reevaluation of plan (A) In general A hospital shall annually evaluate its staffing plan in each unit in relation to actual patient care requirements. (B) Update A hospital shall update its staffing plan to the extent appropriate based on such evaluation. (4) Transparency (A) In general Any staffing plan or method used to create and evaluate acuity-level and adopted by a hospital under this section shall be transparent in all respects, including disclosure of detailed documentation of the methodology used to determine nursing staffing, identifying each factor, assumption, and value used in applying such methodology. (B) Public availability The Secretary shall establish procedures to provide that the documentation submitted under subsection (d) is available for public inspection in its entirety. (5) Registered nurse participation A staffing plan of a hospital— (A) shall be developed and subsequent reevaluations shall be conducted under this subsection on the basis of input from direct care registered nurses at the hospital from each unit or patient care area