The Bush administration shut off a source of information last fall about abuse and neglect in long-term care facilities. The rule designates state inspectors and Medicare and Medicaid contractors as federal employees. The new rule, which was issued in September, generally prohibits state health departments and contractors from participating in private lawsuits involving facilities that are in the federal assistance program without approval by the head of the Department of Health and Human Services. So essentially you have state vs. federal rights clashing heads. The practical effect is to force litigants to go to greater lengths to obtain inspection reports or depositions for cases they are pursuing or defending. The effect of the directives has started to play out in the nation’s courtrooms. Requests for information, once fairly routine, now are stalled between state and federal officials.