Federal Register / Vol. 64, No. 52 /Thursday, March 18, 1999 /Rules and Regulations 13351

(5) Permit 4911–033–1319–0 Plant

Atkinson conditions 8 through 13.

(6) Permit 4911–033–6951 Plant

McDonough conditions 5 through 10.

(7) Permit 4922–028–10902 Atlanta

Gas Light Company conditions 20 and

21.

(8) Permit 4922–031–10912 Atlanta

Gas Light Company conditions 27 and

28.

(9) Permit 2631–033–11436 Austell

Box Board Corp. conditions 1 through 5.

(10) Permit 8922–044–10094 Emory

University conditions 19 through 26.

(11) Permit 3711–044–11453 General

Motors Corporation conditions 1

thorough 6 and Attachment A.

(12) Permit 2077–058–11226 Georgia

Proteins Company conditions 16

through 23 and Attachment A.

(13) Permit 3221–060–10576 OwensBrockway Glass Container, Inc.

conditions 26 through 28 and

Attachment A.

(14) Permit 3296–060–10079 OwensCorning Fiberglass Corporation

conditions 25 through 29.

(15) Permit 3354–038–6686–0

William L. Bonnell Co. conditions 17

through 30.

(16) Permit 4922–075–10217

Transcontinental Gas Pipe Line

Corporation conditions 21 through 24.

(17) Permit 9711–033–11456

Lockheed-Georgia Company conditions

1 through 11.

(18) Permit 3241–060–8670 Blue

Circle Incorporated conditions 48

through 54.

(ii) Other material. None.

[FR Doc. 99–6505 Filed 3–17–99; 8:45 am]

BILLING CODE 6560–50–P

ENVIRONMENTAL PROTECTION

AGENCY

40 CFR Part 52

[CA 211–0126 EC; FRL–6235–5]

Approval and Promulgation of

Implementation Plans; Arizona and

California State Implementation Plan

Revision; Maricopa County, Arizona,

Antelope Valley Air Pollution Control

District, San Diego County Air

Pollution Control District, San Joaquin

Valley Unified Air Pollution Control

District, and Ventura County Air

Pollution Control District

AGENCY: Environmental Protection

Agency (EPA).

ACTION: Direct final rule.

SUMMARY: EPA is taking direct final

action to approve revisions to the

Arizona and California State

Implementation Plans (SIP). The

revisions concern rules from the

following districts: Maricopa County,

Arizona; Antelope Valley Air Pollution

Control District, California; San Diego

County Air Pollution Control District,

California; San Joaquin Valley Unified

Air Pollution Control District,

California, and Ventura County Air

Pollution Control District, California.

These revisions concern the adoption of

emergency episode plans within federal

guidelines. This approval action will

incorporate these rules into the

Federally approved SIP. The intended

effect of approving these rules is to

regulate emergency preparedness in

accordance with the requirements of the

Clean Air Act (CAA or the Act). Thus,

EPA is finalizing the approval of these

revisions into the Arizona and

California SIPs under provisions of the

CAA regarding EPA action on SIP

submittals, SIPs for national primary

and secondary ambient air quality

standards and plan requirements for

nonattainment areas.

DATES: This rule is effective on May 17,

1999 without further notice, unless EPA

receives adverse comments by April 19,

1999. If EPA receives such comment, it

will publish a timely withdrawal in the

Federal Register informing the public

that this rule will not take effect.

ADDRESSES: Written comments must be

submitted to Andrew Steckel at the

Region IX office listed below. Copies of

the rule revision and EPA’s evaluation

report of each rule are available for

public inspection at EPA’s Region 9

office during normal business hours.

Copies of the submitted rule revisions

are also available for inspection at the

following locations:

Rulemaking Office (AIR–4), Air

Division, U.S. Environmental

Protection Agency, Region IX, 75

Hawthorne Street, San Francisco, CA

94105.

Environmental Protection Agency, Air

Docket (6102), 401 ‘‘M’’ Street, S.W.,

Washington, D.C. 20460 California Air

Resources Board, Stationary Source

Division, Rule Evaluation Section,

2020 ‘‘L’’ Street, Sacramento, CA

95812.

Maricopa County Environmental

Services Department, Air Quality

Division, 1001 North Central Avenue,

Ste. 201, Phoenix, Arizona 85004–

1942;

Antelope Valley Air Pollution Control

District, 315 West Pondera Street,

Lancaster, California, 93534;

San Diego County Air Pollution Control

District, 9150 Chesapeake Drive, San

Diego, California 92123–1096;

San Joaquin Valley Unified Air

Pollution Control District, 1999

Tuolumne Street, Suite 200, Fresno,

California, 93721, and

Ventura County Air Pollution Control

District, 669 County Square Drive,

Ventura, California, 93003.

FOR FURTHER INFORMATION CONTACT:

Andrew Steckel, Rulemaking Office

(AIR–4), Air Division, U.S.

Environmental Protection Agency,

Region IX, 75 Hawthorne Street, San

Francisco, CA 94105–3901, Telephone:

(415) 744–1185.

SUPPLEMENTARY INFORMATION:

I. Applicability

The rules being approved into the

Arizona and California SIP include:

Maricopa County, Arizona, Regulation

VI, Rule 600—Emergency Episode;

Antelope Valley APCD, Rule 701—Air

Pollution Emergency Contingency

Action; San Diego County APCD, Rule

127—Episode Criteria Levels, Rule

128—Episode Declaration, and Rule

130—Episode Actions; San Joaquin

Valley Unified APCD, Rule 6010—

General Statement, Rule 6020—

Applicable Areas, Rule 6030—Episode

Criteria Levels, Rule 6040—Episode

Stages, Rule 6050—Division of

Responsibility, Rule 6060—

Administration of Emergency Program,

Rule 6070—Advisory of High Air

Pollution Potential, Rule 6080—

Declaration of Episode, Rule 6081—

Episode Action—Health Advisory, Rule

6090—Episode Action Stage 1: (Health

Advisory-Alert), Rule 6100—Episode

Action Stage 2: (Warning), Rule 6110—

Episode Action Stage 3: (Emergency),

Rule 6120—Episode Termination, Rule

6130—Stationary Source Curtailment

Plans and Traffic Abatement Plans, Rule

6140—Episode Abatement Plan, and

Rule 6150—Enforcement; and Ventura

County Air Pollution Control District,

Rule 150—General, Rule 151—Episode

Criteria, Rule 152—Episode Notification

Procedures, Rule 153—Health Advisory

Episode Actions, Rule 154—Stage 1

Episode Actions, Rule 155—Stage 2

Episode Actions, Rule 156—Stage 3

Episode Actions, Rule 157—Air

Pollution Disaster, Rule 158—Source

Abatement Plans, and Rule 159—Traffic

Abatement Procedures.

These rules were submitted by the

Arizona DEP to EPA on January 4, 1990

and by the California Air Resources

Board on March 10, 1998 (Antelope

Valley); January 28, 1992 (San Diego),

March 3, 1997 (San Joaquin), and

January 28, 1992 (Ventura).

II. Background

The Clean Air Act of 1970 (42 USC s.

7401 et seq.; CAA or the Act) required

states to develop plans to prevent and
13352 Federal Register / Vol. 64, No. 52 /Thursday, March 18, 1999 /Rules and Regulations

control air quality from degrading to the

level of significant harm. By the end of

1971, a regulatory structure was in place

that continues to this day, see 40 CFR

Part 51.150 et seq. (Subpart H) and

Appendix L (following 40 CFR Part

51.680). Except for changes in the

significant harm level of criteria

pollutants and a few other minor

changes, the regulatory structure has

remained consistent for many years.

Subpart H requires local agencies to

determine if they exceed the minimum

threshold for criteria pollutants and

then to prepare plans to avoid

significant harm levels of these

pollutants. Agencies are encouraged to

develop a graduated response that

depends on the level of threat to human

health and environmental degradation

that the existing and projected pollutant

levels indicate.

III. EPA Evaluation and Action

In determining the approvability of an

emergency episode rule, EPA must

evaluate the rule for consistency with

the requirements of the CAA and EPA

regulations, as found in section 110 of

the CAA and 40 CFR part 51

(Requirements for Preparation,

Adoption and Submittal of

Implementation Plans). The EPA

interpretation of these requirements,

which forms the basis for this action,

appears in various EPA policy guidance

documents, most notably the Guide for

Air Pollution Episode Avoidance (EPA,

1971) and other derivative publications.

In general, these guidance documents,

as well as other relevant and applicable

guidance documents, have been set

forth to ensure that submitted

emergency episode rules meet Federal

requirements and are fully enforceable

and strengthen or maintain the SIP.

Maricopa County, Arizona’s earlier

emergency episode rule was approved

into the SIP in 1982. The new rule

recasts the information about episode

level criteria and adds a section on

appropriate control actions to be

undertaken as air quality would

deteriorate. The administrative

requirements section is substantially

unchanged.

The Antelope Valley Air Pollution

Control District (AVAPCD) has adopted

an emergency episode regulation

intended to comply with 40 CFR 51.150;

this rule will replace South Coast

AQMD Rule 701 which has been in the

Antelope Valley SIP.

The regulations for APCDs include

the following general elements:

(1) The plan shall identify the

appropriate criteria pollutants and the

levels of those pollutants that would

trigger pollution control and avoidance

activities,

(2) The plan shall identify a level of

significant harm that meets or exceeds

the federal standards as established at

40 CFR s. 51.51,

(3) The plan shall identify specific

control and avoidance actions that the

district would take when harmful levels

of criteria pollutants are reached.

The Maricopa County Environmental

Services Department (MCESD), the San

Diego County Air Pollution Control

District (SDCAPCD), the San Joaquin

Valley Unified Air Pollution Control

District (SJVUAPCD), and the Ventura

County Air Pollution Control District

(VCAPCD) have adopted revisions to

their earlier emergency episode plans

that have incorporated revised federal

standards and improved surveillance

and control activities. A more detailed

discussion of emergency episode

requirements and provisions can be

found in the Technical Support

Document (TSD) for this action, dated

November 18, 1998.

EPA has evaluated the submitted

rules and has determined that they are

consistent with the CAA, EPA

regulations and EPA policy. Therefore,

Maricopa County Rule 600, Antelope

Valley APCD Rule 701, San Diego

County APCD Rules 127, 128, and 130,

San Joaquin Valley Unified APCD Rules

6010, 6020, 6030, 6040, 6050, 6060,

6070, 6080, 6081, 6090, 6100, 6110,

6120, 6130, 6140, and 6150, and

Ventura County APCD Rules 150, 151,

152, 153, 154, 155, 156, 157, 158, and

159 are being approved under section

110 (k)(3) of the CAA as meeting the

requirements of section 110 (a)(2)(G) of

the Act.

EPA is publishing this rule without

prior proposal because the Agency

views this as a noncontroversial

amendment and anticipates no adverse

comments. However, in the proposed

rules section of this Federal Register

publication, EPA is publishing a

separate document that will serve as the

proposal to approve the SIP revision

should adverse comments be filed. This

rule will be effective May 17, 1999

without further notice unless the

Agency receives adverse comments by

April 19, 1999.

If the EPA receives such comments,

then EPA will publish a timely

withdrawal in the Federal Register

informing the public that the rule will

not take effect. All public comments

received will then be addressed in a

subsequent final rule based on the

proposed rule. The EPA will not

institute a second comment period on

this rule. Any parties interested in

commenting on this rule should do so

at this time. If no such comments are

received, the public is advised that this

rule will be effective on May 17, 1999

and no further action will be taken on

the proposed rule.

IV. Administrative Requirements

A. Executive Order 12866

The Office of Management and Budget

(OMB) has exempted this regulatory

action from Executive Order (E.O.)

12866, entitled ‘‘Regulatory Planning

and Review.’’

B. Executive Order 12875

Under E.O. 12875, EPA may not issue

a regulation that is not required by

statute and that creates a mandate upon

a state, local, or tribal government,

unless the Federal government provides

the funds necessary to pay the direct

compliance costs incurred by those

governments. If EPA complies by

consulting, Executiver Order 12875

requires EPA to provide to the Office of

Management and Budget a description

of the extent of EPA’s prior consultation

with representatives of affected state,

local, and tribal governments, the nature

of their concerns, copies of written

communications from the governments,

and a statement supporting the need to

issue the regulation. In addition, E.O.

12875 requires EPA to develop an

effective process permitting elected

officials and other representatives of

state, local, and tribal governments ‘‘to

provide meaningful and timely input in

the development of regulatory proposals

containing significant unfunded

mandates.’’ Today’s rule does not create

a mandate on state, local or tribal

governments. The rule does not impose

any enforceable duties on these entities.

Accordingly, the requirements of

section 1(a) of E.O. 12875 do not apply

to this rule.

C. Executive Order 13045

‘‘Protection of Children from

Environmental Health Risks and Safety

Risks,’’ (62 FR 19885, April 23, 1997),

applies to any rule that: (1) is

determined to be ‘‘economically

significant’’ as defined under E.O.

12866, and (2) concerns an

environmental health or safety risk that

EPA has reason to believe may have a

disporportionate effect on children. If

the regulatory action meets both criteria,

the Agency must evaluate the

environmental health and safety effects

of the planned rule on children, and

explain why the planned regulation is

preferable to other potentially effective

and reasonably feasible alternatives

considered by the Agency.
Federal Register / Vol. 64, No. 52 /Thursday, March 18, 1999 /Rules and Regulations 13353

This rule is not subject to E.O. 13045

because it does not involve decisions

intended to mitigate environmental

health and safety risks.

D. Executive Order 13084

Under E.O. 13084, EPA may not issue

a regulation that is not required by

statute, that significantly affects or

uniquely affects the communities of

Indian tribal governments, and that

imposes substantial direct compliance

costs on those communities, unless the

Federal government provides the funds

necessary to pay the direct compliance

costs incurred by the tribal

governments. If the EPA complies by

consulting, Executive Order 13084

requires EPA to provide to the Office of

Management and Budget, in a separately

identified section of the preamble to the

rule, a description of the extent of EPA’s

prior consultation with representatives

of affected tribal governments, a

summary of the nature of their concerns,

and a statement supporting the need to

issue the regulation. In addition,

representatives of Indian tribal

governments ‘‘to provide meaningful

and timely input in the development of

regulatory policies on matters that

significantly or uniquely affect their

communities.’’ Today’s rule does not

significantly or uniquely affect the

communities of Indian tribal

governments. Accordingly, the

requirements of section 3(b) of E.O.

13084 do not apply to this rule.

E. Regulatory Flexibility Act

The Regulatory Flexibility Act (RFA)

generally requires an agency to conduct

a regulatory flexibility analysis of any

rule subject to notice and comment

rulemaking requirements unless the

agency certifies that the rule will not

have a significant economic impact on

a substantial number of small entities.

Small entities include small businesses,

small not-for-profit enterprises, and

small governmental jurisdictions. This

final rule will not have a significant

impact on a substantial number of small

entities because SIP approvals under

section 110 and subchapter I, part D of

the Clean Air Act do not create any new

requirements but simply approve

requirements that the State is already

imposing. Therefore, because the

Federal SIP approval does not create

any new requirements, I certify that this

action will not have a significant

economic impact on a substantial

number of small entities. Moreover, due

to the nature of the Federal-State

relationship under the Clean Air Act,

preparation of flexibility analysis would

constitute Federal inquiry into the

economic reasonableness of state action.

The Clean Air Act forbids EPA to base

its actions concerning SIPs on such

grounds. Union Electric Co., v. U.S.

EPA, 427 U.S. 246, 255–66 (1976); 42

U.S.C. 7410(a)(2).

F. Unfunded Mandates

Under Section 202 of the Unfunded

Mandates Reform Act of 1995

(‘‘Unfunded Mandates Act’’), signed

into law on March 22, 1995, EPA must

prepare a budgetary impact statement to

accompany any proposed or final rule

that includes a Federal mandate that

may result in estimated annual costs to

State, local, or tribal governments in the

aggregate; or to private sector, of $100

million or more. Under Section 205,

EPA must select the most cost-effective

and least burdensome alternative that

achieves the objectives of the rule and

is consistent with statutory

requirements. Section 203 requires EPA

to establish a plan for informing and

advising any small governments that

may be significantly or uniquely

impacted by the rule.

EPA has determined that the approval

action promulgated does not include a

Federal mandate that may result in

estimated annual costs of $100 million

or more to either State, local, or tribal

governments in the aggregate, or to the

private sector. This Federal action

approves pre-existing requirements

under State or local law, and imposes

no new requirements. Accordingly, no

additional costs to State, local, or tribal

governments, or to the private sector,

result from this action.

G. Submission to Congress and the

Comptroller General

The Congressional Review Act, 5

U.S.C. 801 et seq., as added by the Small

Business Regulatory Enforcement

Fairness Act of 1996, generally provides

that before a rule may take effect, the

agency promulgating the rule must

submit a rule report, which includes a

copy of the rule, to each House of the

Congress and to the Comptroller General

of the United States. EPA will submit a

report containing this rule and other

required information to the U.S. Senate,

the U.S. House of Representatives, and

the Comptroller General of the United

States prior to publication of the rule in

the Federal Register. This rule is not a

‘‘major’’ rule as defined by 5 U.S.C.

804(2).

H. Petitions for Judicial Review

Under section 307(b)(1) of the Clean

Air Act, petitions for judicial review of

this action must be filed in the United

States Court of Appeals for the

appropriate circuit by May 17, 1999.

Filing a petition for reconsideration by

the Administrator of this final rule does

not affect the finality of this rule for the

purposes of judicial review nor does it

extend the time within which a petition

for judicial review may be filed, and

shall not postpone the effectiveness of

such rule or action. This action may not

be challenged later in proceedings to

enforce its requirements. (See section

307(b)(2).)

List of Subjects in 40 CFR Part 52

Environmental protection, Air

pollution control, Incorporation by

reference, Intergovernmental relations,

Ozone, Particulates, Carbon monoxide,

Volatile organic compounds, Reporting

and recordkeeping requirements.

Note: Incorporation by reference of the

State Implementation Plan for the States of

Arizona and California was approved by the

Director of the Federal Register on July 1,

1982.

Dated: February 4, 1999.

Laura Yoshii,

Deputy Regional Administrator, Region IX.

Part 52, chapter I, title 40 of the Code

of Federal Regulations is amended as

follows:

PART 52—[AMENDED]

1. The authority citation for Part 52

continues to read as follows:

Authority: 42 U.S.C. 7401 et seq.

Subpart D—Arizona

2. Section 52.120 is amended by

adding paragraph (c) (67) (i) (C) to read

as follows:

§ 52.120 Identification of plan.

* * * * *

(c) * * *

(67) * * *

(i) * * *

(C) Amended Regulation VI, Rule 600,

revised on July 13, 1988.

* * * * * *

Subpart F—California

3. Section 52.220 is amended by

adding paragraphs (c)(187)(i)(B)(3),

(187)(i)(D), (199)(i)(D)(3), (244)(i)(E), and

(256)(i)(D) to read as follows:

§ 52.220 Identification of plan.

* * * * *

(c) * * *

(187) * * *

(i) * * *

(B) * * *

(3) New rules 150 to 159 amended on

September 17, 1991.

* * * * *

(D) San Diego County Air Pollution

Control District.
13354 Federal Register / Vol. 64, No. 52 /Thursday, March 18, 1999 /Rules and Regulations

(1) New rules 127, 128, and 130

amended on September 17, 1991.

* * * * *

(199) * * *

(i) * * *

(D) * * *

(3) Rules 6010, 6020, 6040, 6050,

6060, 6070, 6080, 6081, 6090, 6100,

6110, 6120, 6130, 6140, and 6150 were

adopted on May 21, 1992; amended on

December 17, 1992.

* * * * *

(244) * * *

(i) * * *

(E) San Joaquin Valley Unified Air

Pollution Control District.

(1) Rule 6030 adopted on May 21,

1992; amended on November 13, 1996.

* * * * *

(256) * * *

(i) * * *

(D) Antelope Valley Air Pollution

Control District.

(1) Rule 701 was amended on January

20, 1998.

* * * * *

[FR Doc. 99–6180 Filed 3–17–99; 8:45am]

BILLING CODE 6560–50–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

42 CFR Part 488

[HCFA–2035–FC]

RIN 0938–AJ35

Medicare and Medicaid Programs; Civil

Money Penalties for Nursing Homes

(SNF/NF), Change in Notice

Requirements, and Expansion of

Discretionary Remedy Delegation

AGENCY: Health Care Financing

Administration (HCFA), HHS.

ACTION: Final rule with comment period.

SUMMARY: This final rule with comment

period expands current Medicare and

Medicaid regulations regarding the

imposition of civil money penalties

imposed on nursing homes that are not

in compliance with program

requirements. The existing regulations

provide for the imposition of a civil

money penalty in a specific amount for

each day of noncompliance and provide

further that the civil money penalty

stays in place until the facility comes

into substantial compliance with all

participation requirements or the

facility is terminated from participation

in the program. This new rule adds the

ability for HCFA or the State to impose

a single civil money penalty amount for

an instance of a nursing home’s

noncompliance. We are also deleting

language to remove the requirement of

a maximum notification period for

imposition of a remedy.

DATES: Effective date: These regulations

are effective on May 17, 1999.

Comment date: Comments will be

considered if we receive them at the

appropriate address, as provided below,

no later than 5 p.m. on May 17, 1999.

ADDRESSES: Mail an original and 3

copies of written comments to the

following address: Health Care

Financing Administration, Department

of Health and Human Services,

Attention: HCFA–2035–FC, P.O. Box

26585, Baltimore, MD 21207–0385.

If you prefer, you may deliver an

original and 3 copies of your written

comments to one of the following

addresses: Room 309–G, Hubert H.

Humphrey Building, 200 Independence

Avenue, SW., Washington, D.C. 20201,

or Room C5–09–26, 7500 Security

Boulevard, Baltimore, Maryland 21244–

1850.

Comments may also be submitted

electronically to the following e-mail

address: HCFA2035FC@hcfa.gov. For email comment procedures, see the

beginning of SUPPLEMENTARY

INFORMATION. For further

information on ordering copies of the

Federal Register contained in this

document, see the beginning of

Supplementary Information.

FOR FURTHER INFORMATION CONTACT:

Cynthia Graunke, 410–786–6782

SUPPLEMENTARY INFORMATION:

E-mail, Comments, Procedures, and

Availability of Copies

E-mail comments must include the

full name and address of the sender, and

must be submitted to the referenced

address in order to be considered. All

comments must be incorporated in the

e-mail message because we may not be

able to access attachments.

Electronically submitted comments will

be available for public inspection at the

Independence Avenue address, below.

Because of staffing and resource

limitations, we cannot accept comments

by facsimile (FAX) transmission. In

commenting, please refer to file code

HCFA–2035–FC. Comments received

timely will be available for public

inspection as they are received,

generally beginning approximately 3

weeks after publication of a document,

in Room 309–G of the Department’s

offices at 200 Independence Avenue,

SW., Washington, D.C., on Monday

through Friday of each week from 8:30

a.m. to 5 p.m. (phone: (202) 690–7890).

Copies: To order copies of the Federal

Register containing this document, send

your request to: New Orders,

Superintendent of Documents, P.O. Box

371954, Pittsburgh, PA 15250–7954.

Specify the date of the issue requested

and enclose a check or money order

payable to the Superintendent of

Documents, or enclose your Visa or

Master Card number and expiration

date. Credit card orders can also be

placed by calling the order desk at (202)

512–1800 or by faxing to (202) 512–

2250. The cost for each copy is $8. As

an alternative, you can view and

photocopy the Federal Register

document at most libraries designated

as Federal Depository Libraries and at

many other public and academic

libraries throughout the country that

receive the Federal Register.

This Federal Register document is

also available from the Federal Register

online database through GPO Access, a

service of the U.S. Government Printing

Office. Free public access is available on

a Wide Area Information Server (WAIS)

through the Internet and via

asynchronous dial-in. Internet users can

access the database by using the World

Wide Web; the Superintendent of

Documents home page address is http:/

/www.access.gpo.gov/nara/, by using

local WAIS client software, or by telnet

to swais.access.gpo.gov, then login as

guest (no password required). Dial-in

users should use communications

software and modem to call (202) 512–

1661; type swais, then login as guest (no

password required).

I. Background

To participate in the Medicare and or

Medicaid programs, long-term care

facilities must be certified as meeting

Federal participation requirements.

Long-term care facilities include skilled

nursing facilities for Medicare and

nursing facilities for Medicaid. The

Federal participation requirements for

these facilities are specified in the

statute at sections 1819 and 1919 of the

Social Security Act (the Act) and in

implementing regulations at 42 CFR Part

483, Subpart B.

Section 1864(a) of the Act authorizes

the Secretary to enter into agreements

with State survey agencies to determine

whether skilled nursing facilities meet

the Federal participation requirements

for Medicare. Section 1902(a)(33)(B) of

the Act provides for State survey

agencies to perform the same survey

tasks for facilities participating or

seeking to participate in the Medicaid

program. The results of these Medicare

and Medicaid surveys are used by

HCFA and the State Medicaid agency,

respectively, as the basis for a decision