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Across the country, the supply of nursing homes is dwindling. Nationally, the Centers for Medicare & Medicaid Services reports 900 fewer certified nursing homes in 2025 than in 2015. Why the decline? The most commonly cited reason is inadequate payments from Medicaid, the leading payer for nursing home care, which generally pays less than the daily cost of care.  Another is staffing:  nursing home jobs pay poorly and are considered stressful, making it difficult to attract and retain staff. Even the erosion in the number of beds may not completely capture the decline in access to skilled nursing care.  More [...]

Twenty-five states have sued the federal government in response to the interim final rule published by the Centers for Medicare & Medicaid Services to implement the enhanced work and community engagement requirements for Medicaid eligibility established in H.R. 1, last year’s federal budget reconciliation law. H.R. 1 calls for tougher standards for Medicaid eligibility, including a mandate that most Medicaid participants either work or are engaged in some form of approved community engagement, such as attending school or participating in volunteer work. But the 25 states – all with Democratic governors and attorneys general – claim that CMS’s implementation of [...]