Medicaid Payment Ceilings Decline
		• The Medicaid nursing facility  formula’s Direct Care payment ceilings have been lowered dramatically over the past ten years. As facilities increase their wages, benefits and staffing hours, payments are capped and direct care deficits escalate. • The majority of WAHSA member facilities exceed the direct care cost ceilings, meaning that added nursing costs are not reimbursed  by Medicaid resulting in higher losses.