Three different nursing home groups have sued the Division of Medicaid over cuts to the program's reimbursement rate.  The governor claims that the cuts are necessary because the state budget is in a deficit.  However, the cuts will have a significant impact on nursing homes' ability to stay open because almost all nursing home residents are Medicaid recipients.  While the homes will no doubt be able to find some places to cut expenses, most people do not realize the large number of expenses that are simply out of the control of the nursing home operators.  In order to qualify to receive Medicaid funds, a nursing home must meet significant requirements in facilities and staffing at a significant cost.  If homes were given some flexibility in these expenses it would be easier for them to cut costs, but federal and state mandates significantly handcuff these facilities in their ability to cut.