Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations 59263 

6. On page 47888: 

a. In the 1st column, in the 1st full 

paragraph, in line 18, the amount 

‘‘$10,660’’ is corrected to read 

‘‘$10,713.’’ 

b. In the 1st column, in the 2nd full 

paragraph, in line 9, the value ‘‘1.5’’ is 

corrected to read ‘‘1.4.’’ 

c. In the 2nd column, the 2nd full 

paragraph, lines 9 through 14, the 

sentence: ‘‘The largest decrease in 

payments as a result of these updates is 

a 0.1 percent decrease to rural 

freestanding IRFs, urban IRFs in the East 

South Central and Mountain regions, 

and rural IRFs in the Pacific region.’’ is 

corrected to read, ‘‘The largest decrease 

in payments as a result of these updates 

is a 0.1 percent decrease to rural IRF 

hospitals, urban for-profit IRFs, urban 

IRFs in the East South Central and 

Mountain regions, rural IRFs in the 

Pacific region, and teaching IRFs with 

resident to ADC ratios greater than 19 

percent.’’ 

7. On page 47890, in the 1st column, 

the 2nd full paragraph, lines 1 through 

4, the sentence, ‘‘Overall the largest 

payment increase is estimated at 4.1 

percent for rural government-owned 

IRFs and rural IRFs in the West South 

Central region.’’ is corrected to read, 

‘‘Overall, the largest payment increases 

are estimated at 4.1 percent for rural 

government-owned IRFs, and 4.0 

percent for rural IRFs in the Middle 

Atlantic and West South Central 

regions.’’ 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: September 19, 2011. 

Barbara J. Holland, 

Deputy Executive Secretary to the 

Department. 

[FR Doc. 2011–24671 Filed 9–23–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 412, 413, and 476 

[CMS–1518–CN3] 

RIN 0938–AQ24; 0938–AQ92 

Medicare Program; Hospital Inpatient 

Prospective Payment Systems for 

Acute Care Hospitals and the LongTerm Care Hospital Prospective 

Payment System and Fiscal Year 2012 

Rates; Hospitals’ FTE Resident Caps 

for Graduate Medical Education 

Payment; Corrections 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Correction of final rule. 

SUMMARY: This document corrects 

technical errors and typographical 

errors in the final rule entitled 

‘‘Medicare Program; Hospital Inpatient 

Prospective Payment Systems for Acute 

Care Hospitals and the Long-Term Care 

Hospital Prospective Payment System 

and FY 2012 Rates; Hospitals’ FTE 

Resident Caps for Graduate Medical 

Education Payment; Corrections’’ which 

appeared in the August 18, 2011 

Federal Register. 

DATES: This correction document is 

effective October 1, 2011. 

FOR FURTHER INFORMATION CONTACT:

Brian Slater, (410) 786–5229, Hospital 

inpatient wage data. 

Michele Hudson, (410) 786–4487, Longterm care hospital wage data. 

Caroline Gallaher, (410) 786–8705, 

Long-term care hospital quality 

measures. 

SUPPLEMENTARY INFORMATION:

I. Background 

In FR Doc. 2011–19719 of August 18, 

2011 (76 FR 51476), the final rule 

entitled ‘‘Medicare Program; Hospital 

Inpatient Prospective Payment Systems 

for Acute Care Hospitals and the LongTerm Care Hospital Prospective 

Payment System and FY 2012 Rates; 

Hospitals’ FTE Resident Caps for 

Graduate Medical Education Payment; 

Corrections’’ (hereinafter referred to as 

the FY 2012 IPPS/FY 2012 LTCH PPS 

final rule) there were a number of 

technical errors that are identified and 

corrected in the Correction of Errors 

section. We have already made changes 

to our rates through PRICER and joint 

signature memoranda. Accordingly, the 

corrections are effective October 1, 

2011. 

II. Summary of Errors and Corrections 

Posted on the CMS Web Site 

A. Errors in the Preamble 

On page 51745, in our discussion of 

quality reporting for long-term care 

hospitals (LTCHs) for FY 2014 payment 

determinations, Measure #1, we 

inadvertently miscounted and omitted a 

footnote. 

On pages 51746 and 51747, in our 

discussion of the technical expert panel 

(TEP) we made typographical errors and 

made a technical error in a footnote. 

On page 51747, in our discussion of 

the TEP, the acronym for Center Line 

Catheter-Associated Bloodstream 

Infection (CLABSI) was inadvertently 

misspelled. 

On page 51748, in our discussion of 

quality reporting for LTCHs for FY 2014 

payment determinations, Measure #2, 

we inadvertently included an incorrect 

Web site link for detailed information 

on the Standardized Infection Ratio 

(SIR). 

On page 51752, in our discussion of 

quality reporting for LTCHs data 

submission, we made an error in 

referencing the number of States in 

which healthcare associated infections 

(HAIs) reporting is already or soon will 

be mandated. 

On page 51754, in our discussion of 

the method of data collection and 

submission for the pressure ulcer 

measure, we made typographical and 

technical errors. 

On page 51755, in our discussion of 

Continuity Assessment Record & 

Evaluation (CARE), we made a 

grammatical error. 

On page 51780, in our discussion of 

the information collection requirements 

(ICRs) for the quality reporting program 

for LTCHs, we made an error in the 

number of States that already submitted 

HAI data to National Healthcare Safety 

Network (NHSN). 

On page 51813, in our discussion of 

the Web site location for the LTCH PPS 

tables for the FY 2012 IPPS/FY 2012 

LTCH PPS final rule, we made a 

typographical error in the regulation 

number. 

B. Corrections Posted on the CMS Web 

Site 

On pages 51812 and 51813, we list 

tables 2, 3A, 3B, 3C, 4A, 4B, 4C, 4J, 9A, 

9C, 12A, and 12B as tables that are 

available only through the Internet. 

In Table 2.—Acute Care Hospitals 

Case-Mix Indexes for Discharges 

Occurring in Federal Fiscal Year 2010; 

Hospital Wage Indexes for Federal 

Fiscal Year 2012; Hospital Average 

Hourly Wages for Federal Fiscal Years 

2010 (2006 Wage Data), 2011 (2007 


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59264 Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations 

Wage Data), and 2012 (2008 Wage Data); 

and 3-Year Average of Hospital Average 

Hourly Wages, we are correcting 

technical errors in hospitals’ wage data 

or geographic classifications that were 

used in calculating the wage index that 

was published in the FY 2012 IPPS/FY 

2012 LTCH PPS final rule. We are 

correcting Table 2 by including 

corrections to the wage data for 

providers 010001 and 340039; the 

providers’ corrected wage data were 

inadvertently omitted from the final FY 

2012 wage index database. In addition, 

we are correcting errors in geographic 

classification for 3 providers (providers 

150112, 180017, and 190246). As a 

result of the wage data and geographic 

classification corrections made for the 5 

providers noted, we are also correcting 

the wage index for other providers that 

are located in or reclassified to the same 

geographic area. 

In Table 3A.—FY 2012 and 3-Year 

Average Hourly Wage for Acute Care 

Hospitals in Urban Areas by CBSA and 

Table 3B—FY 2012 and 3-Year Average 

Hourly Wage for Acute Care Hospitals 

in Rural Areas by CBSA, we are 

correcting certain area average hourly 

wages based on corrections to errors in 

hospital wage data. As discussed 

previously, in Table 2 we are correcting 

the wage data for 2 providers. The 

corrections for one of these 2 providers 

(010001) require a correction in the 

associated area average hourly wage. 

The correction of the geographic 

classification of provider 190246 also 

requires corrections to the associated 

area average hourly wages. Therefore, 

we are correcting the area average 

hourly wage for CBSA 20020 (Dothan, 

AL) and CBSA 33740 (Monroe, LA) in 

Table 3A and also correcting the area 

average hourly wage for CBSA 19 (rural 

Louisiana) in Table 3B. The correction 

to the wage data for provider 340039 

does not result in a change in the 

associated area wage index. 

In Table 4A.—Wage Index and Capital 

Geographic Adjustment Factor (GAF) for 

Acute Care Hospitals in Urban Areas; 

Table 4B.—Wage Index and Capital 

Geographic Adjustment Factor (GAF) for 

Acute Care Hospitals in Rural Areas; 

and Table 4C.—Wage Index and Capital 

Geographic Adjustment Factor (GAF) for 

Acute Care Hospitals that are 

Reclassified, we are correcting technical 

errors in hospitals’ wage data and 

geographic classifications that were 

used in calculating the wage index that 

was published in the FY 2012 IPPS/FY 

2012 LTCH PPS final rule. In addition 

to correcting the wage data for provider 

010001, provider 150112 should have 

been withdrawn from its reclassification 

to CBSA 26900 Indianapolis-Carmel, IN 

(that is, removing the provider from 

Table 9A); provider 180017 had 

reinstated a prior reclassification to 

CBSA 14540 Bowling Green, KY (that is, 

adding the provider to Table 9A) and 

provider 190246 was incorrectly listed 

in CBSA 19 (rural Louisiana), but 

should have been listed in CBSA 33740 

Monroe, LA. CBSA 14 (rural Illinois) is 

removed from Table 4C because the 

only provider in Illinois that was 

reclassified to CBSA 14 cancelled its 

rural status under § 412.103 (as noted in 

Table 9C). 

In Table 4J.—Out-Migration 

Adjustment for Acute Care Hospitals— 

FY 2012, we are adding provider 140167 

to Table 4J to receive the outmigration 

adjustment because it cancelled its 

Lugar redesignation in order to receive 

the outmigration adjustment. Two 

additional counties are now listed in 

Table 4J. Coffee County, AL has two 

providers now receiving an 

outmigration adjustment (010027 and 

010049). Dale County, AL has one 

provider now receiving an outmigration 

adjustment (010021). The outmigration 

adjustment for Caldwell County, LA has 

changed and affects one provider 

(190184). 

In Table 9A.—Hospital 

Reclassifications and Redesignations— 

FY 2012, we are correcting technical 

errors in hospitals’ geographic 

reclassifications that were used in 

calculating the wage index that was 

published in the FY 2012 IPPS/FY 2012 

LTCH PPS final rule. Provider 150112 

was erroneously listed in Table 9A of 

the Addendum to the final rule as being 

reclassified; and therefore, we are 

correcting the table by removing this 

provider from Table 9A. Conversely, 

provider 180017 is reclassified but was 

inadvertently omitted from Table 9A; 

and therefore, we are correcting this 

error by adding the provider to Table 

9A. 

In Table 9C.—Hospitals Redesignated 

as Rural Under Section 1886(d)(8)(E) of 

the Act—FY 2012, we erroneously listed 

provider 140167 in Table 9C. Therefore, 

we are correcting this error by removing 

provider 140167 from Table 9C. 

In Table 12A.—LTCH PPS Wage 

Index for Urban Areas for Discharges 

Occurring From October 1, 2011 

Through September 30, 2012 and Table 

12B.— LTCH PPS Wage Index for Rural 

Areas for Discharges Occurring From 

October 1, 2011 Through September 30, 

2012, we are correcting errors in the 

LTCH wage indices for 3 CSBAs (20020, 

33740, and 19) as a result of the 

corrections we are making to the IPPS 

wage data that affects Tables 4A, 4B, 

and 4C described in this section of the 

document. 

The corrections to the tables 2 

through 9C discussed in this section of 

the correction document will be posted 

on the CMS Web site at http:// 

www.cms.hhs.gov/AcuteInpatientPPS/ 

01_overview.asp. Click on the link on 

the left side of the screen on titled, ‘‘FY 

2012 IPPS Final Rule Home Page’’ or 

‘‘Acute Inpatient—Files for Download.’’ 

The corrections to the tables 12A and 

12B discussed in this section of the 

correction document will be posted on 

the CMS Web site at http:// 

www.cms.gov/ 

LongTermCareHospitalPPS/ 

LTCHPPSRN/list.asp under the list item 

for regulation number CMS–1518–F. 

III. Waiver of Proposed Rulemaking 

and 30-Day Delay in Effective Date 

We ordinarily publish a notice of 

proposed rulemaking in the Federal 

Register to provide a period for public 

comment before the provisions of a rule 

take effect in accordance with section 

553(b) of the Administrative Procedure 

Act (APA) (5 U.S.C. 553(b)). However, 

we can waive this notice and comment 

procedure if the Secretary finds, for 

good cause, that the notice and 

comment process is impracticable, 

unnecessary, or contrary to the public 

interest, and incorporates a statement of 

the finding and the reasons therefore in 

the notice. 

Section 553(d) of the APA ordinarily 

requires a 30-day delay in effective date 

of final rules after the date of their 

publication in the Federal Register. 

This 30-day delay in effective date can 

be waived, however, if an agency finds 

for good cause that the delay is 

impracticable, unnecessary, or contrary 

to the public interest, and the agency 

incorporates a statement of the findings 

and its reasons in the rule issued. 

In our view, this document does not 

constitute a rulemaking that would be 

subject to the APA notice and comment 

or delayed effective date requirements. 

This document merely corrects 

typographical and technical errors in 

the preamble and addendum of the FY 

2012 IPPS/FY 2012 LTCH PPS final rule 

and does not make substantive changes 

to the policies or payment 

methodologies that were adopted in the 

final rule. As a result, this document is 

intended to ensure that the FY 2012 

IPPS/FY 2012 LTCH PPS final rule 

accurately reflects the policies adopted 

in that rule. 

In addition, 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 


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Federal Register / Vol. 76, No. 186 / Monday, September 26, 2011 / Rules and Regulations 59265 

incorporate the corrections in this 

document into the final rule or delaying 

the effective date would delay these 

corrections beyond the October 1 start of 

the fiscal year, and would be contrary to 

the public interest. Furthermore, such 

procedures would be unnecessary, as 

we are not altering the policies that 

were already subject to comment and 

finalized in our final rule. 

Therefore, we believe we have good 

cause to waive the notice and comment 

and effective date requirements. 

IV. Correction of Errors 

In FR Doc. 2011–19719 of August 18, 

2011 (76 FR 51476), make the following 

corrections: 

1. On page 51745, third column— 

a. Fourth full paragraph, lines 13 and 

14, the footnote reference number ‘‘2’’ is 

corrected to read ‘‘59a’’. 

b. Footnote text at bottom of the 

column, after line 4, the footnotes are 

corrected by adding a footnote to read 

as follows: 

‘‘59a Klevens RM, Edwards JR, Richards CL, 

Horan TC, Gaynes RP, Pollock DA, Cardo 

DM. Estimating healthcare-associated 

infection and deaths in U.S. hospitals, 2002. 

Public Health Reports 2007: 122:160–166. 

Available at http://www.cdc.gov/ncidod/ 

dhqp/pdf/hicpac/infections_deaths.pdf.’’ 

2. On page 51746, 

a. First column, first full paragraph, 

lines 19 through 21, the phrase ‘‘The 

TEP convened by the our’’ is corrected 

to read ‘‘The TEP convened by our’’. 

b. Third column, footnote text at 

bottom of column is corrected to read as 

follows: 

‘‘60 Klevens RM, Edwards JR, Richards CL, 

Horan TC, Gaynes RP, Pollock DA, Cardo 

DM. Estimating healthcare-associated 

infection and deaths in U.S. hospitals, 2002. 

Public Health Reports 2007: 122:160–166. 

Available at http://www.cdc.gov/ncidod/ 

dhqp/pdf/hicpac/infections_deaths.pdf.’’ 

3. On page 51747, third column, 

second full paragraph, line 3, the 

acronym ‘‘CLASBIs’’ is corrected to read 

as ‘‘CLABSI’’. 

4. On page 51748, second column, last 

paragraph, lines 20 through 21, the Web 

site link ‘‘http://www.cdc.gov/nhsn/ 

PDFs/pscManual/ 

7pscCAUTIcurrent.pdf’’ is corrected to 

read ‘‘http://www.cdc.gov/nhsn/pdfs/ 

pscmanual/4psc_clabscurrent.pdf’’. 

5. On page 51752, third column, last 

paragraph, last line, the figure ‘‘11’’ is 

corrected to read ‘‘over 20’’. 

6. On page 51754, third column— 

a. First partial paragraph, line 4, the 

phrase ‘‘nursing home’’ is corrected to 

read as ‘‘skilled nursing facility’’. 

b. Second full paragraph, line 3 and 

4, the phrase ‘‘using a CARE subset of 

standardized data elements to collect’’ is 

corrected to read as ‘‘using a subset of 

standardized CARE data elements to 

collect’’. 

7. On page 51755, second column, 

first full paragraph, lines 9 and 10, the 

phrase ‘‘during the PAC–PRD’’ is 

corrected to read ‘‘during the Post Acute 

Care Payment Reform Demonstration 

(PAC–PRD). 

8. On page 51780, second column, 

fifth paragraph, line 9, the figure ‘‘80’’ 

is corrected to read ‘‘over 200’’. 

9. On page 51813, third column, sixth 

paragraph, line 6, the reference ‘‘CMS– 

1518–P’’ is corrected to read ‘‘CMS– 

1518–F’’. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: September 21, 2011. 

Barbara J. Holland, 

Deputy Executive Secretary to the 

Department, Department of Health Human 

Services. 

[FR Doc. 2011–24669 Filed 9–23–11; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 413 

[CMS–1351–CN] 

RIN 0938–AQ29 

Medicare Program; Prospective 

Payment System and Consolidated 

Billing for Skilled Nursing Facilities for 

FY 2012; Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final rule; correction. 

SUMMARY: This document corrects 

technical errors in the final rule entitled 

‘‘Medicare Program; Prospective 

Payment System and Consolidated 

Billing for Skilled Nursing Facilities for 

FY 2012’’ that appeared in the August 

8, 2011 Federal Register. 

DATES: Effective Date: This correction is 

effective October 1, 2011. 

FOR FURTHER INFORMATION CONTACT: John 

Kane, (410) 786–0557. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2011–19544 of August 8, 

2011 (76 FR 48486), there were three 

technical errors that are identified and 

corrected in the Correction of Errors 

section of this document. The 

corrections in this correction document 

are effective as if they had been 

included in the August 8, 2011 Federal 

Register document. Accordingly, the 

corrections are effective October 1, 

2011. 

II. Summary of Errors 

The Addendum to the Skilled Nursing 

Facility (SNF) Prospective Payment 

System (PPS) final rule (76 FR 48486, 

48540) inadvertently included several 

technical errors in wage index values in 

Table A (‘‘FY 2012 Wage Index for 

Urban Areas Based on CBSA Labor 

Market Areas’’) and Table B (‘‘FY 2012 

Wage Index Based on CBSA Labor 

Market Areas for Rural Areas’’). Tables 

A and B provide the urban and rural 

wage index values, respectively, that are 

used to calculate the labor-related 

portion of the FY 2012 payment rate for 

SNFs. We inadvertently omitted 

corrected wage and geographic 

classification data for two providers 

from the final FY 2012 wage index 

database that should have been 

included in the wage index calculation 

of the FY 2012 payment rates for SNFs. 

This resulted in incorrect wage index 

values being displayed in Table A for 

two CBSAs. Therefore, we are correcting 

the wage index values for those two 

CBSAs in Table A of the Addendum, in 

order to reflect the hospital wage 

index’s most current wage data. The 

first correction in Table A of the 

Addendum (76 FR 48546) involves the 

wage index for CBSA 20020 (Dothan, 

AL–Geneva County, AL–Henry County, 

AL–Houston County, AL), and reflects 

the receipt of revised wage data from an 

Alabama provider. The second 

correction in Table A of the Addendum 

(76 FR 48552) involves the wage index 

for CBSA 33740 (Monroe, LA–Ouachita 

Parish, LA–Union Parish, LA), and 

reflects a change in geographic 

classification for a Louisiana provider. 

Finally, in Table B of the Addendum 

(76 FR 48561), we are correcting the 

wage index value for State Code 19 

(Louisiana), in order to reflect the 

previously-cited change in geographic 

classification for a Louisiana provider. 

As these revisions involve only a 

limited number of individual entries in 

Tables A and B, we are not republishing 

these tables in their entirety in this 

document; however, we note that the 

corrected versions of both tables are 

available on the SNF PPS Web site, 

which can be accessed online at http:// 

www.cms.gov/SNFPPS/. 

III. Waiver of Proposed Rulemaking 

and Delayed Effective Date 

We ordinarily publish a notice of 

proposed rulemaking in the Federal 


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