These regulations would simplify and streamline the procedures by which a health care facility is approved for participation in Medicare and Medicaid. The changes are necessary because many of the current procedures have proved cumbersome and expensive for the Federal and State agencies to administer, and, in many aspects, either unnecessary or ineffective in ensuring the quality of health care services. The elimination or modification of those requirements that have been identified as unnecessary or ineffective would also eliminate any unnecessary burdens on providers. The procedures that have proved effective in the past in protecting the health and safety of patients would be retained. This would permit available resources to be targeted on facilities with compliance problems. These regulations also would implement a recent statutory amendment that removes the 12-month limit on provider agreement with skilled nursing facilities.