There is currently a New York state waiver amendment that would remove long-term managed Medicaid for patients living in SNFs. If approved, this would transition back into a fee-for-service Medicaid for stays over three months and would be implemented at the beginning of 2020. Other states could look to similar strategies as most states are known to currently be keeping a close eye on the state of New York. Such a change would be a major shift in the industry as Medicaid forms the bulk of most nursing facility payments. For more on this please see the @skilled_nursing article below.