Introduction
Many healthcare providers in nursing homes were confounded when the Patient Protection and Affordable Care Act, (PPACA), was passed in March 2010. This act was later amended to include the Health Care and Education Reconciliation Act 2010. The passing of PPACA was a bittersweet occasion for health care providers for two reasons. It was bitter, since it was least expected by most health care providers. For several years, the National Association of Social Workers (NASW) had been advocating for a single-payer system. This desire was trampled by the congressional leaders and the president from the inception. At some moment the enactment of the…..

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