Over 319 SNFs have changed hands recently and 15 new operators are jumping in despite brutal economics—what do they know that you don't? This month we break down Cascade's 40-building acquisition, Pennsylvania's three regulatory death traps (they literally garnish your Medicaid payments), Kadima's insane $39.4M debt on 2.3% margins, the provider tax scheme 39 states use to balance budgets on your back, why CMS's "$50 billion rural transformation" is actually a $105B net cut, and Medicare Advantage's denial racket that profits while you eat penalties.