Long-term care providers were confronted with the cold, stark facts: Federal payments had been cut by billions of dollars and much worse still might be coming.

Providers were bracing for a 2% across-the-board cut to Medicare that was triggered by the inaction of President Obama's debt reduction “super committee.” But it could get even worse.

A bill proposed in the House would take $4.5 billion out of long-term care providers' pockets through relaxation of Medicare bad-debt provisions.

Also at press time, lawmakers were still grappling with the prospect of whether to allow a scheduled 27% Medicare pay cut for doctors to go into effect — and if not, where to get the dollars to offset a reprieve. Less pessimistic but also still unresolved was what to do about an exceptions process for the Medicare Part B therapy caps that were set to expire with the new year.