; (B) in subparagraph (B)— (i) in clause (i), by inserting and after the semicolon; (ii) in clause (ii), by striking ; and and inserting a period; (iii) by striking clause (iii); and (iv) by striking A State may not delegate (through subcontract or otherwise) its responsibility under clause (iii)(II) to the nursing facility. ; (C) by striking subparagraphs (C) and (D); and (D) by adding at the end the following: (C) Disapproval of nurse aide training and competency evaluation programs and nurse aide competency evaluation programs (i) In general With respect to a State, the Secretary shall, in consultation with such State, disapprove, for a period not to exceed two years, a nurse aide training and competency evaluation program or a nurse aide competency evaluation program offered by or in a nursing facility if such facility— (I) has been assessed a civil monetary penalty under section 1819(h)(2)(B)(ii) or subsection (h)(2)(A)(ii) of not less than $10,697 for providing substandard quality of care; and (II) has not, in the determination of the Secretary, corrected the deficiencies in quality of care for which such civil monetary penalty was assessed. (ii) Rescission of disapproval The Secretary shall rescind a disapproval under clause (i) upon demonstration by a nursing facility that all deficiencies for which the civil monetary penalty described in clause (i)(I) was assessed have been remedied. For purposes of rescinding disapproval under the previous sentence, the Secretary may require additional oversight of the nursing facility for a period not to exceed the period of disapproval imposed under clause (i) with respect to such facility.