There are two related substantive changes (12VAC35-105-170 H. and 620 D.3.) from the version of the regulations published at the proposed stage which will have a substantial impact on all providers.  Both contain the expectation that providers, if cited for any violation of any regulation, will produce and implement a corrective action plan that will prevent recurrence. This is an impossible standard to meet. Providers can minimize the possibility as is stated in 170 C, but can’t guarantee that a plan with prevent a recurrence. 12VAC35-105-170 H. and 12VAC35-105-620 D.3. should be removed from the Final regulations and guidance documents produced and up for comment at this time that include reference to these regulations should be pulled and rewritten.