How a contested statistical model fueled doubts about the 2024 election

• September 28, 2026

By Carter Walker for Votebeat, Jessica Huseman for Votebeat

In April 2025, the Election Truth Alliance was a three-month-old Nevada nonprofit with a growing audience in anti-Trump online spaces and a claim that something about the 2024 presidential election did not add up.

The group had released an analysis of the results in Pennsylvania and sent letters to officials there and in Wisconsin asking them to hand-check the results of multiple elections. Now, it wanted to work with Walter Mebane Jr., a tenured University of Michigan political scientist and one of the few academics who had spent decades trying to detect the statistical fingerprints of election fraud.

Mebane was skeptical.

“The name of the group didn’t really inspire confidence,” he told Votebeat. “I was thinking, ‘Oh my god, truthers.’” But Mebane thought the data would be useful for his students and a book he was working on, and by early May, he had produced a working paper analyzing Pennsylvania’s 2024 presidential results. In a note, he credited the ETA for providing the data.

His findings estimated the number of potentially fraudulent votes exceeded President Donald Trump’s margin of victory in Pennsylvania. In the working paper, Mebane noted his findings could also be attributed to factors other than intentional fraud.

The ETA has described Mebane’s work as a “collaboration” that confirmed its conclusions. Mebane described it differently: He said he had no interest in the group’s advocacy and engaged because he believed it had unique data on Pennsylvania. He told Votebeat he did not know the same data was available from the state.

“He is kind of the go-to guy for election forensics in the U.S. He’s the leading expert,” ETA co-founder Nathan Taylor said in a video posted in May 2025 announcing the findings validated their Pennsylvania concerns. Toward the end of the video, a QR code to the group’s donation page flashed on screen. The ETA urged supporters to contact Pennsylvania officials and advocate for hand-count audits, and they heeded the call, sending state and local officials emails that cited Mebane’s work to allege the results were flawed.

In a June 2025 press release, the ETA said Mebane’s findings corroborated its own. “BREAKING,” the group wrote. “Election Forensics Expert Finds Vote Manipulation Concerns in Pennsylvania.

In November, the ETA filed a lawsuit against the Secretary of the Commonwealth of Pennsylvania and three counties questioning the 2024 count and asking the district court to require the counties to “hand count physical ballots.” The group cited its own analysis but relied on Mebane’s findings to suggest abnormalities in Allegheny County.

The ETA’s leaders acknowledge that statistical analysis alone can’t prove fraud. But they say the anomalies they raise warrant independent validation of the election results.

The Pennsylvania paper Mebane gave the ETA did not fully explain the statistical model he used to identify potentially fraudulent votes, which he calls “eforensics.” Mebane later told Votebeat he had “decided not to write it in a way that would make it self contained” and instead referred the ETA to his past work for details on his methodology.

The ETA’s promotion of Mebane’s original working paper and his credentials caught the attention of a network of statisticians and political scientists accustomed to dense models, technical assumptions, and arguments over what statistical analysis of election data can really show.

Justin Grimmer, a Stanford political scientist whose 2021 peer-reviewed paper debunked statistical fraud claims about the 2020 election, said Mebane’s work has been used by the ETA in ways that give unusual weight to its claims about elections, which could otherwise be more easily dismissed as fringe. The result, he added, is a “perfect storm” — a motivated interest group armed with a professor’s academic credentials.

He said giving the original analysis to the ETA was like “handing someone a stick of dynamite and being surprised when you walk away and it detonates.”

As the ETA’s profile rose and its supporters trumpeted Mebane’s findings, Votebeat consulted 10 election and statistics experts about his original Pennsylvania working paper and the statistical model Mebane terms “eforensics.” All said they doubt the model can accurately detect fraud in U.S. elections.

A different kind of election denial

Claims of election fraud and statistical anomalies are now a regular feature of American elections — often blending data, analysis by citizen researchers and the raw emotions of voters who do not want to believe their candidate truly lost. After 2020, when Trump and his allies waged an unprecedented effort to overturn the results, such efforts became closely associated with the political right.

The ETA, which was formed as a nonpartisan nonprofit, has tried to distinguish itself from those movements. “This is not election denial. This is election integrity and auditing,” the ETA’s Taylor told David Pakman, host of the progressive online program “The David Pakman Show,” which has more than 3.6 million YouTube subscribers. Pakman described the 2025 segment as “one of the most requested interviews” in months.

Mebane’s work has fueled public questions about elections before: In South Korea, politicians and activists cited his analysis to allege possible election fraud in 2020. Political scientists later found such claims were flawed and damaged voter confidence.

Now, the ETA is using his work to raise questions about election results in the U.S. In addition to Pennsylvania, the group posted a summary of an unpublished analysis by Mebane of 2024 results in North Carolina, and it has asserted that the fact that his analysis corroborated its findings in Pennsylvania validates its analyses of other states.

“In collaboration with ETA, Dr. Walter Mebane analyzed Pennsylvania vote data for the 2024 November Election and found evidence of potential election fraud, confirming ETA’s analysis of the same Pennsylvania vote data,” an attorney for the ETA wrote in an analysis sent to California election officials, threatening litigation if the state refused to act.

“Consistent with techniques used to analyze Pennsylvania’s vote data,” the ETA said it had identified “evidence consistent with vote manipulation, including ballot-stuffing, deleting votes, and using algorithms to alter tabulator vote counts” in some California counties.

ETA leaders later told Votebeat the group’s lawyer’s use of “confirming” in the letter was “less nuanced” than their own statements, but that they stood by their use of “corroborates,” since, they said, both analyses reached similar conclusions.

The ETA has also sent letters to officials in at least six states, including Minnesota, Michigan and Kentucky, suggesting it has found abnormalities in the 2024 election results or in subsequent ones.

The letters urge election officials to take steps, such as investigating technology used in the elections and conducting hand counts, to verify the results. As of Sept. 2, Pennsylvania is so far the only state where the ETA has sued. A judge recently dismissed the case but left the door open for it to be refiled. When the group resubmitted its complaint in August, it made no mention of Mebane or his analysis. In an interview with Votebeat in April, Taylor said the ETA planned to file suit in Florida next.

The nonprofit is run by three people who came together on Reddit after the 2024 election, none of whom have an apparent background in U.S. elections. Taylor, 27, has a background in information technology; his two co-founders are a U.K.-trained financial professional now living in Arizona and a Canadian policy analyst with experience coordinating resources for British Columbia’s election authority.

The group raises money to support its work, including through donations and selling merchandise such as a “The Math Ain’t Math’n” T-shirt and a women’s sleep shirt reading “Vote Once, Count Twice, Sleep Tight.” Public records show it reported raising more than $422,000 in 2025.

While Mebane said he worked with the group, he told Votebeat that he hasn’t spoken with its founders in months. He told Votebeat that he saw “many, many things” in the ETA’s explanations that he “didn’t think were sound interpretations” of his work. But he said he didn’t want to get into a public debate with them, nor would he detail his specific concerns to Votebeat. He said fact-checking online claims is a distraction from his primary professional focus, a long-gestating book on his eforensics work.

Mebane stands by his model as valid but also said he does not see it as his responsibility to ensure the public understands his work. He stressed that his work has been done transparently and in public through working papers that can be revised.

At the same time, he dismisses the criticism from other academics, saying the experts consulted by Votebeat lack key components he has “deliberately not shown.” Grimmer and University of Pennsylvania political scientist Marc Meredith produced written reviews of Mebane’s 2024 Pennsylvania working paper at Votebeat’s request. Mebane described Grimmer’s critique as “just wrong” because “these views that you’ve solicited here are not based on the whole case that I’m making.” In response to questions, he frequently cited his planned book, saying the answers will ultimately be found there.

From butterfly ballots to eforensics

Mebane described his childhood as that of an inquisitive Black boy coming of age in the Civil Rights Era South, in a household where his parents, both Tuskegee graduates, emphasized the importance of social justice.

“That’s why I cared about elections,” Mebane, 67, said in an April interview on the University of Michigan’s Ann Arbor campus. It seemed to him to be “the one way that wasn’t violent” that could “change who has control of some levers of how decisions get made.”

When he spoke with Votebeat, he sat in a sparsely furnished office at the university’s Institute for Social Research — a space he uses for meetings. He described his primary workspace as “grimy” and packed with books. He wore a faded T-shirt featuring a tarot-style image labeled “The Wanderer,” a symbol of a lone traveler.

Mebane said he has always been drawn to questions about human behavior. At 8, while grocery shopping with his mother, he remembers searching the cereal aisle for hidden cameras, convinced companies must be tracking what people bought to measure the effectiveness of advertisements.

Mebane, who earned his undergraduate degree at Harvard and his doctorate at Yale, was teaching government at Cornell and studying elections in 2000 when the presidential race became too close to call, plunging the country into uncertainty.

He traveled to Florida as part of a team of academic experts working pro bono on a lawsuit challenging Palm Beach County’s butterfly ballot, a confusing two-page design that led some voters to accidentally select the wrong presidential candidate. His team published their findings in the American Political Science Review.

That work was straightforward: Mebane and his colleagues started with a known irregularity — the butterfly ballots — and worked outward, estimating how many votes it may have affected. There was a specific, identifiable problem. His job was to measure it.

His approach to Pennsylvania’s 2024 election works differently.

In the eforensics framework, Mebane starts not with a known problem but with the election results themselves. He compares total votes, votes for the leading candidate, and the number of eligible voters or registrants. Using those inputs, the model looks for patterns Mebane says could be produced by fraud.

Elections are shaped by a wide range of forces, from socioeconomic conditions and demographic differences to weather, campaign spending, and the quirks of individual races. Mebane’s Pennsylvania model does not directly account for those factors, though it does adjust for broad differences in turnout and voting patterns across counties. Instead, using precinct-level vote returns, it classifies precincts as having no fraud, incremental fraud, or extreme fraud — terms Mebane says are not meant to imply intentional wrongdoing.

Critics say that is where the trouble begins. The model flags innocent variations — caused by anything from strong canvassing efforts to hurricanes — as readily as deliberate manipulation.

Mebane recognizes that the model can be affected by other factors. He says his model is unable to account for “lost votes” — votes that were never cast because voters stayed home, for example. The model also sometimes flags strategic behavior — such as a voter intentionally casting their ballot for a party they don’t typically vote for — in the same way as fraud. Critics say such phenomena are commonplace in American elections, making the model a bad fit for the U.S.

“My project is a scientific mission to see whether this estimator and this approach can measure election frauds,” Mebane told Votebeat. “I think it measures frauds in a valid way, but it’s imperfect.”

Experts dispute findings and raise questions about false positives

Michael Alvarez, a political science professor at the California Institute of Technology, tested Mebane’s model with Grimmer and Meredith using simulated data built to contain no fraud. The model still found fraud at levels similar to Mebane’s Pennsylvania working paper.

Grimmer and Meredith said this kind of simulation is a basic way to pressure-test any model. They, along with Alvarez, were surprised Mebane had not done it.

In Mebane’s book manuscript, a partial copy of which he provided to Votebeat, he said he has not used simulated data tests because his preferred test is to compare the model’s results with real elections. He points to examples from France and Mexico, where courts or election authorities later annulled results or otherwise identified serious problems, and his model also found anomalies.

Had Mebane pressure-tested the model with simulated data, Meredith, Grimmer, and Alvarez said, he would have seen that the model could flag fraud even when none existed.

“Mebane’s eforensics model labels precincts as fraudulent when they show just a combination of this disproportionately high turnout and support for the winning candidate,” Meredith said at a recent academic conference. That combination was common across the country in precincts that favored Trump.

Mebane responded that such a result was “no surprise,” because an election simulated to contain no intentional fraud may still effectively simulate high mobilization or strategic behavior — forces his model may flag as eforensics frauds.

All three criticized Mebane’s use of the word “fraud,” with Meredith calling it “very irresponsible” and “frankly, not defensible.”

In his book manuscript, Mebane defines fraud as “malevolent distortions of electors’ intentions that change or potentially can change election outcomes,” even if the distortions aren’t the result of malicious or improper activity. Pressed on his use of the word “fraud,” Mebane defended it.

“I have an imperfect measure of fraud.”

If the anomalies may not be due to fraud, why use the term at all?

“Because it’s eforensics frauds.”

Why not call it an anomaly instead?

“Because it measures frauds.”

Alvarez, who co-edited a foundational academic book on election fraud, took issue with Mebane’s definition. “No one else thinks that’s what the word fraud means,” he said.

Mebane’s eforensics model has not been published in a peer-reviewed paper. He submitted an early version of his eforensics work to the American Political Science Review in 2020. It was rejected, and he said he does not recall the specific critique.

Nevertheless, in a press release announcing Mebane’s findings, the ETA said the model “has been validated in professional scientific publications.” The group did not specify which publications. Many political scientists, who reviewed the model at Votebeat’s request, told Votebeat that it cannot be used to support the claims the ETA is making.

Pennsylvania, a swing state that has long been the subject of voter fraud conspiracy theories, draws intense scrutiny in every election. In 2024, the state had a chief election official appointed by the losing party, bipartisan boards in nearly every county, risk-limiting audits, and smaller spot-check audits.

Meredith questions whether thousands of manufactured or stolen votes could really have slipped through all that scrutiny.

“I am concerned that the model uses fraud as the mechanism to make the model fit the data better,” Meredith wrote.

In Pennsylvania in 2024, Republican registrants turned out at higher rates than Democratic registrants in nearly every county, a pattern Meredith said is more readily explained by partisan enthusiasm than ballot stuffing.

Mebane’s working paper acknowledges this possibility, albeit seven pages in. After repeatedly asserting that his findings of fraud may exceed the 2024 margin in Pennsylvania, Mebane writes that the state is a “key battleground into which extensive and intensive campaigning and mobilization efforts were directed,” adding, “maybe most or almost all of the incremental manufactured votes are false positives prompted by electors’ strategic behaviors.”

The most conservative version of his model puts the number of estimated illegitimate votes well below Trump’s margin of victory in Pennsylvania.

In the version of the working paper provided to the ETA, Mebane described the narrower estimate as “a not negligible proportion” of Trump’s margin. Mebane has since updated that paper for his book and deleted that language, according to a revised version he provided to Votebeat in July.

Mebane also provided Votebeat with a written response to the reviews of his model from his academic peers, which highlight this limitation. In that, he says that when both malevolent distortions and strategic behaviors happen in the same election, “nothing about the model per se” can distinguish between the two.

Experts were also critical of a number of choices Mebane made in his analysis. The working paper, for example, skips steps typically standard for claims of this magnitude. It does not rigorously engage with alternative explanations, address the fact that Pennsylvania’s election results were audited, or show through simulation that the model can return a no-fraud result in a setting like Pennsylvania’s.

The Pennsylvania analysis also relies on data Mebane obtained via the ETA, even though that data was also publicly available from the state. Mebane said he did not check the data with election officials before publishing his findings, something Grimmer characterizes as a basic precaution before drawing conclusions from any model.

Grimmer and the other experts said taking that step would have helped Mebane understand and account for obvious data issues that instead distorted his findings. Votebeat separately found additional data interpretation errors in Mebane’s work. After Votebeat raised its discovery with Mebane, he acknowledged it and revised his findings of precincts labeled as “extreme frauds.”

Mebane’s updated Pennsylvania analysis also changes which counties he identifies as having significant levels of “malevolent distortions.” His original paper focused on Philadelphia and Huntingdon. The revised version provided to Votebeat instead focuses on Philadelphia and Bradford.

The new paper does not explain the change, and the earlier version — accusing Huntingdon of having high levels of fraud — remains on Mebane’s website.

‘There is an element of faith’

The ETA stressed in an email to Votebeat that its claims do not rely solely on Mebane’s working paper or model, noting that it ran multiple statistical tests “to avoid putting too much weight on any one individual method.” But some of those other tests are variations on the same basic idea as Mebane’s eforensics model.

For instance, in Pennsylvania, the group used a method developed by a Russian physicist that treats precincts with both high turnout and high support for the leading candidate as potentially fraudulent — a pattern colloquially known as a “Russian tail.” Grimmer said that kind of approach runs into the same barrier as Mebane’s model: The pattern it flags may be real, but the model cannot say why it exists.

A political methodologist and researcher at Stanford University’s Hoover Institution, Kirill Kalinin, told Votebeat that he spoke with the ETA last year and warned the group its methods could produce false positives.

The ETA’s founders also spoke with Votebeat and answered additional questions, but they did not answer a final list of questions about their methods, claims, and organization. They also did not directly respond to Grimmer and Meredith’s written critiques of Mebane’s work.

“Our team remains open to transparent, unbiased data analysis, including amending and correcting errors when they are discovered or brought to our attention,” they said in an email. “We welcome and encourage constructive criticism of our methodologies or our characterization of others’ work as we seek to ensure the accuracy and integrity of election results, and to bridge the gap between academia and the general public.”

But by both sides’ accounts, the group and the professor are no longer working together, with Mebane voicing doubts about how the group is using his work. The ETA said it repeatedly reached out to Mebane to ask if it had accurately characterized his work or should adjust its framing of it but received no response.

The ETA’s founders — Taylor, Emily Barner, and Clive Griffiths — said they are not the full extent of the ETA’s team, describing a wider network that includes members with advanced statistics training and doctorates in relevant fields, but declined to name most of them.

Barner, who goes by Lilli McGregor in her work for the ETA — which she told Votebeat is a combination of a nickname and her married name — said the group is trying to protect those members from reprisal and that supporters will ultimately have to take them at their word.

“There is an element of faith,” she said.

At least one of the founders has expressed strong views about the 2024 election. Griffiths — who goes by the nickname Jive online — said on X before the election that it was “about to be stolen.” The day after the election, he posted that “we are gonna prove” Trump cheated. After Votebeat asked about the posts, the account became private.

Mebane confirmed he also analyzed North Carolina data given to him by the group, which published a summary of his findings that claims he found more than 200,000 potentially fraudulent votes. However, Mebane said he asked the ETA not to publish his full paper, leaving that summary the only public account of his findings.

Mebane said he raised his objections explicitly in “a couple of Zoom meetings.” The group disputes that, saying it only learned of his concerns secondhand, around the time of an article in The Atlantic reporting that he did not endorse their claims.

The group has also contacted other academics, including Kalinin, who was advised by Mebane as a University of Michigan doctoral student. Before graduating in 2017, Kalinin worked with Mebane on election forensics methods. Kalinin said the ETA first contacted him over the summer of 2025 and later scheduled a roughly three-hour call in October.

Over the course of the call, Kalinin said, it became clear the group was seeking advice on how to restore its relationship with Mebane following his comments to The Atlantic. He told the ETA members on the call they’d have to reach out to Mebane directly. It was in that conversation, he said, that he cautioned them about false positives.

“These are just anomalies, these are not election fraud,” he said he told them, stressing that “you need to prove it.” Without ruling out alternative explanations, he said, such patterns cannot establish wrongdoing, particularly in democratic elections where normal political behavior can produce similar signals.

Mebane told Votebeat he doesn’t have time to argue with everyone on the internet, pointing to this meme. But his reluctance to publicly address the use of his work has left a vacuum.

For example, in a July 2025 video with more than 650,000 views titled “Yes, There’s Evidence Trump Hacked the 2024 Election,” independent journalist Scott Carney cited the ETA’s interpretation of Mebane’s working paper as evidence the election may have been stolen. He acknowledged he could not fully understand the math and said Mebane didn’t answer his emailed questions.

“C’mon, Mebane!” he said. “You can’t just drop a bombshell like that and then walk away like nothing happened.”

The accountability gap

As the ETA used Mebane’s working paper for advocacy and fundraising, it reached Andrew Gelman, a professor of statistics and political science at Columbia University and a leading authority on statistical methods. It had already baffled another technically sophisticated reader, who sent it to Gelman hoping he could make sense of it.

Gelman read both the Pennsylvania working paper and the underlying eforensics methodology but found the work too opaque to fully evaluate. The only reason anyone was engaging with it, he wrote, was Mebane’s reputation. “Without his name attached to them I don’t think we’d be reading them at all.”

That combination of technical opacity and academic authority is what makes work like this hard to dislodge once it spreads, said Grimmer. Debunking work like Mebane’s requires readers to follow complex assumptions and unfamiliar methods.

Kalinin, who has spent much of his career studying elections in authoritarian countries, defended Mebane’s caveats, calling the original Pennsylvania working paper “balanced.” At the same time, he said, methods like eforensics work “well on autocracies. I’m not so sure about democracies.”

Kalinin said that he has come to believe the ETA was pursuing its own political goals and using the work of academics “as the instrument” to achieve them.

“No amount of academic caution can entirely prevent a motivated organization from stripping away those caveats to advance a specific agenda,” Kalinin said in an email. “ETA is entirely responsible for its own actions. They are clearly exploiting election forensics research for strategic or political gain — something that I cautioned them against during our private conversation.”

“It does not surprise me that ETA may have mischaracterized my work, because that’s what I initially observed them doing to others’ work,” Mebane said in an email. “I take responsibility for what I say, not for what they or anyone else may say.”

Other researchers Votebeat spoke with agreed that the ETA had stripped away important caveats. But they were less willing to separate the ETA’s use of the work from Mebane’s own choices — including the claims he published, the authority his name carried, and his decision to remain largely silent as those claims spread. Academia offers few clear mechanisms for addressing those concerns.

Keith Whittington, a Yale Law School professor who studies academic freedom, said universities are reluctant to police what professors research or say because ideas once dismissed can later prove correct. What responsibility any individual scholar has over how their work is used, he said, is “not at all obvious.”

Ivan Oransky, co-founder of Retraction Watch — a news organization that reports on academic corrections and retractions — said the issue is not whether preliminary or unconventional work can have value. It can, he said. But scholarship is supposed to be iterative, he said: Researchers should revise work in response to criticism and publicize those revisions. Mebane’s website does not indicate whether or how his Pennsylvania analysis has changed in response to the criticism it has received.

Without subjecting your work to that process, Oransky said, “I’m not sure you’re really doing scholarship.”

What makes this different from the dozens of other statistical analyses of the 2020 or 2024 elections he’s reviewed and found flawed, Grimmer said, is who it’s coming from. Claims like these usually come from the political fringe. It is far rarer to see them come from a tenured professor at a major university.

That distinction carries weight, especially in a political climate already primed for suspicion.

“You can see how something like this takes off,” Grimmer said. People tend to put too much stock in credentials when doing so supports their position, and “when they don’t understand, people default to the conclusion they want to reach.”

This story was produced by Votebeat and reviewed and distributed by Stacker.

​ Orange County Register 

Senior living: Nursing home beds are becoming scarcer

• September 28, 2026

By Paula Span, KFF Health News

The San Vicente de Paúl Nursing Home in the South Bronx hasn’t admitted a patient since December 2024. ArchCare, which operates the facility, has reduced its capacity from 120 available beds to 53 and plans to shrink it further.

Another ArchCare nursing home, on Staten Island, has shut down a full floor. North of the city, in Dutchess County, its Ferncliff Nursing Home has contracted from 309 available beds to 196.

The eight nursing homes owned by ArchCare, a nonprofit that provides eldercare through the Archdiocese of New York, have 269 fewer usable beds than they did 18 months ago, a nearly 12% decline, creating waiting lists for patients seeking long-term care.

Across New York state, 24 nursing homes have closed since 2020, resulting in a loss of more than 3,000 licensed beds, according to LeadingAge New York, which represents nonprofit senior living organizations.

That mirrors a national trend. In 2015, the Centers for Medicare & Medicaid Services certified 15,648 nursing facilities. A decade later, that number had fallen by more than 900.

With the oldest baby boomers turning 80 this year, an age when the need for long-term care climbs sharply, researchers are sounding alarms. Will there be enough nursing home beds for a rapidly graying nation?

“We’re seeing a serious problem and it’s heading in the wrong direction,” said David Grabowski, a health policy researcher at Harvard Medical School.

He is an author of a study in JAMA Internal Medicine that found a 5% decrease in national nursing home capacity from 2019 to 2024.

“As you look at the demographics, this is only going to get worse, maybe a lot worse,” he said, especially given looming Trump administration policies on immigration and Medicaid financing.

The reasons for the shrinkage?

ArchCare blames inadequate state reimbursement for Medicaid, a perennial industry complaint. The primary payer for nursing home care, Medicaid provides less than the daily cost of care, said Clif Porter, chief executive of the American Health Care Association, an industry trade group.

“Before the pandemic and inflation, the losses were sustainable,” said Jason Hutchens, ArchCare’s chief operating officer.

More recently, he said, “we were running at an unsustainable loss — we had no choice.”

Nursing homes, most of them for-profit, try to compensate by attracting short-stay patients covered by Medicare, which pays higher rates than Medicaid. When they can’t, “unless you’re extremely rapacious or extremely efficient, you’re not going to make it,” said Vincent Mor, a health services researcher at the Brown University School of Public Health who is an author of an article, published in the New England Journal of Medicine, raising concerns about reduced capacity.

“The numbers don’t add up,” Mor said.

Staff shortages, which have plagued nursing homes for decades, have also caused contractions and closures. Nursing home aides work stressful, low-paying jobs with historically high turnover rates. Their median hourly wage last year was $20.67, according to federal data compiled by PHI, a research and advocacy group for direct care workers. Although pay has risen over the past decade, about 40% of nursing home aides rely on some form of public assistance, such as Medicaid or the Supplemental Nutrition Assistance Program, PHI reported.

The number of nursing home aides has rebounded from the COVID-19 pandemic, according to PHI, but fewer are working than in 2015. And while hiring and retention have improved, Porter said, “there’s still a significant gap between demand, especially future demand, and where the workforce currently is.”

National occupancy rates, which fell sharply during the pandemic, have returned to a more typical 80%.

That figure can be misleading, however: it doesn’t mean 1 bed in 5 sit empty, awaiting a patient. Occupancy counts state-licensed beds, but the more meaningful number is operating beds — how many are actually available depending on a facility’s staffing and other factors.

That number is usually lower and, in many cases, sinking. The American Health Care Association reported in 2024 that almost half of nursing homes were limiting admissions and 57% had waiting lists for new residents.

It’s possible, of course, that they also face financial losses because of lower demand.

“Nursing homes close because people don’t want to go to nursing homes,” said Sam Brooks, director of public policy for the National Consumer Voice for Quality Long-Term Care, an advocacy group. “The quality is so low that people avoid them like the plague.”

Last year, Medicare inspectors found at least one quality violation serious enough to harm or jeopardize residents in 27% of nursing homes, according to an analysis by KFF, a health information nonprofit.

In recent decades, alternatives emerged that diverted patients from nursing homes. About a million older adults currently live in assisted living facilities. And among Medicaid recipients, the ongoing policy shift called “rebalancing” has enabled more people to receive services at home (where most want to be) rather than in nursing homes.

In 1988, only 10% of Medicaid expenditures for long-term services went to home- or community-based services; the rest paid for institutional care. By 2020, more than 60% of expenditures funded home and community care, said Priya Chidambaram, a KFF senior policy manager specializing in Medicaid, citing a staff analysis.

How big a problem these trends pose depends partly on geography. The decline in the number of nursing homes in rural locations — about 10% from 2015 to 2025 — was much greater than the national drop of about 6%.

“It’s more difficult to staff a rural nursing home,” Chidambaram said. “Labor pools are smaller, and it’s hard to get people to take lower-paid or part-time jobs if they have to travel long distances.”

Bed shortages are also creating bottlenecks at hospitals. Where nursing home capacity declined, Grabowski’s team found, patients stayed in hospitals longer because they couldn’t locate posthospital care. They often had to travel farther to find facilities. “It gums up the entire system,” Grabowski said.

On two fronts, Trump administration policies could make matters worse, experts said. Revoking legal status for certain immigrant groups has worsened staffing shortages.

So far, “we’re not seeing significant impact across the country,” Porter said.

But the effects are being felt in specific locations, including Florida, New York and Massachusetts, he confirmed. With further revocations and deportations, Grabowski said, “a lot fewer older adults are going to have caregivers.”

The administration’s more than $900 billion in cuts to Medicaid over a decade are also expected to exact a toll. As states grapple with reduced funding, analysts expect home and community services to take a greater initial hit than institutional care. But that could increase pressure on nursing homes if patients who lose home care turn to institutions instead.

Less of these services “means more nursing home entry,” Grabowski said.

As policy ideas circulate — with calls for better data tracking, special visas for immigrant health workers, and targeted grants for nursing homes serving high-cost populations — researchers, advocates and families are waiting to see what unfolds.

“So much of this is speculative,” Chidambaram said. “We don’t know what states will decide. We don’t know how the market will react. We’re in new territory here.”

The New Old Age is produced through a partnership with The New York Times.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism. 

​ Orange County Register 

Officials say mediators are still working with Iran and the US on a possible deal

• September 28, 2026

By SAMY MAGDY and COLLIN BINKLEY

CAIRO (AP) — Three officials tell The Associated Press that mediators were still working with Iran and the United States on a deal to end the fighting and open the Strait of Hormuz, with the indirect talks expected to resume on Monday.

The details were revealed as the war enters its eighth month after causing widespread economic suffering. Multiple efforts to allow safe shipping on one of the world’s most crucial waterways have failed.

There was uncertainty over the weekend after President Donald Trump told journalists he had rejected Tehran’s latest proposal to reopen the strait in a week if the U.S. lifts its blockade of Iranian ports, releases frozen Iranian assets and waives sanctions on Iranian oil sales, among other conditions.

Iran’s foreign minister, however, remained in New York and said he awaited word from mediators. Qatar has been mediating.

The deal would first reopen the strait and lift the US blockade

Two of the officials speaking to the AP on Monday confirmed that mediators are working with both sides on a proposal that would include reopening the strait and lifting the U.S. blockade, and then removing sanctions.

According to the draft text being discussed, the strait would reopen in accordance with a separate deal that Iran has been discussing with Oman, on the other side of the strait, and it would include no tolls — something Tehran has pursued. That deal seeks to temporarily manage shipping traffic on what was seen as an international waterway before the war.

The two officials also said that despite Trump’s public comments, the U.S. has not officially rejected the current proposal, indicating that his remarks may have been a negotiating tactic.

The third official said the U.S is seeking Iranian concessions on its nuclear program, including allowing inspectors to enter the country. Under the Memorandum of Understanding the two sides signed in June that collapsed within days, Iran’s nuclear program was meant to be discussed over a 60-day period.

All three officials spoke on condition of anonymity to discuss behind-the-scenes diplomatic negotiations.

One official reported positive signals coming from both sides. A second reported “slight progress” over the weekend. The third said mediators are still trying “to soften” the positions of both sides.

The White House did not immediately respond to a request for comment.

Iran’s latest proposal has sought a faster timeline

While Iran’s latest proposal echoes the June deal, a key difference is speed.

Foreign Minister Abbas Araghchi told a closed-door meeting on the sidelines of the U.N. General Assembly last week that Tehran had pitched the deal as benefiting Trump in the midterm elections. Araghchi later told journalists that “the seven-day timeline will start as soon as the United States accepts this plan.”

Both the U.S. and Iran have been hurting economically — the U.S. from high oil prices as Iran attacks ships on the strait, and Tehran from the naval blockade and a growing number of U.S. sanctions that bottle up its oil sales. Brent crude, the international standard, is above $108.

For months, the two sides have been trying to outlast the other, while regional countries put up with missile and drone attacks as Tehran claims to target U.S. military assets in the region.

Reflecting Iran’s impatience, a rare statement on Monday attributed to the theocracy’s Supreme Leader Ayatollah Mojtaba Khamenei noted the “painful blows” that enemy forces have received near the strait. “Before long, the Arabian Sea, too, will be rid of them,” the statement added.

The latest proposed deal again seeks to end the fighting on all fronts, including in Lebanon. But a new front has emerged in recent weeks as Iran-backed rebels in Yemen are now perched on another crucial waterway, the Bab el-Mandeb Strait at the southern entrance to the Red Sea. That has further pressured global markets.

Iran argues that the Houthis have their own demands, and that their conflict with neighboring Saudi Arabia is separate from the U.S.-Iran war, but Iranian officials said they are willing to help in finding a settlement between the Houthis and the Saudis, one of the officials said.

Binkley reported from Washington. Associated Press Middle East editor Victoria Eastwood contributed.

​ Orange County Register 

Endorsement: Laurie Davies for Assembly District 74

• September 28, 2026

Voters figuring out who will represent them in the coastal 74th Assembly will see at least one new name on the ballot.

After prevailing over Democrat Scott Rhinehart in 2020, Republican Assemblywoman Laurie Davies successfully fended off subsequent challenges from San Clemente Councilman Chris Duncan. With Duncan this time opting for a state Senate contest, Davies is facing off against San Juan Capistrano Councilman Sergio Farias.

Davies has built a reputation as someone very practical and willing to work. Accordingly, she has been a member of the bipartisan California Problem Solvers Caucus, and her legislative priorities are generally uncontroversial. She’s promoted access to naloxone to help prevent overdoses, worked to combat childhood drownings, protected the privacy of victims of crime, and authored a bill just signed by the governor to raise awareness of the threat of sextortion in schools.

One bill of hers that we appreciated this year was Assembly Bill 2690, which, as one bill analysis summarized, “provides a taxpaying resident or corporation with standing to sue the state, a state entity, or any other state governmental body for alleged wasteful or illegal expenditures.” That’s music to our ears. Alas, it didn’t advance despite support from ACLU California Action, the Western Center on Law & Poverty, and the Howard Jarvis Taxpayers Association.

As reflected by HJTA’s scorecard of lawmakers and their defense of taxpayer interests, Davies has certainly been better than most. Though often receiving a “B” grade over the years, she has worked up to an “A+” in the 2025 scorecard.

We haven’t always agreed with Davies, including her vote for Assembly Bill 1383 to boost public safety pensions. That bill was mercifully vetoed by Gov. Gavin Newsom, who rightly defended taxpayers across the state from the pension tsunami it would’ve triggered. But Davies generally gets things right.

Davies is a believer in the California dream, in having a state government that spends within its means, in promoting entrepreneurship. She’s also direct when she speaks, as when she criticized Sacramento politicians for bungling the state’s finances. “They’ve never run a business, never signed a check. We had a surplus of $100 billion; instead of putting that money aside and knowing we were having hard times, it was kind of like Oprah — ‘You get a car, you get this, you get that.’ It’s a shell game.” That’s why we’ve consistently endorsed her over the years.

This time, though, she does have a challenger in Farias who says a lot of the right things. He stresses that he is pro-development, he supports a free market in insurance, he supports Proposition 13 and is not supporting the wealth tax. He also criticized Gov. Newsom’s results on homelessness, giving him an “F” grade. And while he says he thinks the state is obligated to finish the high-speed rail project, he says if it continues to fail, it should be brought back to the voters.

If more Democrats in the Legislature were like Farias, the state would likely be in better shape.

Ultimately, though, the question we ask ourselves is whether it’s worth it to oust a sensible conservative who is earnestly trying to work across the aisle in favor of yet another member of the supermajority? We don’t think so.

Both Davies and Farias have their share of public sector union endorsements. California Professional Firefighters and the Peace Officer Research Association are backing Davies, while Farias has the backing of the California Teachers Association, the California Federation of Teachers, and the Service Employees International Union (SEIU) California.

While her vote for AB 1383 shows she isn’t immune to union pressure on public safety issues, her broader track record demonstrates she can resist some of the influence of public sector unions. But if Farias gets elected as a Democrat to the Assembly, would he? We don’t know that, but based on the behavior of Democrats in the Legislature, we have major doubts.

Davies deserves re-election. She is a needed voice for taxpayer interests in the Capitol and represents the district well.

Laurie Davies has our endorsement.

​ Orange County Register 

Endorsement: No on Proposition 4. California doesn’t need taxpayer-funded campaigns

• September 28, 2026

With 14 statewide ballot measures on the ballot, Proposition 4 is thankfully simple to understand.

If approved, Prop. 4 will repeal California’s general ban on public funding of campaigns and allow most cities and the state to establish public-financing programs if they so choose. That ban was enacted by voters as part of Proposition 73 in 1988, which sought to constrain the use of tax dollars in elections.

As proponents of Prop. 73, including the late Joel Fox, argued at the time in proposing the ban on public funding of campaigns: “Keeping government spending under control is hard enough. Imagine how much harder it will be to keep politicians from spending more tax money on the most important thing in their lives — getting elected and reelected.”

Such concerns are perhaps the chief reason to leave the ban in place.

While Prop. 73’s ban applies to the state and general law cities, charter cities  — those operating under their own local constitution, or charter — are allowed to authorize public financing of campaigns if they choose to. Out of the 126 charter cities in the state, only Los Angeles, San Francisco, Oakland, Berkeley, and Long Beach have authorized such programs. However, Oakland’s “Democracy Dollars” program, while officially approved in 2022, has been postponed due to fiscal challenges in the city.

Proponents of such systems argue that such systems help rebalance the scales in local elections often dominated by special interests with deep pockets. Empirical evidence on the impact of such systems is limited, but some research has found such systems are associated with more candidates entering races and spending less time on fundraising.

As a real-world example,  former Los Angeles Times opinion editor Mariel Garza notes, “Los Angeles’ public financing system provides a 6:1 match and likely helped Karen Bass win the mayor’s race in 2022 against her wealthy challenger, shopping-mall developer Rick Caruso.” In other words, the system simply replaced private funds with taxpayer dollars to tip the scales for an establishment political careerist over a private-sector outsider. Make of that what you will.

If there were more obvious benefits of such systems, one would expect to see broader implementation of them. Charter cities remain an option for experimentation, for better or worse. But it’s not obvious there’s a need to give a greenlight to every city in the state, or the state itself, to hand out taxpayer dollars to political campaigns.

Voters are indeed skeptical of Prop. 4, according to recent polling from the Public Policy Institute of California, which found that just 42% of likely voters support it while 53% are opposed, with the balance undecided. This includes the support of just 47% of people from the Los Angeles area and just 41% from the San Francisco Bay area.

Straightforwardly, Prop. 4 just doesn’t pass the common sense test. At a time when governments across the state are hemorrhaging money and turning to tax increases to sustain the services they currently have, why even allow politicians to set up programs giving tax dollars to their campaigns and the campaigns of their friends? While we’re sure politicians would prefer to spend less time fundraising, does that justify diverting finite tax dollars away from things that will directly benefit taxpayers?

If charter cities want to keep experimenting, fine, that’s already allowed. But should we lift the ban on public funding of campaigns across the state? We don’t think so.

Vote no on Prop. 4.

​ Orange County Register 

Rams’ defense falters after Jaylen Watson injury in loss to Broncos

• September 28, 2026

This was the vision at the start of the Rams’ offseason, before the team knew that it would trade for Myles Garrett or that Aaron Donald would come out of retirement. To remake the defense with tough, physical corners to match the safety play. Cover men who wouldn’t allow receivers to get open before the Rams’ pass rush got home.

For a half on Sunday, the vision seemed to be coming to life against the Denver Broncos. The presence of Trent McDuffie and Jaylen Watson helped all the returning pieces from last year’s defense – and of course the future Hall of Famer Donald – fall into their proper places. The pass rush forced Denver quarterback Bo Nix into releasing the ball before he was ready. Safeties came in to clean up tackles instead of trying to pick the right pursuit angle.

But when Watson went out with a shoulder injury at the end of the second quarter, the Rams got a reminder of how fragile an ecosystem can be as a 16-point halftime lead turned into a 30-26 loss.

“It’s tough. But this is sports, you sign up for all it,” head coach Sean McVay said in a press conference that lasted less than two minutes. “And love our group. Just came up short.”

Watson, a Day 1 free agent acquisition, opened the game with a tackle for loss on an outside run, the kind that killed the Rams a year ago with corners unwilling to get dirty in the run game. He left the game in the second quarter with a shoulder injury, but in less than two quarters he still deflected two passes, one of which easily could have turned into an interception.

McDuffie, the former All-Pro the Rams traded a first-round pick for before signing to a then-record contract extension, moved inside to the slot for this matchup to shadow the shifty Jaylen Waddle. McDuffie’s physicality left Waddle visibly frustrated with his hands on his hips.

The Rams (1-2) held the Broncos (2-1) to 67 total yards of offense in the first half, to five first downs and a 2-for-6 mark on third down before heading into the locker room. Everything was going to plan.

By that point, the Rams had built a 16-0 lead. The game plan called for a heavy dose of 13-personnel, with eight of Stafford’s first 10 passes targeting tight ends. Veteran Tyler Higbee went in motion on a play-action pass on the goal line before floating out in the flat. Stafford found him and Higbee lowered his shoulder to go through Riley Moss into the end zone.

But the Rams stalled in their next two trips into the red zone, with penalties by Steve Avila and Davante Adams forcing the team into field goals.

“We had too many penalties that put us in negative situations,” McVay said.

With Watson unable to return in the second half, though, the Rams had to turn to Emmanuel Forbes and Josh Wallace, the holdovers from last year’s cornerback room, to mixed results. Prior to Watson’s departure, Forbes was called for a pass interference after falling to his knees and grabbing Troy Franklin’s jersey to prevent a breakaway play.

But Forbes’ bigger errors came in the second half. He was picked off in the end zone on the Broncos’ opening drive, falling to the navy paint as Pat Bryant got open for a touchdown. Wallace was spun around by Waddle on the ensuing two-point conversion as Denver cut the Rams’ lead in half.

Forbes then did not immediately return to the field after being blocked out of bounds on the next Rams punt. Ethan Evans had to re-punt the ball, and instead of Denver starting on its own 9, it got the ball on its 48 to start the next drive, a 39-yard swing. The Broncos would need just seven plays to score again, erasing the Rams’ 16-point lead.

Wallace got some redemption, intercepting an underthrown ball by Nix under pressure from Kobie Turner to set up a go-ahead 48-yard field goal by Harrison Mevis, his fourth of the game.

The Rams got the ball back with a chance to close out the game. But Stafford misread a coverage, with safety Talanoa Hufanga jumping into the flat to intercept a pass to Kyren Williams. Hufanga took the ball 66 yards for a touchdown to give the Broncos their first lead of the game.

The play made Stafford the NFL’s all-time leader in pick-sixes, but he was unfazed. Four plays later, he found an open Konata Mumpfield up the right sideline for a 48-yard touchdown to go up 26-23.

Wallace appeared to put the game away with an interception as the Broncos drove under the two-minute warning. He jostled with Bryant for position and intercepted the ball along the sidelines. But a flag came out for pass interference, extending Denver’s possession.

“I’ll look at it,” McVay said of the call. “It looked like it was a good, competitive play from my vantage point, but we’ll go back and look at it and see what they say.”

With 47 seconds left, Nix jumped over his offensive line and reached the ball into the end zone to put the Broncos back on top.

Still, Stafford put the Rams in a position to win, reaching the Denver 14 with two seconds to play. A false start moved the Rams back five yards, only for Stafford’s final throw to be intercepted by Hufanga again to seal the Rams’ fate.

​ Orange County Register 

LAFC parts ways with Marc Dos Santos after late-season slide

• September 28, 2026

The Los Angeles Football Club has parted ways with head coach Marc Dos Santos.

LAFC on Sunday announced that less than one full season into Dos Santos’s term as head coach of the Black & Gold, the organization is headed in another direction.

An interim coach will be named soon, according to a statement provided by the club, and the organization is commencing a search for its fourth full-time head coach.

Hired last December following Steve Cherundolo’s successful four-year tenure, Dos Santos was a member of the original LAFC coaching staff during Bob Bradley’s expansion-leading season in 2018.

Dos Santos spent the next two and a half seasons as head coach of the Vancouver Whitecaps before being fired in the summer of 2021 with a 22-37-18 record.

In 2022, Dos Santos returned to the LAFC bench as an assistant for Cherundolo and the Black & Gold won its lone MLS Cup. Dos Santos remained on Cherundolo’s staff and that continuity was one reason given for the organization’s decision to make him head coach.

“Marc has given a great deal to this club over the years, and we are grateful for his commitment, care and contributions to LAFC,” president of soccer operations John Thorrington said in a statement on Sunday. “We wish Marc and his family all the best moving forward.”

LAFC started in fine form under Dos Santos, a native of Montréal, Québec, Canada.

Unbeaten in a club-record 11 straight matches, including an MLS record six consecutive shutouts to open a season, Dos Santos appeared to pull all the right strings. However, that early success gave way to inconsistent outcomes and middling performances, leading to extended spells of dropped points and, ultimately, the first instance of LAFC removing a head coach from the job.

Cherundolo chose to depart after the 2025 season.

Bradley’s contract was not renewed following the 2021 campaign, when LAFC missed the MLS Cup playoffs for the only time.

Dos Santos’ time with LAFC was challenged by injuries and a busy transfer window.

Last December, Thorrington and the ownership group said that the players’ support for elevating Dos Santos from assistant to head coach was critical to the club’s decision.

Demonstrating what Thorrington described as “a clear conviction of what the best version of LAFC looks like” during the interview process, Dos Santos, 49, took control of a roster that appeared primed to succeed, especially with an attack boasting star forwards Denis Bouanga and Son Heung-min.

Since the start of August, LAFC went 1-4-5 in league play, scoring nine times.

Employing a cautious attacking approach that saw the most prolific scoring team in MLS since 2018 repeatedly come up short in the final third, LAFC’s positive outcomes under Dos Santos were generally reliant on stout defending and the stellar work of goalkeeper Hugo Lloris, who is tied for the league lead with 12 clean sheets.

Following a 1-0 loss at Dallas on Saturday, LAFC (11-9-8) is sixth in the MLS Western Conference. Including CONCACAF Champions Cup, which ended with a trip to the semifinal and a defeat to the eventual winner Toluca FC, and Leagues Cup, LAFC went 17-10-12 in all competitions with Dos Santos in charge.

​ Orange County Register 

Trump administration begins airing 2024 Trump campaign ad in latest taxpayer-funded messaging

• September 28, 2026

WASHINGTON (AP) — The Trump administration is using taxpayer funds to air a television advertisement from Donald Trump’s 2024 presidential campaign in the latest in a series of ads promoting the president ahead of the midterms that the White House maintains are “public service announcements.”

The 30-second video, which is virtually identical to one that aired in 2024, shows Trump walking down a hallway as his voice can be heard warning of a “final battle” against “globalists” and “warmongers.” The black-and-white video ends with Trump staring straight into the camera lens with a message that says: “Paid for by the U.S. Government.” The 2024 iteration of the ad from the Trump campaign urged viewers to “Join President Trump’s Fight for America.”

Lawmakers of both parties have criticized the new series of ads for their inherently political nature and the use of taxpayer dollars. The White House maintains they are like the ones used by past presidents, though those previous ads promoted particular policies, not Oval Office occupants.

Spending on the latest ad already topped about $319,000, according to AdImpact, which tracks media spending.

“With you at my side, we will demolish the ‘deep state.’ We will expel the war mongers from our government. We will drive out the globalists; we will cast out the communists, Marxists, and fascists,” he says in the narration. “We will throw off the sick political class that hates our country. We will rout the fake news media, and we will liberate America from these villains once and for all.”

It’s in addition to a minute-long ad that began airing Friday and features scenic videos of Mount Rushmore at night with quotes and clips from Trump’s Fourth of July weekend speech there honoring the country’s 250th anniversary. An earlier 30-second spot that began airing on Wednesday features clips of Trump talking about defeating communism interspersed with onscreen text promoting the “largest tax cuts in history,” “reigniting American manufacturing” and a call to “defend law and order and police.”

The White House in a statement on Friday defended the use of what it described as “public service announcements” and dismissed criticism of them as “deeply dishonest.”

“The announcements are very clearly not campaign ads; President Trump is not on the ballot and there is no call to action,” the White House said. “Instead, the announcements are a reminder for Americans to love their country and know why it’s worth defending — at home, at the border, and abroad.”

Examples cited by the White House include George W. Bush’s administration airing a campaign about a Medicare law and the Biden administration running one about COVID-19 vaccinations.

​ Orange County Register