On February 18, 2011, CMS published an interim final rule with comment period that would implement an ACA provision imposing notification requirements in connection with closure of a Medicare skilled nursing facility (SNF) or Medicaid NF. Under the rule, in the case of a long-term care (LTC) facility closure, the SNF or NF administrator must provide written notification of the impending closure and a plan for the relocation of residents at least 60 days prior to the impending closure (or, if the Secretary terminates the facility’s participation in Medicare or Medicaid, not later than the date the Secretary determines appropriate). While the ACA authorizes civil monetary penalties (CMPs) of up to $100,000 and exclusion for an administrator’s failure to comply with this provision, CMS recognizes that there are times when an administrator has no control over closure procedures. In the rule, CMS therefore sets CMPs of: a minimum of $500 for the first offense; a minimum of $1,500 for the second offense; and a minimum of $3,000 for the third and subsequent offenses. CMS provides appeal rights for an individual who is subject to administrator sanctions under the rule. The rule is effective March 23, 2011, and comments will be accepted until April 19, 2011.