; and (C) to provide access to all veterans that need those services, including through implementing Geriatric and Palliative Specialty Consultative Clinical Resource Hubs to meet the needs of the aging veteran population. (2) Waiver of expansion to medical centers The Secretary may waive the application of the requirements under paragraph (1)(A) with respect to a medical center if the Secretary determines that the medical center does not have the capacity or need to implement a Geriatrics Patient Aligned Care Team model or to provide geriatric and palliative specialty services, as the case may be. (3) Study The Secretary shall conduct a study on the variations in the structure and model consistency of the Geriatrics Patient Aligned Care Team model and delivery and utilization of geriatric and palliative care throughout the Department and how those variations impact quality of care and patient outcomes. (d) Report to Congress (1) In general Not later than two years after the date of the enactment of this Act, and not less frequently than annually thereafter for the following five years, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the implementation of this section. (2) Inclusion of information on waivers The Secretary shall include in the report required by paragraph (1) an identification of any medical center of the Department in receipt of a waiver under subsection (c)(2) and the reason for the waiver. (e) Definitions In this section, the terms rural and highly rural have the meanings given those terms under the Rural-Urban Commuting Areas (RUCA) coding system of the Department of Agriculture. 103. Study on improving recruitment and retention at community living centers of Department of Veterans Affairs (a) In general Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall complete a study on barriers to hiring and retaining staff at