Medicare: Skilled nursing facilities; prospective payment system and consolidated billing; update Correction,

[Federal Register: September 29, 2006 (Volume 71, Number 189)]

[Notices]

[Page 57519-57543]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr29se06-87]

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1530-CN]

RIN 0938-AM46

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Corrections

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Correction notice.

SUMMARY: This document corrects technical errors that appeared in the July 31, 2006 Federal Register, entitled ``Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities--Update--Notice.''

Effective Date: This correction is effective October 1, 2006.

FOR FURTHER INFORMATION CONTACT: Bill Ullman, (410) 786-5667.

SUPPLEMENTARY INFORMATION:

[[Page 57520]]

  1. Background

    In FR Doc. 06-6615 of July 31, 2006 (71 FR 43158), there were several technical errors that this notice serves to identify and correct. One correction involves Table 10, which we use to illustrate the skilled nursing facility (SNF) prospective payment system (PPS) payment rate computations for a fictitious ``XYZ'' SNF located in Cedar Rapids, IA. In the example that appears in this table, RUG Group ``CC2'' serves to illustrate the effect on the payment rates of applying the 128 percent add-on for SNF residents with AIDS under section 511 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA, P.L. 108-173). The table includes a footnote, marked with an asterisk that describes the MMA adjustment; however, we inadvertently omitted the corresponding asterisk within the table itself to identify the particular figure in the table to which this footnote refers. Accordingly, in section II of this document (``Correction of Errors''), we are restoring the asterisk that belongs next to the adjusted CC2 amount of ``$542.54'' that appears in Table 10's ``Percent Adjustment'' column.

    In addition, in Table 12 (which displays the projected impact of the FY 2007 SNF PPS payment update, including the variation in impact by region and by certain other facility characteristics), we are correcting errors pertaining to the rural Outlying region. In the projected impact for the rural Outlying region, we inadvertently entered the incorrect figures of ``-2.9%'' and ``3.3%'' in the columns entitled ``Transition to CBSA'' and ``Total FY 2007 change,'' respectively. In this notice, we correct these figures to read ``0.0%'' and ``6.4%,'' respectively, and we also make corresponding revisions in the text of the narrative that accompanies Table 12. We note that the effect on the corrected table is solely distributional in nature and, accordingly, there is no change in the estimated aggregate expenditures for FY 2007 as set forth in the July 31, 2006 update notice. A further discussion of the projected impact of the FY 2007 SNF PPS payment update appears in the July 31, 2006 update notice (71 FR 43173-43176).

    Finally, we have determined that in the process of developing the most recent hospital wage index, we inadvertently used incorrect wage information for two providers. These two providers notified their fiscal intermediary in a timely fashion that their wage data were incorrect and we agreed to correct the wage data for these two providers. However, we inadvertently published the uncorrected wage data in the July 31, 2006 update notice. Incorporating their corrected data into our calculation of the national average hourly wage results in revised wage index values for a number of Core-Based Statistical Areas (CBSAs). Accordingly, we are revising and republishing Tables 8 and 9, which appeared in an addendum to the July 31, 2006 update notice, to reflect the correct information.

  2. Correction of Errors

    In FR Doc. 06-6615 (71 FR 43158), make the following corrections:

    1. On page 43170, Table 10, in the ``Percent adj'' column, the figure ``$542.54'' is revised to read ``$542.54*''.

    2. On page 43174, third column,

    1. In the first paragraph, line 10, the figure ``3.2 percent'' is revised to read ``6.4 percent''.

    2. In the final paragraph, the second sentence is revised to read as follows: ``For example, though facilities in the rural Mountain region experience only a slight payment increase of 1.2 percent, some providers (such as those in the rural Outlying region) show a greater increase of 6.4 percent. `` In the third sentence, the phrase ``urban Mountain'' is revised to read ``rural Outlying''.

    3. On page 43175, Table 12, the entries displayed for the rural Outlying region in the columns entitled ``Transition to full CBSA'' and ``Total FY 2007 change'' are revised to read ``0.0%'' and ``6.4%'', respectively.

    4. On pages 43176 through 43198, Table 8 is revised to read as follows:

    Table 8.-- FY 2007 Wage Index For Urban Areas Based On CBSA Labor Market Areas

    Wage CBSA code

    Urban area (constituent counties)

    index

    10180....................................... Abilene, TX............................................ 0.8000 Callahan County, TX.................................... Jones County, TX....................................... Taylor County, TX...................................... 10380....................................... Aguadilla-Isabela-San Sebasti[aacute]n, PR............. 0.3915 Aguada Municipio, PR................................... Aguadilla Municipio, PR................................ A[ntilde]asco Municipio, PR............................ Isabela Municipio, PR.................................. Lares Municipio, PR.................................... Moca Municipio, PR..................................... Rinc[oacute]n Municipio, PR............................ San Sebasti[aacute]n Municipio, PR..................... 10420....................................... Akron, OH.............................................. 0.8654 Portage County, OH..................................... Summit County, OH...................................... 10500....................................... Albany, GA............................................. 0.8991 Baker County, GA....................................... Dougherty County, GA................................... Lee County, GA......................................... Terrell County, GA..................................... Worth County, GA....................................... 10580....................................... Albany-Schenectady-Troy, NY............................ 0.8720 Albany County, NY...................................... Rensselaer County, NY.................................. Saratoga County, NY.................................... Schenectady County, NY................................. Schoharie County, NY................................... 10740....................................... Albuquerque, NM........................................ 0.9458

    [[Page 57521]]

    Bernalillo County, NM.................................. Sandoval County, NM.................................... Torrance County, NM.................................... Valencia County, NM.................................... 10780....................................... Alexandria, LA......................................... 0.8006 Grant Parish, LA....................................... Rapides Parish, LA..................................... 10900....................................... Allentown-Bethlehem-Easton, PA-NJ...................... 0.9947 Warren County, NJ...................................... Carbon County, PA...................................... Lehigh County, PA...................................... Northampton County, PA................................. 11020....................................... Altoona, PA............................................ 0.8812 Blair County, PA....................................... 11100....................................... Amarillo, TX........................................... 0.9169 Armstrong County, TX................................... Carson County, TX...................................... Potter County, TX...................................... Randall County, TX..................................... 11180....................................... Ames, IA............................................... 0.9760 Story County, IA....................................... 11260....................................... Anchorage, AK.......................................... 1.2023 Anchorage Municipality, AK............................. Matanuska-Susitna Borough, AK.......................... 11300....................................... Anderson, IN........................................... 0.8681 Madison County, IN..................................... 11340....................................... Anderson, SC........................................... 0.9017 Anderson County, SC.................................... 11460....................................... Ann Arbor, MI.......................................... 1.0826 Washtenaw County, MI................................... 11500....................................... Anniston-Oxford, AL.................................... 0.7770 Calhoun County, AL..................................... 11540....................................... Appleton, WI........................................... 0.9455 Calumet County, WI..................................... Outagamie County, WI................................... 11700....................................... Asheville, NC.......................................... 0.9216 Buncombe County, NC.................................... Haywood County, NC..................................... Henderson County, NC................................... Madison County, NC..................................... 12020....................................... Athens-Clarke County, GA............................... 0.9856 Clarke County, GA...................................... Madison County, GA..................................... Oconee County, GA...................................... Oglethorpe County, GA.................................. 12060....................................... Atlanta-Sandy Springs-Marietta, GA..................... 0.9762 Barrow County, GA...................................... Bartow County, GA...................................... Butts County, GA....................................... Carroll County, GA..................................... Cherokee County, GA.................................... Clayton County, GA..................................... Cobb County, GA........................................ Coweta County, GA...................................... Dawson County, GA...................................... DeKalb County, GA...................................... Douglas County, GA..................................... Fayette County, GA..................................... Forsyth County, GA..................................... Fulton County, GA...................................... Gwinnett County, GA.................................... Haralson County, GA.................................... Heard County, GA....................................... Henry County, GA....................................... Jasper County, GA...................................... Lamar County, GA....................................... Meriwether County, GA.................................. Newton County, GA...................................... Paulding County, GA.................................... Pickens County, GA..................................... Pike County, GA........................................

    [[Page 57522]]

    Rockdale County, GA.................................... Spalding County, GA.................................... Walton County, GA...................................... 12100....................................... Atlantic City, NJ...................................... 1.1831 Atlantic County, NJ.................................... 12220....................................... Auburn-Opelika, AL..................................... 0.8096 Lee County, AL......................................... 12260....................................... Augusta-Richmond County, GA-SC......................... 0.9667 Burke County, GA....................................... Columbia County, GA.................................... McDuffie County, GA.................................... Richmond County, GA.................................... Aiken County, SC....................................... Edgefield County, SC................................... 12420....................................... Austin-Round Rock, TX.................................. 0.9344 Bastrop County, TX..................................... Caldwell County, TX.................................... Hays County, TX........................................ Travis County, TX...................................... Williamson County, TX.................................. 12540....................................... Bakersfield, CA........................................ 1.0725 Kern County, CA........................................ 12580....................................... Baltimore-Towson, MD................................... 1.0088 Anne Arundel County, MD................................ Baltimore County, MD................................... Carroll County, MD..................................... Harford County, MD..................................... Howard County, MD...................................... Queen Anne's County, MD................................ Baltimore City, MD..................................... 12620....................................... Bangor, ME............................................. 0.9711 Penobscot County, ME................................... 12700....................................... Barnstable Town, MA.................................... 1.2539 Barnstable County, MA.................................. 12940....................................... Baton Rouge, LA........................................ 0.8084 Ascension Parish, LA................................... East Baton Rouge Parish, LA............................ East Feliciana Parish, LA.............................. Iberville Parish, LA................................... Livingston Parish, LA.................................. Pointe Coupee Parish, LA............................... St. Helena Parish, LA.................................. West Baton Rouge Parish, LA............................ West Feliciana Parish, LA.............................. 12980....................................... Battle Creek, MI....................................... 0.9762 Calhoun County, MI..................................... 13020....................................... Bay City, MI........................................... 0.9251 Bay County, MI......................................... 13140....................................... Beaumont-Port Arthur, TX............................... 0.8595 Hardin County, TX...................................... Jefferson County, TX................................... Orange County, TX...................................... 13380....................................... Bellingham, WA......................................... 1.1104 Whatcom County, WA..................................... 13460....................................... Bend, OR............................................... 1.0743 Deschutes County, OR................................... 13644....................................... Bethesda-Frederick-Gaithersburg, MD.................... 1.0903 Frederick County, MD................................... Montgomery County, MD.................................. 13740....................................... Billings, MT........................................... 0.8712 Carbon County, MT...................................... Yellowstone County, MT................................. 13780....................................... Binghamton, NY......................................... 0.8786 Broome County, NY...................................... Tioga County, NY....................................... 13820....................................... Birmingham-Hoover, AL.................................. 0.8894 Bibb County, AL........................................ Blount County, AL...................................... Chilton County, AL..................................... Jefferson County, AL................................... St. Clair County, AL...................................

    [[Page 57523]]

    Shelby County, AL...................................... Walker County, AL...................................... 13900....................................... Bismarck, ND........................................... 0.7240 Burleigh County, ND.................................... Morton County, ND...................................... 13980....................................... Blacksburg-Christiansburg-Radford, VA.................. 0.8213 Giles County, VA....................................... Montgomery County, VA.................................. Pulaski County, VA..................................... Radford City, VA....................................... 14020....................................... Bloomington, IN........................................ 0.8533 Greene County, IN...................................... Monroe County, IN...................................... Owen County, IN........................................ 14060....................................... Bloomington-Normal, IL................................. 0.8944 McLean County, IL...................................... 14260....................................... Boise City-Nampa, ID................................... 0.9401 Ada County, ID......................................... Boise County, ID....................................... Canyon County, ID...................................... Gem County, ID......................................... Owyhee County, ID...................................... 14484....................................... Boston-Quincy, MA...................................... 1.1679 Norfolk County, MA..................................... Plymouth County, MA.................................... Suffolk County, MA..................................... 14500....................................... Boulder, CO............................................ 1.0350 Boulder County, CO..................................... 14540....................................... Bowling Green, KY...................................... 0.8148 Edmonson County, KY.................................... Warren County, KY...................................... 14740....................................... Bremerton-Silverdale, WA............................... 1.0913 Kitsap County, WA...................................... 14860....................................... Bridgeport-Stamford-Norwalk, CT........................ 1.2659 Fairfield County, CT................................... 15180....................................... Brownsville-Harlingen, TX.............................. 0.9430 Cameron County, TX..................................... 15260....................................... Brunswick, GA.......................................... 1.0164 Brantley County, GA.................................... Glynn County, GA....................................... McIntosh County, GA.................................... 15380....................................... Buffalo-Niagara Falls, NY.............................. 0.9424 Erie County, NY........................................ Niagara County, NY..................................... 15500....................................... Burlington, NC......................................... 0.8674 Alamance County, NC.................................... 15540....................................... Burlington-South Burlington, VT........................ 0.9474 Chittenden County, VT.................................. Franklin County, VT.................................... Grand Isle County, VT.................................. 15764....................................... Cambridge-Newton-Framingham, MA........................ 1.0970 Middlesex County, MA................................... 15804....................................... Camden, NJ............................................. 1.0392 Burlington County, NJ.................................. Camden County, NJ...................................... Gloucester County, NJ.................................. 15940....................................... Canton-Massillon, OH................................... 0.9031 Carroll County, OH..................................... Stark County, OH....................................... 15980....................................... Cape Coral-Fort Myers, FL.............................. 0.9342 Lee County, FL......................................... 16180....................................... Carson City, NV........................................ 1.0025 Carson City, NV........................................ 16220....................................... Casper, WY............................................. 0.9145 Natrona County, WY..................................... 16300....................................... Cedar Rapids, IA....................................... 0.8888 Benton County, IA...................................... Jones County, IA....................................... Linn County, IA........................................ 16580....................................... Champaign-Urbana, IL................................... 0.9644 Champaign County, IL...................................

    [[Page 57524]]

    Ford County, IL........................................ Piatt County, IL....................................... 16620....................................... Charleston, WV......................................... 0.8542 Boone County, WV....................................... Clay County, WV........................................ Kanawha County, WV..................................... Lincoln County, WV..................................... Putnam County, WV...................................... 16700....................................... Charleston-North Charleston, SC........................ 0.9145 Berkeley County, SC.................................... Charleston County, SC.................................. Dorchester County, SC.................................. 16740....................................... Charlotte-Gastonia-Concord, NC-SC...................... 0.9554 Anson County, NC....................................... Cabarrus County, NC.................................... Gaston County, NC...................................... Mecklenburg County, NC................................. Union County, NC....................................... York County, SC........................................ 16820....................................... Charlottesville, VA.................................... 1.0125 Albemarle County, VA................................... Fluvanna County, VA.................................... Greene County, VA...................................... Nelson County, VA...................................... Charlottesville City, VA............................... 16860....................................... Chattanooga, TN-GA..................................... 0.8948 Catoosa County, GA..................................... Dade County, GA........................................ Walker County, GA...................................... Hamilton County, TN.................................... Marion County, TN...................................... Sequatchie County, TN.................................. 16940....................................... Cheyenne, WY........................................... 0.9060 Laramie County, WY..................................... 16974....................................... Chicago-Naperville-Joliet, IL.......................... 1.0751 Cook County, IL........................................ DeKalb County, IL...................................... DuPage County, IL...................................... Grundy County, IL...................................... Kane County, IL........................................ Kendall County, IL..................................... McHenry County, IL..................................... Will County, IL........................................ 17020....................................... Chico, CA.............................................. 1.1053 Butte County, CA....................................... 17140....................................... Cincinnati-Middletown, OH-KY-IN........................ 0.9601 Dearborn County, IN.................................... Franklin County, IN.................................... Ohio County, IN........................................ Boone County, KY....................................... Bracken County, KY..................................... Campbell County, KY.................................... Gallatin County, KY.................................... Grant County, KY....................................... Kenton County, KY...................................... Pendleton County, KY................................... Brown County, OH....................................... Butler County, OH...................................... Clermont County, OH.................................... Hamilton County, OH.................................... Warren County, OH...................................... 17300....................................... Clarksville, TN-KY..................................... 0.8436 Christian County, KY................................... Trigg County, KY....................................... Montgomery County, TN.................................. Stewart County, TN..................................... 17420....................................... Cleveland, TN.......................................... 0.8109 Bradley County, TN..................................... Polk County, TN........................................ 17460....................................... Cleveland-Elyria-Mentor, OH............................ 0.9400 Cuyahoga County, OH....................................

    [[Page 57525]]

    Geauga County, OH...................................... Lake County, OH........................................ Lorain County, OH...................................... Medina County, OH...................................... 17660....................................... Coeur d'Alene, ID...................................... 0.9344 Kootenai County, ID.................................... 17780....................................... College Station-Bryan, TX.............................. 0.9045 Brazos County, TX...................................... Burleson County, TX.................................... Robertson County, TX................................... 17820....................................... Colorado Springs, CO................................... 0.9701 El Paso County, CO..................................... Teller County, CO...................................... 17860....................................... Columbia, MO........................................... 0.8542 Boone County, MO....................................... Howard County, MO...................................... 17900....................................... Columbia, SC........................................... 0.8933 Calhoun County, SC..................................... Fairfield County, SC................................... Kershaw County, SC..................................... Lexington County, SC................................... Richland County, SC.................................... Saluda County, SC...................................... 17980....................................... Columbus, GA-AL........................................ 0.8239 Russell County, AL..................................... Chattahoochee County, GA............................... Harris County, GA...................................... Marion County, GA...................................... Muscogee County, GA.................................... 18020....................................... Columbus, IN........................................... 0.9318 Bartholomew County, IN................................. 18140....................................... Columbus, OH........................................... 1.0107 Delaware County, OH.................................... Fairfield County, OH................................... Franklin County, OH.................................... Licking County, OH..................................... Madison County, OH..................................... Morrow County, OH...................................... Pickaway County, OH.................................... Union County, OH....................................... 18580....................................... Corpus Christi, TX..................................... 0.8564 Aransas County, TX..................................... Nueces County, TX...................................... San Patricio County, TX................................ 18700....................................... Corvallis, OR.......................................... 1.1546 Benton County, OR...................................... 19060....................................... Cumberland, MD-WV...................................... 0.8446 Allegany County, MD.................................... Mineral County, WV..................................... 19124....................................... Dallas-Plano-Irving, TX................................ 1.0075 Collin County, TX...................................... Dallas County, TX...................................... Delta County, TX....................................... Denton County, TX...................................... Ellis County, TX....................................... Hunt County, TX........................................ Kaufman County, TX..................................... Rockwall County, TX.................................... 19140....................................... Dalton, GA............................................. 0.9093 Murray County, GA...................................... Whitfield County, GA................................... 19180....................................... Danville, IL........................................... 0.9266 Vermilion County, IL................................... 19260....................................... Danville, VA........................................... 0.8451 Pittsylvania County, VA................................ Danville City, VA...................................... 19340....................................... Davenport-Moline-Rock Island, IA-IL.................... 0.8846 Henry County, IL....................................... Mercer County, IL...................................... Rock Island County, IL................................. Scott County, IA.......................................

    [[Page 57526]]

    19380....................................... Dayton, OH............................................. 0.9037 Greene County, OH...................................... Miami County, OH....................................... Montgomery County, OH.................................. Preble County, OH...................................... 19460....................................... Decatur, AL............................................ 0.8159 Lawrence County, AL.................................... Morgan County, AL...................................... 19500....................................... Decatur, IL............................................ 0.8172 Macon County, IL....................................... 19660....................................... Deltona-Daytona Beach-Ormond Beach, FL................. 0.9263 Volusia County, FL..................................... 19740....................................... Denver-Aurora, CO...................................... 1.0930 Adams County, CO....................................... Arapahoe County, CO.................................... Broomfield County, CO.................................. Clear Creek County, CO................................. Denver County, CO...................................... Douglas County, CO..................................... Elbert County, CO...................................... Gilpin County, CO...................................... Jefferson County, CO................................... Park County, CO........................................ 19780....................................... Des Moines-West Des Moines, IA......................... 0.9214 Dallas County, IA...................................... Guthrie County, IA..................................... Madison County, IA..................................... Polk County, IA........................................ Warren County, IA...................................... 19804....................................... Detroit-Livonia-Dearborn, MI........................... 1.0281 Wayne County, MI....................................... 20020....................................... Dothan, AL............................................. 0.7381 Geneva County, AL...................................... Henry County, AL....................................... Houston County, AL..................................... 20100....................................... Dover, DE.............................................. 0.9847 Kent County, DE........................................ 20220....................................... Dubuque, IA............................................ 0.9133 Dubuque County, IA..................................... 20260....................................... Duluth, MN-WI.......................................... 1.0042 Carlton County, MN..................................... St. Louis County, MN................................... Douglas County, WI..................................... 20500....................................... Durham, NC............................................. 0.9826 Chatham County, NC..................................... Durham County, NC...................................... Orange County, NC...................................... Person County, NC...................................... 20740....................................... Eau Claire, WI......................................... 0.9630 Chippewa County, WI.................................... Eau Claire County, WI.................................. 20764....................................... Edison, NJ............................................. 1.1190 Middlesex County, NJ................................... Monmouth County, NJ.................................... Ocean County, NJ....................................... Somerset County, NJ.................................... 20940....................................... El Centro, CA.......................................... 0.9076 Imperial County, CA.................................... 21060....................................... Elizabethtown, KY...................................... 0.8697 Hardin County, KY...................................... Larue County, KY....................................... 21140....................................... Elkhart-Goshen, IN..................................... 0.9426 Elkhart County, IN..................................... 21300....................................... Elmira, NY............................................. 0.8240 Chemung County, NY..................................... 21340....................................... El Paso, TX............................................ 0.9053 El Paso County, TX..................................... 21500....................................... Erie, PA............................................... 0.8827 Erie County, PA........................................ 21604....................................... Essex County, MA....................................... 1.0418 Essex County, MA.......................................

    [[Page 57527]]

    21660....................................... Eugene-Springfield, OR................................. 1.0876 Lane County, OR........................................ 21780....................................... Evansville, IN-KY...................................... 0.9071 Gibson County, IN...................................... Posey County, IN....................................... Vanderburgh County, IN................................. Warrick County, IN..................................... Henderson County, KY................................... Webster County, KY..................................... 21820....................................... Fairbanks, AK.......................................... 1.1059 Fairbanks North Star Borough, AK....................... 21940....................................... Fajardo, PR............................................ 0.4036 Ceiba Municipio, PR.................................... Fajardo Municipio, PR.................................. Luquillo Municipio, PR................................. 22020....................................... Fargo, ND-MN........................................... 0.8250 Cass County, ND........................................ Clay County, MN........................................ 22140....................................... Farmington, NM......................................... 0.8589 San Juan County, NM.................................... 22180....................................... Fayetteville, NC....................................... 0.8945 Cumberland County, NC.................................. Hoke County, NC........................................ 22220....................................... Fayetteville-Springdale-Rogers, AR-MO.................. 0.8865 Benton County, AR...................................... Madison County, AR..................................... Washington County, AR.................................. McDonald County, MO.................................... 22380....................................... Flagstaff, AZ.......................................... 1.1601 Coconino County, AZ.................................... 22420....................................... Flint, MI.............................................. 1.0969 Genesee County, MI..................................... 22500....................................... Florence, SC........................................... 0.8388 Darlington County, SC.................................. Florence County, SC.................................... 22520....................................... Florence-Muscle Shoals, AL............................. 0.7843 Colbert County, AL..................................... Lauderdale County, AL.................................. 22540....................................... Fond du Lac, WI........................................ 1.0063 Fond du Lac County, WI................................. 22660....................................... Fort Collins-Loveland, CO.............................. 0.9544 Larimer County, CO..................................... 22744....................................... Fort Lauderdale-Pompano Beach-Deerfield Beach, FL...... 1.0133 Broward County, FL..................................... 22900....................................... Fort Smith, AR-OK...................................... 0.7731 Crawford County, AR.................................... Franklin County, AR.................................... Sebastian County, AR................................... Le Flore County, OK.................................... Sequoyah County, OK.................................... 23020....................................... Fort Walton Beach-Crestview-Destin, FL................. 0.8643 Okaloosa County, FL.................................... 23060....................................... Fort Wayne, IN......................................... 0.9517 Allen County, IN....................................... Wells County, IN....................................... Whitley County, IN..................................... 23104....................................... Fort Worth-Arlington, TX............................... 0.9569 Johnson County, TX..................................... Parker County, TX...................................... Tarrant County, TX..................................... Wise County, TX........................................ 23420....................................... Fresno, CA............................................. 1.0943 Fresno County, CA...................................... 23460....................................... Gadsden, AL............................................ 0.8066 Etowah County, AL...................................... 23540....................................... Gainesville, FL........................................ 0.9277 Alachua County, FL..................................... Gilchrist County, FL................................... 23580....................................... Gainesville, GA........................................ 0.8958 Hall County, GA........................................ 23844....................................... Gary, IN............................................... 0.9334

    [[Page 57528]]

    Jasper County, IN...................................... Lake County, IN........................................ Newton County, IN...................................... Porter County, IN...................................... 24020....................................... Glens Falls, NY........................................ 0.8324 Warren County, NY...................................... Washington County, NY.................................. 24140....................................... Goldsboro, NC.......................................... 0.9171 Wayne County, NC....................................... 24220....................................... Grand Forks, ND-MN..................................... 0.7949 Polk County, MN........................................ Grand Forks County, ND................................. 24300....................................... Grand Junction, CO..................................... 0.9668 Mesa County, CO........................................ 24340....................................... Grand Rapids-Wyoming, MI............................... 0.9455 Barry County, MI....................................... Ionia County, MI....................................... Kent County, MI........................................ Newaygo County, MI..................................... 24500....................................... Great Falls, MT........................................ 0.8598 Cascade County, MT..................................... 24540....................................... Greeley, CO............................................ 0.9602 Weld County, CO........................................ 24580....................................... Green Bay, WI.......................................... 0.9787 Brown County, WI....................................... Kewaunee County, WI.................................... Oconto County, WI...................................... 24660....................................... Greensboro-High Point, NC.............................. 0.8866 Guilford County, NC.................................... Randolph County, NC.................................... Rockingham County, NC.................................. 24780....................................... Greenville, NC......................................... 0.9432 Greene County, NC...................................... Pitt County, NC........................................ 24860....................................... Greenville, SC......................................... 0.9804 Greenville County, SC.................................. Laurens County, SC..................................... Pickens County, SC..................................... 25020....................................... Guayama, PR............................................ 0.3235 Arroyo Municipio, PR................................... Guayama Municipio, PR.................................. Patillas Municipio, PR................................. 25060....................................... Gulfport-Biloxi, MS.................................... 0.8915 Hancock County, MS..................................... Harrison County, MS.................................... Stone County, MS....................................... 25180....................................... Hagerstown-Martinsburg, MD-WV.......................... 0.9038 Washington County, MD.................................. Berkeley County, WV.................................... Morgan County, WV...................................... 25260....................................... Hanford-Corcoran, CA................................... 1.0282 Kings County, CA....................................... 25420....................................... Harrisburg-Carlisle, PA................................ 0.9402 Cumberland County, PA.................................. Dauphin County, PA..................................... Perry County, PA....................................... 25500....................................... Harrisonburg, VA....................................... 0.9073 Rockingham County, VA.................................. Harrisonburg City, VA.................................. 25540....................................... Hartford-West Hartford-East Hartford, CT............... 1.0894 Hartford County, CT.................................... Litchfield County, CT.................................. Middlesex County, CT................................... Tolland County, CT..................................... 25620....................................... Hattiesburg, MS........................................ 0.7430 Forrest County, MS..................................... Lamar County, MS....................................... Perry County, MS....................................... 25860....................................... Hickory-Lenoir-Morganton, NC........................... 0.9010 Alexander County, NC................................... Burke County, NC.......................................

    [[Page 57529]]

    Caldwell County, NC.................................... Catawba County, NC..................................... 25980....................................... Hinesville-Fort Stewart, GA1........................... 0.9177 Liberty County, GA..................................... Long County, GA........................................ 26100....................................... Holland-Grand Haven, MI................................ 0.9163 Ottawa County, MI...................................... 26180....................................... Honolulu, HI........................................... 1.1096 Honolulu County, HI.................................... 26300....................................... Hot Springs, AR........................................ 0.8782 Garland County, AR..................................... 26380....................................... Houma-Bayou Cane-Thibodaux, LA......................... 0.8082 Lafourche Parish, LA................................... Terrebonne Parish, LA.................................. 26420....................................... Houston-Sugar Land-Baytown, TX......................... 1.0008 Austin County, TX...................................... Brazoria County, TX.................................... Chambers County, TX.................................... Fort Bend County, TX................................... Galveston County, TX................................... Harris County, TX...................................... Liberty County, TX..................................... Montgomery County, TX.................................. San Jacinto County, TX................................. Waller County, TX...................................... 26580....................................... Huntington-Ashland, WV-KY-OH........................... 0.8997 Boyd County, KY........................................ Greenup County, KY..................................... Lawrence County, OH.................................... Cabell County, WV...................................... Wayne County, WV....................................... 26620....................................... Huntsville, AL......................................... 0.9007 Limestone County, AL................................... Madison County, AL..................................... 26820....................................... Idaho Falls, ID........................................ 0.9088 Bonneville County, ID.................................. Jefferson County, ID................................... 26900....................................... Indianapolis-Carmel, IN................................ 0.9895 Boone County, IN....................................... Brown County, IN....................................... Hamilton County, IN.................................... Hancock County, IN..................................... Hendricks County, IN................................... Johnson County, IN..................................... Marion County, IN...................................... Morgan County, IN...................................... Putnam County, IN...................................... Shelby County, IN...................................... 26980....................................... Iowa City, IA.......................................... 0.9714 Johnson County, IA..................................... Washington County, IA.................................. 27060....................................... Ithaca, NY............................................. 0.9928 Tompkins County, NY.................................... 27100....................................... Jackson, MI............................................ 0.9560 Jackson County, MI..................................... 27140....................................... Jackson, MS............................................ 0.8271 Copiah County, MS...................................... Hinds County, MS....................................... Madison County, MS..................................... Rankin County, MS...................................... Simpson County, MS..................................... 27180....................................... Jackson, TN............................................ 0.8853 Chester County, TN..................................... Madison County, TN..................................... 27260....................................... Jacksonville, FL....................................... 0.9165 Baker County, FL....................................... Clay County, FL........................................ Duval County, FL....................................... Nassau County, FL...................................... St. Johns County, FL................................... 27340....................................... Jacksonville, NC....................................... 0.8231

    [[Page 57530]]

    Onslow County, NC...................................... 27500....................................... Janesville, WI......................................... 0.9655 Rock County, WI........................................ 27620....................................... Jefferson City, MO..................................... 0.8332 Callaway County, MO.................................... Cole County, MO........................................ Moniteau County, MO.................................... Osage County, MO....................................... 27740....................................... Johnson City, TN....................................... 0.8043 Carter County, TN...................................... Unicoi County, TN...................................... Washington County, TN.................................. 27780....................................... Johnstown, PA.......................................... 0.8620 Cambria County, PA..................................... 27860....................................... Jonesboro, AR.......................................... 0.7662 Craighead County, AR................................... Poinsett County, AR.................................... 27900....................................... Joplin, MO............................................. 0.8605 Jasper County, MO...................................... Newton County, MO...................................... 28020....................................... Kalamazoo-Portage, MI.................................. 1.0704 Kalamazoo County, MI................................... Van Buren County, MI................................... 28100....................................... Kankakee-Bradley, IL................................... 1.0083 Kankakee County, IL.................................... 28140....................................... Kansas City, MO-KS..................................... 0.9495 Franklin County, KS.................................... Johnson County, KS..................................... Leavenworth County, KS................................. Linn County, KS........................................ Miami County, KS....................................... Wyandotte County, KS................................... Bates County, MO....................................... Caldwell County, MO.................................... Cass County, MO........................................ Clay County, MO........................................ Clinton County, MO..................................... Jackson County, MO..................................... Lafayette County, MO................................... Platte County, MO...................................... Ray County, MO......................................... 28420....................................... Kennewick-Richland-Pasco, WA........................... 1.0343 Benton County, WA...................................... Franklin County, WA.................................... 28660....................................... Killeen-Temple-Fort Hood, TX........................... 0.8901 Bell County, TX........................................ Coryell County, TX..................................... Lampasas County, TX.................................... 28700....................................... Kingsport-Bristol-Bristol, TN-VA....................... 0.7985 Hawkins County, TN..................................... Sullivan County, TN.................................... Bristol City, VA....................................... Scott County, VA....................................... Washington County, VA.................................. 28740....................................... Kingston, NY........................................... 0.9367 Ulster County, NY...................................... 28940....................................... Knoxville, TN.......................................... 0.8249 Anderson County, TN.................................... Blount County, TN...................................... Knox County, TN........................................ Loudon County, TN...................................... Union County, TN....................................... 29020....................................... Kokomo, IN............................................. 0.9669 Howard County, IN...................................... Tipton County, IN...................................... 29100....................................... La Crosse, WI-MN....................................... 0.9426 Houston County, MN..................................... La Crosse County, WI................................... 29140....................................... Lafayette, IN.......................................... 0.8931 Benton County, IN...................................... Carroll County, IN.....................................

    [[Page 57531]]

    Tippecanoe County, IN.................................. 29180....................................... Lafayette, LA.......................................... 0.8289 Lafayette Parish, LA................................... St. Martin Parish, LA.................................. 29340....................................... Lake Charles, LA....................................... 0.7914 Calcasieu Parish, LA................................... Cameron Parish, LA..................................... 29404....................................... Lake County-Kenosha County, IL-WI...................... 1.0570 Lake County, IL........................................ Kenosha County, WI..................................... 29460....................................... Lakeland, FL........................................... 0.8879 Polk County, FL........................................ 29540....................................... Lancaster, PA.......................................... 0.9589 Lancaster County, PA................................... 29620....................................... Lansing-East Lansing, MI............................... 1.0088 Clinton County, MI..................................... Eaton County, MI....................................... Ingham County, MI...................................... 29700....................................... Laredo, TX............................................. 0.7811 Webb County, TX........................................ 29740....................................... Las Cruces, NM......................................... 0.9273 Dona Ana County, NM.................................... 29820....................................... Las Vegas-Paradise, NV................................. 1.1430 Clark County, NV....................................... 29940....................................... Lawrence, KS........................................... 0.8365 Douglas County, KS..................................... 30020....................................... Lawton, OK............................................. 0.8065 Comanche County, OK.................................... 30140....................................... Lebanon, PA............................................ 0.8679 Lebanon County, PA..................................... 30300....................................... Lewiston, ID-WA........................................ 0.9853 Nez Perce County, ID................................... Asotin County, WA...................................... 30340....................................... Lewiston-Auburn, ME.................................... 0.9126 Androscoggin County, ME................................ 30460....................................... Lexington-Fayette, KY.................................. 0.9181 Bourbon County, KY..................................... Clark County, KY....................................... Fayette County, KY..................................... Jessamine County, KY................................... Scott County, KY....................................... Woodford County, KY.................................... 30620....................................... Lima, OH............................................... 0.9042 Allen County, OH....................................... 30700....................................... Lincoln, NE............................................ 1.0092 Lancaster County, NE................................... Seward County, NE...................................... 30780....................................... Little Rock-North Little Rock, AR...................... 0.8890 Faulkner County, AR.................................... Grant County, AR....................................... Lonoke County, AR...................................... Perry County, AR....................................... Pulaski County, AR..................................... Saline County, AR...................................... 30860....................................... Logan, UT-ID........................................... 0.9022 Franklin County, ID.................................... Cache County, UT....................................... 30980....................................... Longview, TX........................................... 0.8788 Gregg County, TX....................................... Rusk County, TX........................................ Upshur County, TX...................................... 31020....................................... Longview, WA........................................... 1.0011 Cowlitz County, WA..................................... 31084....................................... Los Angeles-Long Beach-Glendale, CA.................... 1.1760 Los Angeles County, CA................................. 31140....................................... Louisville, KY-IN...................................... 0.9118 Clark County, IN....................................... Floyd County, IN....................................... Harrison County, IN.................................... Washington County, IN.................................. Bullitt County, KY.....................................

    [[Page 57532]]

    Henry County, KY....................................... Jefferson County, KY................................... Meade County, KY....................................... Nelson County, KY...................................... Oldham County, KY...................................... Shelby County, KY...................................... Spencer County, KY..................................... Trimble County, KY..................................... 31180....................................... Lubbock, TX............................................ 0.8613 Crosby County, TX...................................... Lubbock County, TX..................................... 31340....................................... Lynchburg, VA.......................................... 0.8694 Amherst County, VA..................................... Appomattox County, VA.................................. Bedford County, VA..................................... Campbell County, VA.................................... Bedford City, VA....................................... Lynchburg City, VA..................................... 31420....................................... Macon, GA.............................................. 0.9519 Bibb County, GA........................................ Crawford County, GA.................................... Jones County, GA....................................... Monroe County, GA...................................... Twiggs County, GA...................................... 31460....................................... Madera, CA............................................. 0.8154 Madera County, CA...................................... 31540....................................... Madison, WI............................................ 1.0840 Columbia County, WI.................................... Dane County, WI........................................ Iowa County, WI........................................ 31700....................................... Manchester-Nashua, NH.................................. 1.0243 Hillsborough County, NH................................ Merrimack County, NH................................... 31900....................................... Mansfield, OH1......................................... 0.9271 Richland County, OH.................................... 32420....................................... Mayagu[eacute]z, PR.................................... 0.3848 Hormigueros Municipio, PR.............................. Mayag[uuml]ez Municipio, PR............................ 32580....................................... McAllen-Edinburg-Pharr, TX............................. 0.8773 Hidalgo County, TX..................................... 32780....................................... Medford, OR............................................ 1.0818 Jackson County, OR..................................... 32820....................................... Memphis, TN-MS-AR...................................... 0.9373 Crittenden County, AR.................................. DeSoto County, MS...................................... Marshall County, MS.................................... Tate County, MS........................................ Tunica County, MS...................................... Fayette County, TN..................................... Shelby County, TN...................................... Tipton County, TN...................................... 32900....................................... Merced, CA............................................. 1.1471 Merced County, CA...................................... 33124....................................... Miami-Miami Beach-Kendall, FL.......................... 0.9812 Miami-Dade County, FL.................................. 33140....................................... Michigan City-La Porte, IN............................. 0.9118 LaPorte County, IN..................................... 33260....................................... Midland, TX............................................ 0.9786 Midland County, TX..................................... 33340....................................... Milwaukee-Waukesha-West Allis, WI...................... 1.0218 Milwaukee County, WI................................... Ozaukee County, WI..................................... Washington County, WI.................................. Waukesha County, WI.................................... 33460....................................... Minneapolis-St. Paul-Bloomington, MN-WI................ 1.0946 Anoka County, MN....................................... Carver County, MN...................................... Chisago County, MN..................................... Dakota County, MN...................................... Hennepin County, MN.................................... Isanti County, MN......................................

    [[Page 57533]]

    Ramsey County, MN...................................... Scott County, MN....................................... Sherburne County, MN................................... Washington County, MN.................................. Wright County, MN...................................... Pierce County, WI...................................... St. Croix County, WI................................... 33540....................................... Missoula, MT........................................... 0.8928 Missoula County, MT.................................... 33660....................................... Mobile, AL............................................. 0.7913 Mobile County, AL...................................... 33700....................................... Modesto, CA............................................ 1.1729 Stanislaus County, CA.................................. 33740....................................... Monroe, LA............................................. 0.7997 Ouachita Parish, LA.................................... Union Parish, LA....................................... 33780....................................... Monroe, MI............................................. 0.9707 Monroe County, MI...................................... 33860....................................... Montgomery, AL......................................... 0.8009 Autauga County, AL..................................... Elmore County, AL...................................... Lowndes County, AL..................................... Montgomery County, AL.................................. 34060....................................... Morgantown, WV......................................... 0.8423 Monongalia County, WV.................................. Preston County, WV..................................... 34100....................................... Morristown, TN......................................... 0.7933 Grainger County, TN.................................... Hamblen County, TN..................................... Jefferson County, TN................................... 34580....................................... Mount Vernon-Anacortes, WA............................. 1.0517 Skagit County, WA...................................... 34620....................................... Muncie, IN............................................. 0.8562 Delaware County, IN.................................... 34740....................................... Muskegon-Norton Shores, MI............................. 0.9941 Muskegon County, MI.................................... 34820....................................... Myrtle Beach-Conway-North Myrtle Beach, SC............. 0.8810 Horry County, SC....................................... 34900....................................... Napa, CA............................................... 1.3374 Napa County, CA........................................ 34940....................................... Naples-Marco Island, FL................................ 0.9941 Collier County, FL..................................... 34980....................................... Nashville-Davidson--Murfreesboro, TN................... 0.9847 Cannon County, TN...................................... Cheatham County, TN.................................... Davidson County, TN.................................... Dickson County, TN..................................... Hickman County, TN..................................... Macon County, TN....................................... Robertson County, TN................................... Rutherford County, TN.................................. Smith County, TN....................................... Sumner County, TN...................................... Trousdale County, TN................................... Williamson County, TN.................................. Wilson County, TN...................................... 35004....................................... Nassau-Suffolk, NY..................................... 1.2662 Nassau County, NY...................................... Suffolk County, NY..................................... 35084....................................... Newark-Union, NJ-PA.................................... 1.1892 Essex County, NJ....................................... Hunterdon County, NJ................................... Morris County, NJ...................................... Sussex County, NJ...................................... Union County, NJ....................................... Pike County, PA........................................ 35300....................................... New Haven-Milford, CT.................................. 1.1953 New Haven County, CT................................... 35380....................................... New Orleans-Metairie-Kenner, LA........................ 0.8831 Jefferson Parish, LA................................... Orleans Parish, LA.....................................

    [[Page 57534]]

    Plaquemines Parish, LA................................. St. Bernard Parish, LA................................. St. Charles Parish, LA................................. St. John the Baptist Parish, LA........................ St. Tammany Parish, LA................................. 35644....................................... New York-Wayne-White Plains, NY-NJ..................... 1.3177 Bergen County, NJ...................................... Hudson County, NJ...................................... Passaic County, NJ..................................... Bronx County, NY....................................... Kings County, NY....................................... New York County, NY.................................... Putnam County, NY...................................... Queens County, NY...................................... Richmond County, NY.................................... Rockland County, NY.................................... Westchester County, NY................................. 35660....................................... Niles-Benton Harbor, MI................................ 0.8915 Berrien County, MI..................................... 35980....................................... Norwich-New London, CT................................. 1.1932 New London County, CT.................................. 36084....................................... Oakland-Fremont-Hayward, CA............................ 1.5819 Alameda County, CA..................................... Contra Costa County, CA................................ 36100....................................... Ocala, FL.............................................. 0.8867 Marion County, FL...................................... 36140....................................... Ocean City, NJ......................................... 1.0472 Cape May County, NJ.................................... 36220....................................... Odessa, TX............................................. 1.0073 Ector County, TX....................................... 36260....................................... Ogden-Clearfield, UT................................... 0.8995 Davis County, UT....................................... Morgan County, UT...................................... Weber County, UT....................................... 36420....................................... Oklahoma City, OK...................................... 0.8843 Canadian County, OK.................................... Cleveland County, OK................................... Grady County, OK....................................... Lincoln County, OK..................................... Logan County, OK....................................... McClain County, OK..................................... Oklahoma County, OK.................................... 36500....................................... Olympia, WA............................................ 1.1081 Thurston County, WA.................................... 36540....................................... Omaha-Council Bluffs, NE-IA............................ 0.9450 Harrison County, IA.................................... Mills County, IA....................................... Pottawattamie County, IA............................... Cass County, NE........................................ Douglas County, NE..................................... Sarpy County, NE....................................... Saunders County, NE.................................... Washington County, NE.................................. 36740....................................... Orlando, FL............................................ 0.9452 Lake County, FL........................................ Orange County, FL...................................... Osceola County, FL..................................... Seminole County, FL.................................... 36780....................................... Oshkosh-Neenah, WI..................................... 0.9315 Winnebago County, WI................................... 36980....................................... Owensboro, KY.......................................... 0.8748 Daviess County, KY..................................... Hancock County, KY..................................... McLean County, KY...................................... 37100....................................... Oxnard-Thousand Oaks-Ventura, CA....................... 1.1546 Ventura County, CA..................................... 37340....................................... Palm Bay-Melbourne-Titusville, FL...................... 0.9443 Brevard County, FL..................................... 37460....................................... Panama City-Lynn Haven, FL............................. 0.8027 Bay County, FL......................................... 37620....................................... Parkersburg-Marietta, WV-OH............................ 0.7977

    [[Page 57535]]

    Washington County, OH.................................. Pleasants County, WV................................... Wirt County, WV........................................ Wood County, WV........................................ 37700....................................... Pascagoula, MS......................................... 0.8215 George County, MS...................................... Jackson County, MS..................................... 37860....................................... Pensacola-Ferry Pass-Brent, FL......................... 0.8000 Escambia County, FL.................................... Santa Rosa County, FL.................................. 37900....................................... Peoria, IL............................................. 0.8982 Marshall County, IL.................................... Peoria County, IL...................................... Stark County, IL....................................... Tazewell County, IL.................................... Woodford County, IL.................................... 37964....................................... Philadelphia, PA....................................... 1.0996 Bucks County, PA....................................... Chester County, PA..................................... Delaware County, PA.................................... Montgomery County, PA.................................. Philadelphia County, PA................................ 38060....................................... Phoenix-Mesa-Scottsdale, AZ............................ 1.0287 Maricopa County, AZ.................................... Pinal County, AZ....................................... 38220....................................... Pine Bluff, AR......................................... 0.8383 Cleveland County, AR................................... Jefferson County, AR................................... Lincoln County, AR..................................... 38300....................................... Pittsburgh, PA......................................... 0.8674 Allegheny County, PA................................... Armstrong County, PA................................... Beaver County, PA...................................... Butler County, PA...................................... Fayette County, PA..................................... Washington County, PA.................................. Westmoreland County, PA................................ 38340....................................... Pittsfield, MA......................................... 1.0266 Berkshire County, MA................................... 38540....................................... Pocatello, ID.......................................... 0.9400 Bannock County, ID..................................... Power County, ID....................................... 38660....................................... Ponce, PR.............................................. 0.4842 Juana D[iacute]az Municipio, PR........................ Ponce Municipio, PR.................................... Villalba Municipio, PR................................. 38860....................................... Portland-South Portland-Biddeford, ME.................. 0.9908 Cumberland County, ME.................................. Sagadahoc County, ME................................... York County, ME........................................ 38900....................................... Portland-Vancouver-Beaverton, OR-WA.................... 1.1416 Clackamas County, OR................................... Columbia County, OR.................................... Multnomah County, OR................................... Washington County, OR.................................. Yamhill County, OR..................................... Clark County, WA....................................... Skamania County, WA.................................... 38940....................................... Port St. Lucie-Fort Pierce, FL......................... 0.9833 Martin County, FL...................................... St. Lucie County, FL................................... 39100....................................... Poughkeepsie-Newburgh-Middletown, NY................... 1.0911 Dutchess County, NY.................................... Orange County, NY...................................... 39140....................................... Prescott, AZ........................................... 0.9836 Yavapai County, AZ..................................... 39300....................................... Providence-New Bedford-Fall River, RI-MA............... 1.0783 Bristol County, MA..................................... Bristol County, RI..................................... Kent County, RI........................................ Newport County, RI.....................................

    [[Page 57536]]

    Providence County, RI.................................. Washington County, RI.................................. 39340....................................... Provo-Orem, UT......................................... 0.9537 Juab County, UT........................................ Utah County, UT........................................ 39380....................................... Pueblo, CO............................................. 0.8753 Pueblo County, CO...................................... 39460....................................... Punta Gorda, FL........................................ 0.9405 Charlotte County, FL................................... 39540....................................... Racine, WI............................................. 0.9356 Racine County, WI...................................... 39580....................................... Raleigh-Cary, NC....................................... 0.9864 Franklin County, NC.................................... Johnston County, NC.................................... Wake County, NC........................................ 39660....................................... Rapid City, SD......................................... 0.8833 Meade County, SD....................................... Pennington County, SD.................................. 39740....................................... Reading, PA............................................ 0.9622 Berks County, PA....................................... 39820....................................... Redding, CA............................................ 1.3198 Shasta County, CA...................................... 39900....................................... Reno-Sparks, NV........................................ 1.1963 Storey County, NV...................................... Washoe County, NV...................................... 40060....................................... Richmond, VA........................................... 0.9177 Amelia County, VA...................................... Caroline County, VA.................................... Charles City County, VA................................ Chesterfield County, VA................................ Cumberland County, VA.................................. Dinwiddie County, VA................................... Goochland County, VA................................... Hanover County, VA..................................... Henrico County, VA..................................... King and Queen County, VA.............................. King William County, VA................................ Louisa County, VA...................................... New Kent County, VA.................................... Powhatan County, VA.................................... Prince George County, VA............................... Sussex County, VA...................................... Colonial Heights City, VA.............................. Hopewell City, VA...................................... Petersburg City, VA.................................... Richmond City, VA...................................... 40140....................................... Riverside-San Bernardino-Ontario, CA................... 1.0904 Riverside County, CA................................... San Bernardino County, CA.............................. 40220....................................... Roanoke, VA............................................ 0.8647 Botetourt County, VA................................... Craig County, VA....................................... Franklin County, VA.................................... Roanoke County, VA..................................... Roanoke City, VA....................................... Salem City, VA......................................... 40340....................................... Rochester, MN.......................................... 1.1408 Dodge County, MN....................................... Olmsted County, MN..................................... Wabasha County, MN..................................... 40380....................................... Rochester, NY.......................................... 0.8994 Livingston County, NY.................................. Monroe County, NY...................................... Ontario County, NY..................................... Orleans County, NY..................................... Wayne County, NY....................................... 40420....................................... Rockford, IL........................................... 0.9989 Boone County, IL....................................... Winnebago County, IL................................... 40484....................................... Rockingham County-Strafford County, NH................. 1.0159 Rockingham County, NH..................................

    [[Page 57537]]

    Strafford County, NH................................... 40580....................................... Rocky Mount, NC........................................ 0.8854 Edgecombe County, NC................................... Nash County, NC........................................ 40660....................................... Rome, GA............................................... 0.9193 Floyd County, GA....................................... 40900....................................... Sacramento--Arden-Arcade--Roseville, CA................ 1.3372 El Dorado County, CA................................... Placer County, CA...................................... Sacramento County, CA.................................. Yolo County, CA........................................ 40980....................................... Saginaw-Saginaw Township North, MI..................... 0.8874 Saginaw County, MI..................................... 41060....................................... St. Cloud, MN.......................................... 1.0362 Benton County, MN...................................... Stearns County, MN..................................... 41100....................................... St. George, UT......................................... 0.9265 Washington County, UT.................................. 41140....................................... St. Joseph, MO-KS...................................... 1.0118 Doniphan County, KS.................................... Andrew County, MO...................................... Buchanan County, MO.................................... DeKalb County, MO...................................... 41180....................................... St. Louis, MO-IL....................................... 0.9005 Bond County, IL........................................ Calhoun County, IL..................................... Clinton County, IL..................................... Jersey County, IL...................................... Macoupin County, IL.................................... Madison County, IL..................................... Monroe County, IL...................................... St. Clair County, IL................................... Crawford County, MO.................................... Franklin County, MO.................................... Jefferson County, MO................................... Lincoln County, MO..................................... St. Charles County, MO................................. St. Louis County, MO................................... Warren County, MO...................................... Washington County, MO.................................. St. Louis City, MO..................................... 41420....................................... Salem, OR.............................................. 1.0438 Marion County, OR...................................... Polk County, OR........................................ 41500....................................... Salinas, CA............................................ 1.4337 Monterey County, CA.................................... 41540....................................... Salisbury, MD.......................................... 0.8953 Somerset County, MD.................................... Wicomico County, MD.................................... 41620....................................... Salt Lake City, UT..................................... 0.9402 Salt Lake County, UT................................... Summit County, UT...................................... Tooele County, UT...................................... 41660....................................... San Angelo, TX......................................... 0.8362 Irion County, TX....................................... Tom Green County, TX................................... 41700....................................... San Antonio, TX........................................ 0.8844 Atascosa County, TX.................................... Bandera County, TX..................................... Bexar County, TX....................................... Comal County, TX....................................... Guadalupe County, TX................................... Kendall County, TX..................................... Medina County, TX...................................... Wilson County, TX...................................... 41740....................................... San Diego-Carlsbad-San Marcos, CA...................... 1.1354 San Diego County, CA................................... 41780....................................... Sandusky, OH........................................... 0.9302 Erie County, OH........................................ 41884....................................... San Francisco-San Mateo-Redwood City, CA............... 1.5165 Marin County, CA.......................................

    [[Page 57538]]

    San Francisco County, CA............................... San Mateo County, CA................................... 41900....................................... San Germ[aacute]n-Cabo Rojo, PR........................ 0.4885 Cabo Rojo Municipio, PR................................ Lajas Municipio, PR.................................... Sabana Grande Municipio, PR............................ San Germ[aacute]n Municipio, PR........................ 41940....................................... San Jose-Sunnyvale-Santa Clara, CA..................... 1.5543 San Benito County, CA.................................. Santa Clara County, CA................................. 41980....................................... San Juan-Caguas-Guaynabo, PR........................... 0.4452 Aguas Buenas Municipio, PR............................. Aibonito Municipio, PR................................. Arecibo Municipio, PR.................................. Barceloneta Municipio, PR.............................. Barranquitas Municipio, PR............................. Bayam[oacute]n Municipio, PR........................... Caguas Municipio, PR................................... Camuy Municipio, PR.................................... Can[oacute]vanas Municipio, PR......................... Carolina Municipio, PR................................. Cata[ntilde]o Municipio, PR............................ Cayey Municipio, PR.................................... Ciales Municipio, PR................................... Cidra Municipio, PR.................................... Comer[iacute]o Municipio, PR........................... Corozal Municipio, PR.................................. Dorado Municipio, PR................................... Florida Municipio, PR.................................. Guaynabo Municipio, PR................................. Gurabo Municipio, PR................................... Hatillo Municipio, PR.................................. Humacao Municipio, PR.................................. Juncos Municipio, PR................................... Las Piedras Municipio, PR.............................. Lo[iacute]za Municipio, PR............................. Manat[iacute] Municipio, PR............................ Maunabo Municipio, PR.................................. Morovis Municipio, PR.................................. Naguabo Municipio, PR.................................. Naranjito Municipio, PR................................ Orocovis Municipio, PR................................. Quebradillas Municipio, PR............................. R[iacute]o Grande Municipio, PR........................ San Juan Municipio, PR................................. San Lorenzo Municipio, PR.............................. Toa Alta Municipio, PR................................. Toa Baja Municipio, PR................................. Trujillo Alto Municipio, PR............................ Vega Alta Municipio, PR................................ Vega Baja Municipio, PR................................ Yabucoa Municipio, PR.................................. 42020....................................... San Luis Obispo-Paso Robles, CA........................ 1.1598 San Luis Obispo County, CA............................. 42044....................................... Santa Ana-Anaheim-Irvine, CA........................... 1.1473 Orange County, CA...................................... 42060....................................... Santa Barbara-Santa Maria-Goleta, CA................... 1.1091 Santa Barbara County, CA............................... 42100....................................... Santa Cruz-Watsonville, CA............................. 1.5457 Santa Cruz County, CA.................................. 42140....................................... Santa Fe, NM........................................... 1.0824 Santa Fe County, NM.................................... 42220....................................... Santa Rosa-Petaluma, CA................................ 1.4464 Sonoma County, CA...................................... 42260....................................... Sarasota-Bradenton-Venice, FL.......................... 0.9868 Manatee County, FL..................................... Sarasota County, FL.................................... 42340....................................... Savannah, GA........................................... 0.9351 Bryan County, GA....................................... Chatham County, GA..................................... Effingham County, GA...................................

    [[Page 57539]]

    42540....................................... Scranton--Wilkes-Barre, PA............................. 0.8347 Lackawanna County, PA.................................. Luzerne County, PA..................................... Wyoming County, PA..................................... 42644....................................... Seattle-Bellevue-Everett, WA........................... 1.1434 King County, WA........................................ Snohomish County, WA................................... 42680....................................... Sebastian-Vero Beach, FL............................... 0.9573 Indian River County, FL................................ 43100....................................... Sheboygan, WI.......................................... 0.9026 Sheboygan County, WI................................... 43300....................................... Sherman-Denison, TX.................................... 0.8502 Grayson County, TX..................................... 43340....................................... Shreveport-Bossier City, LA............................ 0.8865 Bossier Parish, LA..................................... Caddo Parish, LA....................................... De Soto Parish, LA..................................... 43580....................................... Sioux City, IA-NE-SD................................... 0.9200 Woodbury County, IA.................................... Dakota County, NE...................................... Dixon County, NE....................................... Union County, SD....................................... 43620....................................... Sioux Falls, SD........................................ 0.9559 Lincoln County, SD..................................... McCook County, SD...................................... Minnehaha County, SD................................... Turner County, SD...................................... 43780....................................... South Bend-Mishawaka, IN-MI............................ 0.9842 St. Joseph County, IN.................................. Cass County, MI........................................ 43900....................................... Spartanburg, SC........................................ 0.9174 Spartanburg County, SC................................. 44060....................................... Spokane, WA............................................ 1.0447 Spokane County, WA..................................... 44100....................................... Springfield, IL........................................ 0.8890 Menard County, IL...................................... Sangamon County, IL.................................... 44140....................................... Springfield, MA........................................ 1.0079 Franklin County, MA.................................... Hampden County, MA..................................... Hampshire County, MA................................... 44180....................................... Springfield, MO........................................ 0.8469 Christian County, MO................................... Dallas County, MO...................................... Greene County, MO...................................... Polk County, MO........................................ Webster County, MO..................................... 44220....................................... Springfield, OH........................................ 0.8593 Clark County, OH....................................... 44300....................................... State College, PA...................................... 0.8784 Centre County, PA...................................... 44700....................................... Stockton, CA........................................... 1.1442 San Joaquin County, CA................................. 44940....................................... Sumter, SC............................................. 0.8083 Sumter County, SC...................................... 45060....................................... Syracuse, NY........................................... 0.9691 Madison County, NY..................................... Onondaga County, NY.................................... Oswego County, NY...................................... 45104....................................... Tacoma, WA............................................. 1.0789 Pierce County, WA...................................... 45220....................................... Tallahassee, FL........................................ 0.8942 Gadsden County, FL..................................... Jefferson County, FL................................... Leon County, FL........................................ Wakulla County, FL..................................... 45300....................................... Tampa-St. Petersburg-Clearwater, FL.................... 0.9144 Hernando County, FL.................................... Hillsborough County, FL................................ Pasco County, FL....................................... Pinellas County, FL....................................

    [[Page 57540]]

    45460....................................... Terre Haute, IN........................................ 0.8765 Clay County, IN........................................ Sullivan County, IN.................................... Vermillion County, IN.................................. Vigo County, IN........................................ 45500....................................... Texarkana, TX-Texarkana, AR............................ 0.8104 Miller County, AR...................................... Bowie County, TX....................................... 45780....................................... Toledo, OH............................................. 0.9586 Fulton County, OH...................................... Lucas County, OH....................................... Ottawa County, OH...................................... Wood County, OH........................................ 45820....................................... Topeka, KS............................................. 0.8730 Jackson County, KS..................................... Jefferson County, KS................................... Osage County, KS....................................... Shawnee County, KS..................................... Wabaunsee County, KS................................... 45940....................................... Trenton-Ewing, NJ...................................... 1.0835 Mercer County, NJ...................................... 46060....................................... Tucson, AZ............................................. 0.9202 Pima County, AZ........................................ 46140....................................... Tulsa, OK.............................................. 0.8103 Creek County, OK....................................... Okmulgee County, OK.................................... Osage County, OK....................................... Pawnee County, OK...................................... Rogers County, OK...................................... Tulsa County, OK....................................... Wagoner County, OK..................................... 46220....................................... Tuscaloosa, AL......................................... 0.8542 Greene County, AL...................................... Hale County, AL........................................ Tuscaloosa County, AL.................................. 46340....................................... Tyler, TX.............................................. 0.8811 Smith County, TX....................................... 46540....................................... Utica-Rome, NY......................................... 0.8396 Herkimer County, NY.................................... Oneida County, NY...................................... 46660....................................... Valdosta, GA........................................... 0.8369 Brooks County, GA...................................... Echols County, GA...................................... Lanier County, GA...................................... Lowndes County, GA..................................... 46700....................................... Vallejo-Fairfield, CA.................................. 1.5137 Solano County, CA...................................... 47020....................................... Victoria, TX........................................... 0.8560 Calhoun County, TX..................................... Goliad County, TX...................................... Victoria County, TX.................................... 47220....................................... Vineland-Millville-Bridgeton, NJ....................... 0.9832 Cumberland County, NJ.................................. 47260....................................... Virginia Beach-Norfolk-Newport News, VA-NC............. 0.8790 Currituck County, NC................................... Gloucester County, VA.................................. Isle of Wight County, VA............................... James City County, VA.................................. Mathews County, VA..................................... Surry County, VA....................................... York County, VA........................................ Chesapeake City, VA.................................... Hampton City, VA....................................... Newport News City, VA.................................. Norfolk City, VA....................................... Poquoson City, VA...................................... Portsmouth City, VA.................................... Suffolk City, VA....................................... Virginia Beach City, VA................................ Williamsburg City, VA.................................. 47300....................................... Visalia-Porterville, CA................................ 0.9968

    [[Page 57541]]

    Tulare County, CA...................................... 47380....................................... Waco, TX............................................... 0.8633 McLennan County, TX.................................... 47580....................................... Warner Robins, GA...................................... 0.8380 Houston County, GA..................................... 47644....................................... Warren-Troy-Farmington Hills, MI....................... 1.0054 Lapeer County, MI...................................... Livingston County, MI.................................. Macomb County, MI...................................... Oakland County, MI..................................... St. Clair County, MI................................... 47894....................................... Washington-Arlington-Alexandria, DC-VA-MD-WV........... 1.1054 District of Columbia, DC............................... Calvert County, MD..................................... Charles County, MD..................................... Prince George's County, MD............................. Arlington County, VA................................... Clarke County, VA...................................... Fairfax County, VA..................................... Fauquier County, VA.................................... Loudoun County, VA..................................... Prince William County, VA.............................. Spotsylvania County, VA................................ Stafford County, VA.................................... Warren County, VA...................................... Alexandria City, VA.................................... Fairfax City, VA....................................... Falls Church City, VA.................................. Fredericksburg City, VA................................ Manassas City, VA...................................... Manassas Park City, VA................................. Jefferson County, WV................................... 47940....................................... Waterloo-Cedar Falls, IA............................... 0.8408 Black Hawk County, IA.................................. Bremer County, IA...................................... Grundy County, IA...................................... 48140....................................... Wausau, WI............................................. 0.9722 Marathon County, WI.................................... 48260....................................... Weirton-Steubenville, WV-OH............................ 0.8063 Jefferson County, OH................................... Brooke County, WV...................................... Hancock County, WV..................................... 48300....................................... Wenatchee, WA.......................................... 1.0346 Chelan County, WA...................................... Douglas County, WA..................................... 48424....................................... West Palm Beach-Boca Raton-Boynton Beach, FL........... 0.9649 Palm Beach County, FL.................................. 48540....................................... Wheeling, WV-OH........................................ 0.7010 Belmont County, OH..................................... Marshall County, WV.................................... Ohio County, WV........................................ 48620....................................... Wichita, KS............................................ 0.9063 Butler County, KS...................................... Harvey County, KS...................................... Sedgwick County, KS.................................... Sumner County, KS...................................... 48660....................................... Wichita Falls, TX...................................... 0.8311 Archer County, TX...................................... Clay County, TX........................................ Wichita County, TX..................................... 48700....................................... Williamsport, PA....................................... 0.8139 Lycoming County, PA.................................... 48864....................................... Wilmington, DE-MD-NJ................................... 1.0684 New Castle County, DE.................................. Cecil County, MD....................................... Salem County, NJ....................................... 48900....................................... Wilmington, NC......................................... 0.9835 Brunswick County, NC................................... New Hanover County, NC................................. Pender County, NC...................................... 49020....................................... Winchester, VA-WV...................................... 1.0091

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    Frederick County, VA................................... Winchester City, VA.................................... Hampshire County, WV................................... 49180....................................... Winston-Salem, NC...................................... 0.9276 Davie County, NC....................................... Forsyth County, NC..................................... Stokes County, NC...................................... Yadkin County, NC...................................... 49340....................................... Worcester, MA.......................................... 1.0722 Worcester County, MA................................... 49420....................................... Yakima, WA............................................. 0.9847 Yakima County, WA...................................... 49500....................................... Yauco, PR.............................................. 0.3854 Gu[aacute]nica Municipio, PR........................... Guayanilla Municipio, PR............................... Pe[ntilde]uelas Municipio, PR.......................... Yauco Municipio, PR.................................... 49620....................................... York-Hanover, PA....................................... 0.9397 York County, PA........................................ 49660....................................... Youngstown-Warren-Boardman, OH-PA...................... 0.8802 Mahoning County, OH.................................... Trumbull County, OH.................................... Mercer County, PA...................................... 49700....................................... Yuba City, CA.......................................... 1.0730 Sutter County, CA...................................... Yuba County, CA........................................ 49740....................................... Yuma, AZ............................................... 0.9109 Yuma County, AZ........................................

    \1\ At this time, there are no hospitals located in this urban area on which to base a wage index.

    Table 9.--FY 2007 Wage Index Based on CBSA Labor Market Areas for Rural Areas

    Wage CBSA code

    Nonurban area

    index

    1.......................... Alabama......................... 0.7591 2.......................... Alaska.......................... 1.0661 3.......................... Arizona......................... 0.8908 4.......................... Arkansas........................ 0.7307 5.......................... California...................... 1.1454 6.......................... Colorado........................ 0.9325 7.......................... Connecticut..................... 1.1709 8.......................... Delaware........................ 0.9705 10......................... Florida......................... 0.8594 11......................... Georgia......................... 0.7593 12......................... Hawaii.......................... 1.0448 13......................... Idaho........................... 0.8120 14......................... Illinois........................ 0.8320 15......................... Indiana......................... 0.8538 16......................... Iowa............................ 0.8681 17......................... Kansas.......................... 0.7998 18......................... Kentucky........................ 0.7768 19......................... Louisiana....................... 0.7438 20......................... Maine........................... 0.8443 21......................... Maryland........................ 0.8926 22......................... Massachusetts \1\............... 1.0216 23......................... Michigan........................ 0.9062 24......................... Minnesota....................... 0.9153 25......................... Mississippi..................... 0.7738 26......................... Missouri........................ 0.7927 27......................... Montana......................... 0.8590 28......................... Nebraska........................ 0.8677 29......................... Nevada.......................... 0.8944 30......................... New Hampshire................... 1.0853 31......................... New Jersey \1\.................. ......... 32......................... New Mexico...................... 0.8332 33......................... New York........................ 0.8232 34......................... North Carolina.................. 0.8588 35......................... North Dakota.................... 0.7215 36......................... Ohio............................ 0.8658 37......................... Oklahoma........................ 0.7629 38......................... Oregon.......................... 0.9753 39......................... Pennsylvania.................... 0.8320 40......................... Puerto Rico \1\................. 0.4047 41......................... Rhode Island \1\................ ......... 42......................... South Carolina.................. 0.8566 43......................... South Dakota.................... 0.8480 44......................... Tennessee....................... 0.7827 45......................... Texas........................... 0.7965 46......................... Utah............................ 0.8140 47......................... Vermont......................... 0.9744 48......................... Virgin Islands.................. 0.8467 49......................... Virginia........................ 0.7940 50......................... Washington...................... 1.0263 51......................... West Virginia................... 0.7607 52......................... Wisconsin....................... 0.9553 53......................... Wyoming......................... 0.9295 65......................... Guam............................ 0.9611

    \1\ All counties within the State are classified as urban, with the exception of Massachusetts and Puerto Rico. Massachusetts and Puerto Rico have areas designated as rural; however, no short-term, acute care hospitals are located in the area(s) for FY 2007. Because more recent data are not available for those areas, we are using last year's wage index value.

  3. Waiver of Proposed Rulemaking and Delayed 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 notice such as this take effect in accordance with section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). We also ordinarily provide a 30-day delay in the effective date of the provisions of a notice in accordance with section 553(d) of the APA (5 U.S.C. 553(d)). However, we can waive both the notice and comment procedure and the 30-day delay in effective date if the Secretary finds, for good cause, that a 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.

    We find for good cause that it is unnecessary to undertake notice and comment rulemaking because this notice merely provides technical corrections to the 2007 SNF PPS update notice. We are not making substantive changes to our payment methodologies or policies, but rather, are simply implementing correctly the payment methodologies and policies that we previously proposed, received comment on, and subsequently finalized. The public has already had the opportunity to comment on these payment

    [[Page 57543]]

    methodologies and policies, and this correction notice is intended solely to ensure that the FY 2007 SNF PPS update notice accurately reflects them. Therefore, we believe that undertaking further notice and comment procedures to incorporate these corrections into the update notice is unnecessary and contrary to the public interest.

    Further, we believe a delayed effective date is unnecessary because this correction notice merely corrects inadvertent technical errors. The changes noted above do not make any substantive changes to the SNF PPS payment methodologies or policies. Moreover, we regard imposing a delay in the effective date as being contrary to the public interest. We believe that it is in the public interest for providers to receive appropriate SNF PPS payments in as timely a manner as possible and to ensure that the FY 2007 SNF PPS update notice accurately reflects our payment methodologies, payment rates, and policies. Therefore, we find good cause to waive notice and comment procedures, as well as the 30- day delay in effective date.

    (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare--Hospital Insurance; and Program No. 93.774, Medicare-- Supplementary Medical Insurance Program)

    Dated: September 22, 2006. Ann C. Agnew, Executive Secretary to the Department.

    [FR Doc. E6-15979 Filed 9-28-06; 8:45 am]

    BILLING CODE 4120-01-P

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