existing computer software and hardware.
    - (C) Making upgrades and other improvements to existing computer software and hardware to enable e-prescribing.
    - (D) Providing education and training to eligible [long-term care facility](/usc/42/1397j.md?p=15) staff on the use of such technology to implement the electronic transmission of prescription and patient information.
  - (3) **Application—**
    - (A) **In general—** To be eligible to receive a [grant](/usc/42/1397j.md?p=10) under this subsection, a [long-term care facility](/usc/42/1397j.md?p=15) shall submit an application to the [Secretary](/usc/42/1301.md?p=a-6) at such time, in such manner, and containing such information as the [Secretary](/usc/42/1301.md?p=a-6) may require (which may include evidence of consultation with the [State](/usc/42/619.md?p=5) in which the [long-term care facility](/usc/42/1397j.md?p=15) is located with respect to carrying out activities funded under the [grant](/usc/42/1397j.md?p=10)).
    - (B) **Authority to limit number of applicants—** Nothing in this subsection shall be construed as prohibiting the [Secretary](/usc/42/1301.md?p=a-6) from limiting the number of applicants for a [grant](/usc/42/1397j.md?p=10) under this subsection.
  - (4) **Participation in State health exchanges—** A [long-term care facility](/usc/42/1397j.md?p=15) that receives a [grant](/usc/42/1397j.md?p=10) under this subsection shall, where available, participate in activities conducted by a [State](/usc/42/619.md?p=5) or a qualified [State](/usc/42/619.md?p=5)-designated entity (as defined in [section 300jj–33(f) of this title](/usc/42/300jj–33.md?p=f)) under a [grant](/usc/42/1397j.md?p=10) under [section 300jj–33 of this title](/usc/42/300jj–33.md) to coordinate care and for other purposes determined appropriate by the [Secretary](/usc/42/1301.md?p=a-6).
  - (5) **Accountability measures—** The [Secretary](/usc/42/1301.md?p=a-6) shall develop accountability measures to ensure that the activities conducted using funds made available under this subsection help improve patient safety and reduce adverse events and health care complications resulting from medication errors.
- (c) **Adoption of standards for transactions involving clinical data by long-term care facilities—**
  - (1) **Standards and compatibility—** The [Secretary](/usc/42/1301.md?p=a-6) shall adopt electronic [standards](/usc/42/1320d.md?p=7) for the exchange of clinical data by [long-term care facilities](/usc/42/1397j.md?p=15), [including](/usc/42/1301.md?p=b), where available, [standards](/usc/42/1320d.md?p=7) for messaging and nomenclature. [Standards](/usc/42/1320d.md?p=7) adopted by the [Secretary](/usc/42/1301.md?p=a-6) under the preceding sentence shall be compatible with [standards](/usc/42/1320d.md?p=7) established under part C of subchapter XI, [standards](/usc/42/1320d.md?p=7) established under subsections (b)(2)(B)(i) and (e)(4) of [section 1395w–104 of this title](/usc/42/1395w–104.md), [standards](/usc/42/1320d.md?p=7) adopted under [section 300jj–14 of this title](/usc/42/300jj–14.md), and general [health information](/usc/42/1320d.md?p=4) technology [standards](/usc/42/1320d.md?p=7).
  - (2) **Electronic submission of data to the Secretary—**
    - (A) **In general—** Not later than 10 years after March 23, 2010, the [Secretary](/usc/42/1301.md?p=a-6) shall have procedures in place to accept the optional electronic submission of clinical data by [long-term care facilities](/usc/42/1397j.md?p=15) pursuant to the [standards](/usc/42/1320d.md?p=7) adopted under [paragraph (1)](#c-1).
    - (B) **Rule of construction—** Nothing in this subsection shall be construed to require a [long-term care facility](/usc/42/1397j.md?p=15) to submit clinical data electronically to the [Secretary](/usc/42/1301.md?p=a-6).
  - (3) **Regulations—** The [Secretary](/usc/42/1301.md?p=a-6) shall promulgate regulations to carry out this subsection. Such regulations shall require a [State](/usc/42/619.md?p=5), as a condition of the receipt of funds under this part, to conduct such data collection and reporting as the [Secretary](/usc/42/1301.md?p=a-6) determines are necessary to satisfy the requirements of this subsection.
- (d) **Authorization of appropriations—** There are authorized to be appropriated to carry out this section—
  - (1) for [fiscal year](/usc/42/619.md?p=3) 2011, $20,000,000;
  - (2) for [fiscal year](/usc/42/619.md?p=3) 2012, $17,500,000; and
  - (3) for each of [fiscal years](/usc/42/619.md?p=3) 2013 and 2014, $15,000,000.

## Source credit

(Aug. 14, 1935, ch. 531, title XX, § 2041, as added Pub. L. 111–148, title VI, § 6703(a)(1)(C), Mar. 23, 2010, 124 Stat. 791.)

## Notes

### Editorial Notes

### References in Text

Part C of subchapter XI, referred to in subsec. (c)(1), is classified to section 1320d et seq. of this title.