On November 22, 2021, CANHR and 13 partner organizations submitted a letter and recommendations to the Department of Health Care Services (DHCS) on reforming California’s $5 billion-a-year Medi-Cal payment system for skilled nursing facilities, which is scheduled to sunset next year. The payment system, known as AB 1629, was originally enacted in 2004 and has been extended several times. Designed by the nursing home industry with promises to improve staffing and care, it has instead produced billionaire owners and epidemic levels of neglect throughout California nursing homes.