“Facing deficits,states get out sharper knives.” That ominous headline appeared on the top ofpage 1 in Monday’s New York Times. The article noted that most states “arescrambling to find ways to get through the rest of the year.” That’s achallenge more of us now find ourselves facing. But let’s hope that budgetcutters at the state level don’t get too carried away. The reality is thatproviders are already being shortchanged by states. Medicaid alone underpaysoperators by more than $4 billion, according to a study commissioned by theAmerican Health Care Association. It’s no secret that these are challengingtimes times. But that’s hardly an excuse for states to abdicate theirresponsibilities to our nation’s elderly – or to the providers increasinglytasked with delivering the care they need.