In recent years, skilled nursing and rehabilitation centers across the nation have endured billions of dollars in cuts for the care of elder and disabled beneficiaries of Medicare. Here in Maryland, in three of the past five years, payments for the care of Marylanders most in need were cut more than $180 million. Through outstanding public/private partnership, only recently have these cuts been reduced.

However, possible additional state cuts loom on the horizon. Now Congress is looking at ways to potentially make additional cuts to Medicare and Medicaid through the Super Committee and by other means.

If our elders and neighbors had fewer needs and felt less pressure today than they did yesterday, and if millions of Americans of all ages suddenly didn't need long-term or rehabilitative care, it would make perfect sense for our leaders in Washington to cut Medicare and for states to cut Medicaid. Sadly, this is not the case.

At a time when the unemployment rate is above 9 percent and the need for care continues to grow, now is the time to invest in and create jobs in health, long-term and rehabilitative care. It's time for care, not cuts.

Today's rapidly aging America and escalating needs for rehabilitative services in less costly settings than acute hospitals present incredible opportunities. We must become "carepreneurs" — creating health care jobs for younger Americans and recent college graduates while increasing access and capacity across all continuums of care to keep people of all ages healthy and engaged.

Joseph DeMattos Jr., Columbia

The writer is president of the Health Facilities Association of Maryland.