• Regulatory changes to Medicare payment system for Skilled Nursing Facilities; possible legislative changes to Medicare and Medicaid payments to Skilled Nursing Facilities

Duration: April 1, 2006 to June 30, 2013

General Issues: Health Issues, Medicare/Medicaid

Spending: about $15,826,246 (But it's complicated. Here's why.)

It can be tricky to figure out how much an organization spent on a particular lobbying engagement. The law only requires lobbyists to report the amount they were paid for federal lobbying each quarter rounded to the nearest $10,000—and if it's less than $3,000 in a given quarter (or less than $13,000 for organizations with in-house lobbyists), they don't have to disclose it at all. Plus, some organizations include spending that doesn’t belong in the report—for instance, money spent lobbying state governments or other legal work.

Agencies lobbied since 2006: House of Representatives, U.S. Senate, Health & Human Services - Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), White House Office, White House Office,, Centers For Medicare and Medicaid Services (CMS)

Affiliated organizations: Advocat, Inc; Britthaven Inc; Complete Health Care Resources; Cypress Healthcare; Direct Supply Inc; Extendicare Health Services Inc; Fundamental Long Term Care Holdings, LLC; Genesis Health Care Corporation; Harborside Healthcare; HCR Manor Care; Kindred Healthcare Inc; Medical Facilities of America, Inc.; NHS Management LLC; SavaSeniorCare LLC; Sun Healthcare Group Inc; Tandem Health Care Inc.; UHS-Pruitt Corporation