I am a speech-language pathologist who works at two community hospitals in California. For the past 17 years I have provided services in the evaluation and treatment of adult patients with communication and swallowing disorders. The patients I treat are in the hospital because of strokes, respiratory disorders, head injuries, head and neck cancer, and neurological diseases, such as Parkinson’s. Their swallowing problems at times can be severe enough to cause respiratory distress, pneumonia, or even death from aspiration of food/fluid into their lungs. Hence, problems must be recognized and treated quickly or the patient’s life could be in jeopardy. In the past, Medicare has allowed speech-language pathologists the time to work with patients so they could regain their swallowing and communication abilities. The clinician would continue to see the patient as long as he or she was progressing and demonstrated the potential to get better. The Balanced Budget Act of 1997 was supposed to save taxpayers money by dramatically changing the nature of rehabilitation in all health care settings. While these regulations have saved money in the short term, they are putting patients in hospitals and nursing homes at risk and are costing taxpayers more than ever expected.