One of the Legislature's challenges over the next decade is to promote adequate access to nursing facility beds for the state's population. Our review suggests that it is possible that there will be a disparity between the need for nursing facility services and the growth of bed supply over the next decade. Furthermore, the current Medi-Cal reimbursement system may be (1) contributing to low supply growth, (2) causing access problems to nursing facility beds for Medi-Cal clients, and (3) providing incentives that encourage expansion of facilities that are more costly to operate.