; and (2) applicable requirements of Federal law to provide such services. (b) Minimum provider standards (1) In general The Secretary shall establish, evaluate, and update national minimum standards to ensure the quality of services provided under this Act and to monitor efforts by States to ensure the quality of such services. A State may also establish additional minimum standards which providers shall meet with respect to services provided in such State. (2) National minimum standards The national minimum standards under paragraph (1) shall be established for institutional providers of services and individual health care practitioners. Except as the Secretary may specify in order to carry out this Act, a hospital, skilled nursing facility, or other institutional provider of services shall meet standards for such a provider under the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq.). Such standards also may include, where appropriate, elements relating to— (A) adequacy and quality of facilities; (B) training and competence of personnel (including continuing education requirements); (C) comprehensiveness of service; (D) continuity of service; (E) patient satisfaction, including waiting time and access to services