H.R. 8244 would increase the limit on the amount of civil monetary penalties a skilled nursing facility may have assessed against it while maintaining approval to operate a nursing aides’ training program. CBO estimates that enacting H.R. 8244 would not affect direct spending or revenues. CBO has not estimated the bill’s effects on spending subject to appropriation. The bill contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.