The NASEM report made two suggestions to extend the transparency and accountability of finances, operation, and ownership. First, we really helpful that the Department of Health and Human Services collect, audit, and make publicly out there detailed facility-level knowledge on the funds, operations, and ownership of all nursing properties. HHS ought to be sure that the data permit the evaluation of financial arrangements and payments, associated celebration entities, and corporate structures. Second, we recommended that HHS make sure that accurate and complete data on the funds, operations, and ownership of all nursing houses are available in a real-time, readily usable, and searchable database. The proposed rule explicitly acknowledges these challenges and not solely supplies rural facilities further time to conform but in addition presents exemptions for services facing a decent labor market. “Even with a HELOC at today’s rates preserving their major mortgage at doubtless a sub 3 or round …