; and (ii) is not subject to a quality-of-care corporate integrity agreement (relating to one or more programs under this Act) that is in effect with the Inspector General of the Department of Health and Human Services and that requires the facility to retain an independent quality monitor. The Secretary may make a determination under clause (ii) based upon the most current information contained in the website of the Inspector General. (B) Waiver of ratings to ensure access The Secretary may, upon application, waive the requirement of subparagraph (A)(i) for a skilled nursing facility in order to ensure access to extended care services that are not post-hospital extended care services in particular underserved geographic areas. (C) Grace period for correction of ratings In the case of a skilled nursing facility that qualifies as a qualified skilled nursing facility for a period and that would be disqualified under subparagraph (A)(i) because of a decline in its star rating, before disqualifying the facility the Secretary shall provide the facility with a grace period of 1 year during which the facility seeks to improve its ratings based on a plan of correction approved by the Secretary. (D) Holding beneficiaries harmless in case of disqualification of a facility In the case of a skilled nursing facility that qualifies as a qualified skilled nursing facility for a period and that is disqualified under subparagraph (A), such disqualification shall not apply to or affect individuals who are admitted to the facility at the time of the disqualification. . (b) MedPAC study of cost of implementation The Medicare Payment Advisory Commission shall conduct a study of, and submit a report to Congress and the Secretary of Health and Human Services on, the cost of impact of the amendment made by subsection (a), no later than June 3, 2019.