It has been a wild roller coaster ride in New York State government since Andrew Cuomo took the reigns. Governor Cuomo was saddled with a very tough financial situation and has made some good headway in beginning to get our State back on it's feet again. One thing that everyone agrees upon is that there is still a long way to go. As we search for solutions, one basic concept seems pretty clear. State government is either going to need to do more with less or completely discontinue programs and services that have been offered in the past. The last few months has revealed what some of these changes are to be in the area of Medicaid reimbursement for Long Term Care. Providers are beginning to see what the future will look like.