During 2009, Medicare paid $5.1 billion to skilled nursing facilities (SNF) that provided care described as “poor” by a federal review. These facilities failed to meet Medicare care planning and/or discharge planning requirements. The $5.1 billion represents about one-fifth of the $26.9 billion Medicare paid to SNFs in 2009. For 37% of stays that year, SNFs did not develop care plans that met requirements or did not provide services in accordance with care plans. Medicare paid about $4.5 billion for these stays. For 31% of stays, SNFs did not meet discharge-planning requirements . . .