Centers for Medicare and Medicaid Services' proposal last night, seeking to scale down the joint replacement bundled program and eliminate the cardiac rehab bundle program, will have minimal impact on home nursing providers, if finalized as proposed, Jefferies analyst Brian Tanquilut tells investors in a research note. The analyst's checks suggest that provider referral patterns have already shifted and are unlikely to reverse, even absent Care for Joint Replacement's incentives. He notes that Almost Family (AFAM), Amedisys (AMED) and LHC Group (LHCG) have seen fairly minimal benefit to-date from the Comprehensive Care for Joint Replacement program.