<prompt> Translate the following text to EnglishKwa kuwa, kulingana na HCFA, hospitali zote zinazohusika na sheria ni vyombo vidogo, itakuwa vigumu kupunguza athari za sheria kwa vyombo kama hivyo ndani ya vikwazo vya mpango wa Medicare.  <response>: Since, according to HCFA, all hospitals subject to the rule are small entities, it would be difficult to minimize the impact of the rule on such entities within the constraints of the Medicare program. 