Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting; Correction, 52392-52396 [2024-13795]
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Federal Register / Vol. 89, No. 121 / Monday, June 24, 2024 / Rules and Regulations
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 438, 442, and 483
[CMS–3442–F; CMS–3442–CN]
RIN 0938–AV25
Medicare and Medicaid Programs;
Minimum Staffing Standards for LongTerm Care Facilities and Medicaid
Institutional Payment Transparency
Reporting; Correction
Centers for Medicare &
Medicaid Services (CMS), Department
of Health and Human Services (HHS).
ACTION: Final rule; correction.
AGENCY:
This document corrects
typographical and technical errors in
the final rule that appeared in the May
10, 2024 Federal Register, entitled
‘‘Medicare and Medicaid Programs;
Minimum Staffing Standards for LongTerm Care Facilities and Medicaid
Institutional Payment Transparency
Reporting (referred to hereafter as the
‘‘Minimum Staffing final rule’’). The
effective date of the Minimum Staffing
final rule is June 21, 2024.
DATES: This document is effective June
21, 2024.
FOR FURTHER INFORMATION CONTACT: The
Clinical Standard Group’s Long Term
Care Team at
HealthandSafetyInquiries@cms.hhs.gov
for information related to the minimum
staffing standards. Anne Blackfield,
(410) 786–8518, for information related
to Medicaid institutional payment
transparency reporting.
SUPPLEMENTARY INFORMATION:
SUMMARY:
I. Background
In FR Doc. 2024–08273 of May 10,
2024 (89 FR 40876), there were
typographical and technical errors that
are identified and corrected in this
correcting document. These corrections
are effective as if they had been
included in the Minimum Staffing final
rule. Accordingly, the corrections are
effective June 21, 2024.
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II. Summary of Errors
A. Summary of Errors in the Preamble
On page 40876, we made a
typographical error in the
implementation date for §§ 438.72(a)
and 442.43 that must be implemented
by all States and territories with
Medicaid-certified nursing facilities and
intermediate care facilities for
individuals with intellectual
disabilities.
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On page 40895, we included an
incorrect citation at footnote number 62.
On page 40898, Table 2: Requirements
for the LTC Staffing Statutory Waivers
by Facility Type, portions of the table
content were omitted.
On page 40901, we included incorrect
links for the Bureau of Labor Statistic’s
Occupational Employment and Wage
Statistics Query System and the data
source used to calculate the population
for each MSA or non-MSA using
population estimates from the United
States Census Bureau.
On page 40909 we included an
incorrect citation at footnote number 67.
On page 40911, we made an error in
describing the Census Bureau definition
of ‘‘urban’’ as one that used ‘‘counties’’
for the unit of measure.
On pages 40919, 40920, 40923, and
40929, we made typographical errors in
regulatory citations.
On page 40930, we made a
typographical error in a reference to
page numbers in the Federal Register.
On pages 40931 and 40932, we made
typographical errors in regulatory
citations.
On page 40934, we made
typographical errors in the summary of
regulatory language changes.
On page 40935, we included an
incorrect link for the May 2022 National
Occupational Employment and Wage
Statistics.
On page 40948, we included an
incorrect citation at footnote number 96.
On page 40949, we included an
incorrect table number reference.
On page 40992, we included incorrect
links for the May 2022 National
Occupational Employment and Wage
Statistics.
B. Summary of Errors in the Regulation
Text
On page 40995, in the regulation text
for § 442.43(b), we made a reference to
‘‘State directed payments as defined in
§ 438.6(c) of this chapter’’. However,
this definition of State directed
payments was moved to § 438.2 in the
Managed Care Access, Finance, and
Quality final rule (89 FR 41002). We are
correcting this error.
On page 40998, in the regulation text
for § 483.35(h)(2)(iv), we made an
incorrect cross-reference to
§ 483.71(b)(4), which does not exist.
III. Waiver of Proposed Rulemaking
Under 5 U.S.C. 553(b) of the
Administrative Procedure Act (the
APA), the agency is required to publish
a notice of the proposed rule in the
Federal Register before the provisions
of a rule take effect. In addition, section
553(d) of the APA mandates a 30-day
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delay in effective date after issuance or
publication of a substantive rule.
Sections 553(b)(B) and 553(d)(3) of the
APA provide for exceptions from the
APA notice and comment, and delay in
effective date requirements. Section
553(b)(B) of the APA authorizes an
agency to dispense with normal notice
and comment rulemaking procedures
for good cause if the agency makes a
finding that the notice and comment
process is impracticable, unnecessary,
or contrary to the public interest, and
includes a statement of the finding and
the reasons for it in the rule. Similarly,
section 553(d)(3) of the APA allows the
agency to avoid the 30-day delay in
effective date where good cause is found
and the agency includes in the rule a
statement of the finding and the reasons
for it. In our view, this correcting
document does not constitute a
rulemaking that would be subject to
these requirements.
This document merely corrects
technical errors in the Minimum
Staffing final rule. The corrections
contained in this document are
consistent with, and do not make
substantive changes to, the policies that
were proposed, subject to notice and
comment procedures, and adopted in
the Minimum Staffing final rule. As a
result, the corrections made through this
correcting document are intended to
resolve inadvertent errors so that the
rule accurately reflects the policies
adopted in the final rule. Even if this
were a rulemaking to which the notice
and comment and delayed effective date
requirements applied, we find that there
is good cause to waive such
requirements. Undertaking further
notice and comment procedures to
incorporate the corrections in this
document into the Minimum Staffing
final rule or delaying the effective date
of the corrections would be contrary to
the public interest because it is in the
public interest to ensure that the rule
accurately reflects our policies as of the
date they take effect. Further, such
procedures would be unnecessary
because we are not making any
substantive revisions to the final rule,
but rather, we are simply correcting the
Federal Register document to reflect the
policies that we previously proposed,
received public comment on, and
subsequently finalized in the final rule.
For these reasons, we believe there is
good cause to waive the requirements
for notice and comment and delay in
effective date.
IV. Correction of Errors in the Preamble
In FR Doc. 2024–08273 of May 10,
2024 (89 FR 40876), make the following
corrections:
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A. Correction of Errors in the Preamble
1. On page 40876, first column, sixth
paragraph under the heading DATES,
lines 1 through 7, the sentence that
reads ‘‘The regulations at §§ 438.72(a)
and 442.43 must be implemented by all
States and territories with Medicaidcertified nursing facilities and
intermediate care facilities for
individuals with intellectual disabilities
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beginning May 10, 2028.’’ is corrected to
read ‘‘The regulations at §§ 438.72(a)
and 442.43 must be implemented by all
States and territories with Medicaidcertified nursing facilities and
intermediate care facilities for
individuals with intellectual disabilities
beginning June 21, 2028.’’.
2. On page 40895, footnote number 62
that reads ‘‘42 CFR 483.35, https://
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www.whitehouse.gov/briefing-room/
statements-releases/2022/02/28/
factsheet-protecting-seniors-and-peoplewithdisabilities-by-improving-safetyand-quality-of-carein-the-nationsnursing-homes/.’’ is corrected to read
‘‘42 CFR 483.35(b)(1)’’.
3. On page 40898, Table 2, is
corrected to read:
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Federal Register / Vol. 89, No. 121 / Monday, June 24, 2024 / Rules and Regulations
TABLE 2: Requirements for the LTC Staffing Statutory Waivers by Facility Type
Section 1919(b)(4)(C)(ii) of the Act
Section 1819(b)(4)(C)(ii) of the Act
§ 483.35(e) Nursing services. Nursing
facilities: Waiver ofrequirement to
provide licensed nurses on a 24-hour basis
(final rule redesignates this paragraph as
paragraph (I)))
§ 483.35(f) Nursing services. SNFs: Waiver of the
requirement to provide services of a registered
nurse for more than 40 hours a week. (final rule
redesignates this paragraph as (g) and revises
title)
The State can waive the following
requirements:
The Secretary can waive the following
requirement:
1. The facility must provide services by
sufficient numbers of each of the
following types of personnel on a 24-hour
basis to provide nursing care to all
residents in accordance with resident care
plans.
1. The facility must use the services of a registered
nurse for at least 8 consecutive hours a day, 7 days
a week (final rule revises to must have a RN onsite
24 hours per day, for 7 days a week).
Statutory
Citation
Regulatory
Citation and
requirements
for
participation
that can be
waived
2. The facility must use the services of a
registered nurse for at least 8 consecutive
hours a day, 7 days a week (final rule
revises to must have a RN onsite 24 hours
per day, for 7 days a week).
1. The facility must demonstrate to the
satisfaction of the State that the facility has
been unable, despite diligent efforts
(including offering wages at the
community prevailing rate for nursing
facilities), to recruit appropriate personnel.
2. The State determines that a waiver of
the requirement will not endanger the
health or safety of individuals staying in
the facility.
1. The facility is located in a rural area and the
supply of skilled nursing facility services in the
area is not sufficient to meet the needs of
individuals residing in the area.
2. The facility has one full-time registered nurse
who is regularly on duty at the facility 40 hours a
week.
3. The facility either•
Has only patients whose physicians have
indicated (through physicians' orders or
admission notes) that they do not require
the services of a registered nurse or a
physician for a 48-hours period, OR
•
Has made arrangements for a registered
nurse or a physician to spend time at the
facili , as determined necess
b the
3. The State finds that, for any periods in
which licensed nursing services are not
available, a registered nurse or a physician
is obligated to respond immediately to
telephone calls from the facility.
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4. A waiver is subject to annual State
review.
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Criteria that
must be met
to be eligible
for the
statutory
waiver
Federal Register / Vol. 89, No. 121 / Monday, June 24, 2024 / Rules and Regulations
physician, to provide necessary skilled
nursing services on days when the regular
full-time registered nurse is not on duty;
5. In granting or renewing a waiver, a
facility may be required by the State to use
other qualified, licensed personnel.
6. The State agency granting a waiver of
such requirements provides notice of the
waiver to the Office of the State LongTerm Care Ombudsman (established under
section 712 of the Older Americans Act of
1965) and the protection and advocacy
system in the State for individuals with a
mental disorder who are eligible for such
services as provided by the protection and
advocacy agency.
7. The facility must notify residents of the
facility and their resident representatives
of the waiver.
52395
4. The Secretary provides notice of the waiver to
the Office of the State Long-Term Care
Ombudsman (established under section 712 of the
Older Americans Act of 1965) and the protection
and advocacy system in the State for individuals
with developmental disabilities or mental
disorders; and
5. The facility must notify residents of the facility
and their resident representatives of the waiver.
6. The waiver is subject to annual renewal by the
Secretary.
4. On page 40901, third column, first
partial paragraph,
a. Lines 19 and 20, the parenthetical
that reads ‘‘(available at https://
data.bls.gov/oes/#/home)’’ is corrected
to read ‘‘(available at https://
www.bls.gov/oes/tables.htm)’’.
b. Lines 26 through 29, the
parenthetical that reads ‘‘(available at
https://www.census.gov/data/tables/
timeseries/demo/popest/2020scountiestotal.html#v2022)’’ is corrected
to read ‘‘(available at https://
www.census.gov/data/tables/timeseries/demo/popest/2020s-countiestotal.html)’’.
5. On page 40909, footnote number 67
that reads ‘‘https://www.osha.gov/sites/
default/files/publications/
OSHA3905.pdf’’ is corrected to read
‘‘Recommended Practices for AntiRetaliation Programs. OSHA, OSHA
3905–01/2017. Accessed at www.https://
www.osha.gov/sites/default/files/
publications/OSHA3905.pdf. Accessed
on March 1, 2024.’’
6. On page 40911, second column,
first partial paragraph, lines 8 through
14, the sentence that reads ‘‘For
example, if we were to use the Census
Bureau’s definition of ‘urban’, 2,645
counties would be classified as urban,73
while if we were to use OMB’s
definition of ‘urban’, 1,252 counties
would be considered ‘urban.’ 74’’ is
corrected to read ‘‘For example, if we
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were to use the Census Bureau’s
definition of ‘urban’, 2,645 areas
(combination of counties, cities, census
designated areas) would be classified as
urban,73 while if we were to use OMB’s
definition of ‘urban’, 1,252 counties
would be considered ‘urban.’ 74’’
7. On page 40919, in the second
column,
a. First full paragraph, line 9, the
regulatory citation that reads
‘‘§ 442.43(c)’’ is corrected to read
‘‘§ 442.43(b)’’.
b. Second full paragraph, line 15, the
regulatory citation that reads
‘‘§ 442.311(e)’’ is corrected to read
‘‘§ 441.311(e)’’.
8. On page 40920, first column, first
paragraph, line 9, the regulatory citation
that reads ‘‘§ 442.43(c)’’ is corrected to
read ‘‘§ 442.43(b)’’.
9. On page 40923, second column,
first partial paragraph, line 5, the
regulatory citation that reads
‘‘§ 442.43(a)(2)(ix)’’ is corrected to read
‘‘§ 442.43(a)(2)(x)’’.
10. On page 40929, first column, first
partial paragraph, line 27, that
regulatory citation that reads
‘‘§ 442.311(e)(2)’’ is corrected to read
‘‘§ 441.311(e)(4)’’.
11. On page 40930, third column, last
paragraph, lines 12 and 13, the Federal
Register citation that reads ‘‘88 FR
61831 through 61833’’ is corrected to
read ‘‘88 FR 61381 through 61383’’.
12. On page 40931, third column,
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a. Second paragraph, line 1, the
regulatory citation that reads
‘‘§ 442.43(d)(1)’’ is corrected to read
‘‘§ 442.43(d)’’.
b. Third paragraph, line 1, the
regulatory citation that reads
‘‘§ 442.43(d)(2)’’ is corrected to read
‘‘§ 442.43(d)(1)’’.
13. On page 40932, first column,
a. First partial paragraph, line 2, the
regulatory citation that reads
‘‘§ 442.43(d)(3)’’ is corrected to read
‘‘§ 442.43(d)(2)’’.
b. First partial paragraph, line 7, the
regulatory citation that reads
‘‘§ 442.43(d)(3)’’ is corrected to read
‘‘§ 442.43(d)(2)’’.
c. First full paragraph, line 1, the
regulatory citation that reads
‘‘§ 442.43(d)(4)’’ is corrected to
§ 442.43(d)(3)’’.
14. On page 40934,
a. In the second column, sixth
paragraph, lines 7 through 11, the
sentence that reads ‘‘Additionally, we
are finalizing the newly redesignated
paragraph (a)(2)(xi) with a modification
to include nurses and other staff that
providing that clinical supervision.’’ is
corrected to read ‘‘Additionally, we are
finalizing the newly redesignated
paragraph (a)(2)(xi) with a modification
to include nurses and other staff
providing clinical supervision.’’
b. In the third column, third
paragraph, lines 5 through 6, the phrase
‘‘and added a cross-reference to
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*Note: The State has its own independent discretion to waive the requirements is_sued under
section 1919(b)(4)(C) of the Act. Therefore, dually-certified facilities must meet the requirements outlined for
both SNFs and NFs, whichever is more strin ent.
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52396
Federal Register / Vol. 89, No. 121 / Monday, June 24, 2024 / Rules and Regulations
§ 442.43(b)(3).’’ is corrected to ‘‘and in
§ 442.43(b)(1) added a cross-reference to
§ 442.43(b)(3).’’
15. On page 40935, third column,
eighth paragraph, lines 3 through 8, the
sentence that reads ‘‘Unless otherwise
indicated, we obtained all salary
information from the May 2022 National
Occupational Employment and Wage
Estimates, BLS at https://www.bls.gov/
oes/current/oes_nat.htm.’’ is corrected
to read ‘‘Unless otherwise indicated, we
obtained all salary information from the
May 2022 National Occupational
Employment and Wage Estimates, BLS
at https://www.bls.gov/oes/tables.htm.’’
16. On page 40948, footnote number
96, that reads ‘‘https://data.cms.gov/
summary-statistics-on-use-andpayments/medicare-service-typereports/cms-program-statisticsmedicare-skilled-nursing-facility.’’ is
corrected to read ‘‘https://data.cms.gov/
provider-data/dataset/4pq5-n9py.’’.
17. On page 40949, third column, first
full paragraph, line 2, the table reference
that reads ‘‘table 21’’ is corrected to read
‘‘table 31’’.
18. On page 40992,
a. In the second column, first full
paragraph, lines 1 through 9, the
sentence that reads ‘‘Using the wage
information from the Bureau of Labor
Statistics, May 2022 National
Occupational Employment and Wage
Estimates, https://www.bls.gov/oes/
current/oes_nat.htm, for medical and
health service managers (Code 11–
9111), we estimate that the cost of
reviewing this rule is $123.06 per hour,
including overhead and fringe benefits.’’
is corrected to read ‘‘Using the wage
information from the Bureau of Labor
Statistics, May 2022 National
Occupational Employment and Wage
Estimates, https://www.bls.gov/oes/
tables.htm, for medical and health
service managers (Code 11–9111), we
estimate that the cost of reviewing this
rule is $123.06 per hour, including
overhead and fringe benefits.’’
b. In the third column, second
paragraph, lines 1 through 9, the
sentence that reads ‘‘Using the wage
information from the Bureau of Labor
Statistics, May 2022 National
Occupational Employment and Wage
Estimates, https://www.bls.gov/oes/
current/oes_nat.htm, for medical and
health service managers (Code 11–
9111), we estimated that the cost of
reviewing this rule is $123.06 per hour,
including overhead and fringe benefits.’’
is corrected to read ‘‘Using the wage
information from the Bureau of Labor
Statistics, May 2022 National
Occupational Employment and Wage
Estimates, https://www.bls.gov/oes/
tables.htm, for medical and health
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15:39 Jun 21, 2024
Jkt 262001
service managers (Code 11–9111), we
estimated that the cost of reviewing this
rule is $123.06 per hour, including
overhead and fringe benefits.’’
B. Correction of Errors in the Regulation
Text
§ 442.43
[Corrected]
List of Subjects in 45 CFR Part 98
1. On page 40995, third column,
seventh paragraph, the regulation text
for § 443.43(b) introductory text, line 22,
the reference ‘‘§ 438.6(c)’’ is corrected to
read ‘‘§ 438.2’’.
■
§ 483.35
Care and Development Fund (CCDF)’’
rule, published at 89 FR 15366 on
March 1, 2024, included inaccurate
amendatory instructions for § 98.16 and
inadvertently failed to update certain
amended cross-references. This
document corrects the final regulations.
[Corrected]
2. On page 40998, second column,
sixth full paragraph, line 2, in the
regulation text for § 483.35(h)(2)(iv), the
reference ‘‘§ 483.71(b)(4)’’ is corrected to
read ‘‘§ 483.71(c)(4)’’.
■
Wilma Robinson,
Deputy Executive Secretary to the
Department, Department of Health and
Human Services.
Child care, Grant programs—social
programs.
Accordingly, 45 CFR part 98 is
corrected by making the following
correcting amendments:
PART 98—CHILD CARE AND
DEVELOPMENT FUND
1. The authority citation for part 98
continues to read as follows:
■
Authority: 42 U.S.C. 618, 9858.
2. Amend § 98.2 by revising the
definition of Sliding fee scale to read as
follows:
■
[FR Doc. 2024–13795 Filed 6–21–24; 8:45 am]
§ 98.2
BILLING CODE 4120–01–P
*
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
45 CFR Part 98
RIN 0970–AD02
Improving Child Care Access,
Affordability, and Stability in the Child
Care and Development Fund (CCDF);
Corrections
Office of Child Care (OCC),
Administration for Children and
Families (ACF), Department of Health
and Human Services (HHS).
ACTION: Correcting amendments.
AGENCY:
On March 1, 2024, the
Department of Health and Human
Services published a final rule to
improve child care access, affordability,
and stability in the Child Care and
Development Fund. Some amendments
in the final rule could not be
incorporated due to technical
inaccuracies in the instructions.
Additionally, that document
inadvertently failed to update certain
amended cross-references. This
document makes technical changes to
correct the final regulations.
DATES: Effective on June 24, 2024.
FOR FURTHER INFORMATION CONTACT:
Megan Campbell, Office of Child Care,
202–690–6499 or megan.campbell@
acf.hhs.gov.
SUMMARY:
The
‘‘Improving Child Care Access,
Affordability, and Stability in the Child
SUPPLEMENTARY INFORMATION:
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Definitions.
*
*
*
*
Sliding fee scale means a system of
cost-sharing by a family based on
income and size of the family, in
accordance with § 98.45(l);
*
*
*
*
*
■ 3. Amend § 98.16 by:
■ a. Revising paragraph (x);
■ b. Redesignating paragraphs (y)
through (ii) as paragraphs (bb) through
(ll);
■ c. Adding new paragraphs (y) through
(aa); and
■ d. Revising newly redesignated
paragraphs (ee), (ff), and (kk).
The additions and revisions read as
follows:
§ 98.16
Plan revisions.
*
*
*
*
*
(x) A description of the supply of
child care available regardless of
subsidy participation relative to the
population of children requiring child
care, including care for infants and
toddlers, children with disabilities as
defined by the Lead Agency, children
who receive care during nontraditional
hours, and children in underserved
geographic areas, including the data
sources used to identify shortages in the
supply of child care providers;
(y) A description of the Lead Agency’s
strategies and the actions it will take to
address the supply shortages identified
in paragraph (x) of this section and
improve parent choice specifically for
families eligible to participate in CCDF,
including:
(1) For families needing care during
nontraditional hours, which may
include strategies such as higher
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]]>Agencies
[Federal Register Volume 89, Number 121 (Monday, June 24, 2024)]
[Rules and Regulations]
[Pages 52392-52396]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-13795]
[[Page 52392]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 438, 442, and 483
[CMS-3442-F; CMS-3442-CN]
RIN 0938-AV25
Medicare and Medicaid Programs; Minimum Staffing Standards for
Long-Term Care Facilities and Medicaid Institutional Payment
Transparency Reporting; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Final rule; correction.
-----------------------------------------------------------------------
SUMMARY: This document corrects typographical and technical errors in
the final rule that appeared in the May 10, 2024 Federal Register,
entitled ``Medicare and Medicaid Programs; Minimum Staffing Standards
for Long-Term Care Facilities and Medicaid Institutional Payment
Transparency Reporting (referred to hereafter as the ``Minimum Staffing
final rule''). The effective date of the Minimum Staffing final rule is
June 21, 2024.
DATES: This document is effective June 21, 2024.
FOR FURTHER INFORMATION CONTACT: The Clinical Standard Group's Long
Term Care Team at [email protected] for information
related to the minimum staffing standards. Anne Blackfield, (410) 786-
8518, for information related to Medicaid institutional payment
transparency reporting.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2024-08273 of May 10, 2024 (89 FR 40876), there were
typographical and technical errors that are identified and corrected in
this correcting document. These corrections are effective as if they
had been included in the Minimum Staffing final rule. Accordingly, the
corrections are effective June 21, 2024.
II. Summary of Errors
A. Summary of Errors in the Preamble
On page 40876, we made a typographical error in the implementation
date for Sec. Sec. 438.72(a) and 442.43 that must be implemented by
all States and territories with Medicaid-certified nursing facilities
and intermediate care facilities for individuals with intellectual
disabilities.
On page 40895, we included an incorrect citation at footnote number
62.
On page 40898, Table 2: Requirements for the LTC Staffing Statutory
Waivers by Facility Type, portions of the table content were omitted.
On page 40901, we included incorrect links for the Bureau of Labor
Statistic's Occupational Employment and Wage Statistics Query System
and the data source used to calculate the population for each MSA or
non-MSA using population estimates from the United States Census
Bureau.
On page 40909 we included an incorrect citation at footnote number
67.
On page 40911, we made an error in describing the Census Bureau
definition of ``urban'' as one that used ``counties'' for the unit of
measure.
On pages 40919, 40920, 40923, and 40929, we made typographical
errors in regulatory citations.
On page 40930, we made a typographical error in a reference to page
numbers in the Federal Register.
On pages 40931 and 40932, we made typographical errors in
regulatory citations.
On page 40934, we made typographical errors in the summary of
regulatory language changes.
On page 40935, we included an incorrect link for the May 2022
National Occupational Employment and Wage Statistics.
On page 40948, we included an incorrect citation at footnote number
96.
On page 40949, we included an incorrect table number reference.
On page 40992, we included incorrect links for the May 2022
National Occupational Employment and Wage Statistics.
B. Summary of Errors in the Regulation Text
On page 40995, in the regulation text for Sec. 442.43(b), we made
a reference to ``State directed payments as defined in Sec. 438.6(c)
of this chapter''. However, this definition of State directed payments
was moved to Sec. 438.2 in the Managed Care Access, Finance, and
Quality final rule (89 FR 41002). We are correcting this error.
On page 40998, in the regulation text for Sec. 483.35(h)(2)(iv),
we made an incorrect cross-reference to Sec. 483.71(b)(4), which does
not exist.
III. Waiver of Proposed Rulemaking
Under 5 U.S.C. 553(b) of the Administrative Procedure Act (the
APA), the agency is required to publish a notice of the proposed rule
in the Federal Register before the provisions of a rule take effect. In
addition, section 553(d) of the APA mandates a 30-day delay in
effective date after issuance or publication of a substantive rule.
Sections 553(b)(B) and 553(d)(3) of the APA provide for exceptions from
the APA notice and comment, and delay in effective date requirements.
Section 553(b)(B) of the APA authorizes an agency to dispense with
normal notice and comment rulemaking procedures for good cause if the
agency makes a finding that the notice and comment process is
impracticable, unnecessary, or contrary to the public interest, and
includes a statement of the finding and the reasons for it in the rule.
Similarly, section 553(d)(3) of the APA allows the agency to avoid the
30-day delay in effective date where good cause is found and the agency
includes in the rule a statement of the finding and the reasons for it.
In our view, this correcting document does not constitute a rulemaking
that would be subject to these requirements.
This document merely corrects technical errors in the Minimum
Staffing final rule. The corrections contained in this document are
consistent with, and do not make substantive changes to, the policies
that were proposed, subject to notice and comment procedures, and
adopted in the Minimum Staffing final rule. As a result, the
corrections made through this correcting document are intended to
resolve inadvertent errors so that the rule accurately reflects the
policies adopted in the final rule. Even if this were a rulemaking to
which the notice and comment and delayed effective date requirements
applied, we find that there is good cause to waive such requirements.
Undertaking further notice and comment procedures to incorporate the
corrections in this document into the Minimum Staffing final rule or
delaying the effective date of the corrections would be contrary to the
public interest because it is in the public interest to ensure that the
rule accurately reflects our policies as of the date they take effect.
Further, such procedures would be unnecessary because we are not making
any substantive revisions to the final rule, but rather, we are simply
correcting the Federal Register document to reflect the policies that
we previously proposed, received public comment on, and subsequently
finalized in the final rule. For these reasons, we believe there is
good cause to waive the requirements for notice and comment and delay
in effective date.
IV. Correction of Errors in the Preamble
In FR Doc. 2024-08273 of May 10, 2024 (89 FR 40876), make the
following corrections:
[[Page 52393]]
A. Correction of Errors in the Preamble
1. On page 40876, first column, sixth paragraph under the heading
DATES, lines 1 through 7, the sentence that reads ``The regulations at
Sec. Sec. 438.72(a) and 442.43 must be implemented by all States and
territories with Medicaid-certified nursing facilities and intermediate
care facilities for individuals with intellectual disabilities
beginning May 10, 2028.'' is corrected to read ``The regulations at
Sec. Sec. 438.72(a) and 442.43 must be implemented by all States and
territories with Medicaid-certified nursing facilities and intermediate
care facilities for individuals with intellectual disabilities
beginning June 21, 2028.''.
2. On page 40895, footnote number 62 that reads ``42 CFR 483.35,
https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/28/factsheet-protecting-seniors-and-people-withdisabilities-by-improving-safety-and-quality-of-carein-the-nations-nursing-homes/.'' is
corrected to read ``42 CFR 483.35(b)(1)''.
3. On page 40898, Table 2, is corrected to read:
[[Page 52394]]
[GRAPHIC] [TIFF OMITTED] TR24JN24.400
[[Page 52395]]
[GRAPHIC] [TIFF OMITTED] TR24JN24.401
4. On page 40901, third column, first partial paragraph,
a. Lines 19 and 20, the parenthetical that reads ``(available at
https://data.bls.gov/oes/#/home)'' is corrected to read ``(available at
https://www.bls.gov/oes/tables.htm)''.
b. Lines 26 through 29, the parenthetical that reads ``(available
at https://www.census.gov/data/tables/timeseries/demo/popest/2020s-countiestotal.html#v2022)'' is corrected to read ``(available at
https://www.census.gov/data/tables/time-series/demo/popest/2020s-counties-total.html)''.
5. On page 40909, footnote number 67 that reads ``https://www.osha.gov/sites/default/files/publications/OSHA3905.pdf'' is
corrected to read ``Recommended Practices for Anti-Retaliation
Programs. OSHA, OSHA 3905-01/2017. Accessed at www.https://www.osha.gov/sites/default/files/publications/OSHA3905.pdf. Accessed on
March 1, 2024.''
6. On page 40911, second column, first partial paragraph, lines 8
through 14, the sentence that reads ``For example, if we were to use
the Census Bureau's definition of `urban', 2,645 counties would be
classified as urban,\73\ while if we were to use OMB's definition of
`urban', 1,252 counties would be considered `urban.' \74\'' is
corrected to read ``For example, if we were to use the Census Bureau's
definition of `urban', 2,645 areas (combination of counties, cities,
census designated areas) would be classified as urban,\73\ while if we
were to use OMB's definition of `urban', 1,252 counties would be
considered `urban.' \74\''
7. On page 40919, in the second column,
a. First full paragraph, line 9, the regulatory citation that reads
``Sec. 442.43(c)'' is corrected to read ``Sec. 442.43(b)''.
b. Second full paragraph, line 15, the regulatory citation that
reads ``Sec. 442.311(e)'' is corrected to read ``Sec. 441.311(e)''.
8. On page 40920, first column, first paragraph, line 9, the
regulatory citation that reads ``Sec. 442.43(c)'' is corrected to read
``Sec. 442.43(b)''.
9. On page 40923, second column, first partial paragraph, line 5,
the regulatory citation that reads ``Sec. 442.43(a)(2)(ix)'' is
corrected to read ``Sec. 442.43(a)(2)(x)''.
10. On page 40929, first column, first partial paragraph, line 27,
that regulatory citation that reads ``Sec. 442.311(e)(2)'' is
corrected to read ``Sec. 441.311(e)(4)''.
11. On page 40930, third column, last paragraph, lines 12 and 13,
the Federal Register citation that reads ``88 FR 61831 through 61833''
is corrected to read ``88 FR 61381 through 61383''.
12. On page 40931, third column,
a. Second paragraph, line 1, the regulatory citation that reads
``Sec. 442.43(d)(1)'' is corrected to read ``Sec. 442.43(d)''.
b. Third paragraph, line 1, the regulatory citation that reads
``Sec. 442.43(d)(2)'' is corrected to read ``Sec. 442.43(d)(1)''.
13. On page 40932, first column,
a. First partial paragraph, line 2, the regulatory citation that
reads ``Sec. 442.43(d)(3)'' is corrected to read ``Sec.
442.43(d)(2)''.
b. First partial paragraph, line 7, the regulatory citation that
reads ``Sec. 442.43(d)(3)'' is corrected to read ``Sec.
442.43(d)(2)''.
c. First full paragraph, line 1, the regulatory citation that reads
``Sec. 442.43(d)(4)'' is corrected to Sec. 442.43(d)(3)''.
14. On page 40934,
a. In the second column, sixth paragraph, lines 7 through 11, the
sentence that reads ``Additionally, we are finalizing the newly
redesignated paragraph (a)(2)(xi) with a modification to include nurses
and other staff that providing that clinical supervision.'' is
corrected to read ``Additionally, we are finalizing the newly
redesignated paragraph (a)(2)(xi) with a modification to include nurses
and other staff providing clinical supervision.''
b. In the third column, third paragraph, lines 5 through 6, the
phrase ``and added a cross-reference to
[[Page 52396]]
Sec. 442.43(b)(3).'' is corrected to ``and in Sec. 442.43(b)(1) added
a cross-reference to Sec. 442.43(b)(3).''
15. On page 40935, third column, eighth paragraph, lines 3 through
8, the sentence that reads ``Unless otherwise indicated, we obtained
all salary information from the May 2022 National Occupational
Employment and Wage Estimates, BLS at https://www.bls.gov/oes/current/oes_nat.htm.'' is corrected to read ``Unless otherwise indicated, we
obtained all salary information from the May 2022 National Occupational
Employment and Wage Estimates, BLS at https://www.bls.gov/oes/tables.htm.''
16. On page 40948, footnote number 96, that reads ``https://
data.cms.gov/summary-statistics-on-use-and-payments/medicare-service-
type-reports/cms-program-statistics-medicare-skilled-nursing-
facility.'' is corrected to read ``https://data.cms.gov/provider-data/
dataset/4pq5-n9py.''.
17. On page 40949, third column, first full paragraph, line 2, the
table reference that reads ``table 21'' is corrected to read ``table
31''.
18. On page 40992,
a. In the second column, first full paragraph, lines 1 through 9,
the sentence that reads ``Using the wage information from the Bureau of
Labor Statistics, May 2022 National Occupational Employment and Wage
Estimates, https://www.bls.gov/oes/current/oes_nat.htm, for medical and
health service managers (Code 11-9111), we estimate that the cost of
reviewing this rule is $123.06 per hour, including overhead and fringe
benefits.'' is corrected to read ``Using the wage information from the
Bureau of Labor Statistics, May 2022 National Occupational Employment
and Wage Estimates, https://www.bls.gov/oes/tables.htm, for medical and
health service managers (Code 11-9111), we estimate that the cost of
reviewing this rule is $123.06 per hour, including overhead and fringe
benefits.''
b. In the third column, second paragraph, lines 1 through 9, the
sentence that reads ``Using the wage information from the Bureau of
Labor Statistics, May 2022 National Occupational Employment and Wage
Estimates, https://www.bls.gov/oes/current/oes_nat.htm, for medical and
health service managers (Code 11-9111), we estimated that the cost of
reviewing this rule is $123.06 per hour, including overhead and fringe
benefits.'' is corrected to read ``Using the wage information from the
Bureau of Labor Statistics, May 2022 National Occupational Employment
and Wage Estimates, https://www.bls.gov/oes/tables.htm, for medical and
health service managers (Code 11-9111), we estimated that the cost of
reviewing this rule is $123.06 per hour, including overhead and fringe
benefits.''
B. Correction of Errors in the Regulation Text
Sec. 442.43 [Corrected]
0
1. On page 40995, third column, seventh paragraph, the regulation text
for Sec. 443.43(b) introductory text, line 22, the reference ``Sec.
438.6(c)'' is corrected to read ``Sec. 438.2''.
Sec. 483.35 [Corrected]
0
2. On page 40998, second column, sixth full paragraph, line 2, in the
regulation text for Sec. 483.35(h)(2)(iv), the reference ``Sec.
483.71(b)(4)'' is corrected to read ``Sec. 483.71(c)(4)''.
Wilma Robinson,
Deputy Executive Secretary to the Department, Department of Health and
Human Services.
[FR Doc. 2024-13795 Filed 6-21-24; 8:45 am]
BILLING CODE 4120-01-P
