The language within this document places additional burden within the provider community. This doc moves into regulating through guidance. It pushes providers who continue to report knowing the risk of citation outside of the 24 or 48 hr window. The Progressive Action for Repeat Citations does not take into account the size of agency, location, programs and places unreasonable burden on larger providers that is nearly impossible to fulfill. It should be pulled at at the very least re-written with stakeholders involved to give input and include language that takes the above into account.