Your HSR is your main point of contact regarding health and safety matters, so make sure you inform them of any concerns or safety issues. Having your HSR represent your work group can help because: 1  A HSR is likely to understand your views and concerns.
The State has the responsibility for certifying a skilled nursing facilityâs or nursing facilityâs compliance or noncompliance, except in the case of State-operated facilities. However, the Stateâs certification for a skilled nursing facility is subject to CMSâ approval.
Skilled Nursing Facility PPS. CASE MIX PROSPECTIVE PAYMENT FOR SNFs BALANCED BUDGET ACT OF 1997: Section 4432(a) of the Balanced Budget Act (BBA) of 1997 modified how payment is made for Medicare skilled nursing facility (SNF) services.