Skilled Nursing Occupancy Continues Slow Increase

“Demand for skilled nursing seemingly is rising as occupancy has now increased steadily since January and COVID-19 cases declined from January to March.”

- Bill Kauffman

NIC MAP^® Data, powered by NIC MAP Vision, released its latest Skilled Nursing Monthly Report on June 2, 2022. The report includes key monthly data points from January 2012 through March 2022.
Here are some key takeaways from the report.

Skilled nursing property occupancy increased 23 basis points in the month of March, ending the month at 77.1%. This was the highest occupancy level since the beginning of the pandemic in April 2020 but was still well below the pre-pandemic March 2020 level of 84.8%. After declining 30 basis points in January because of the Omicron variant challenges, including increased staffing shortages, occupancy has increased 119 basis points (1.2 percentage points) since January. In addition, it has increased 503 basis points from the low of 72.1% set in January 2021. These data points suggest that demand for skilled nursing properties is growing, although staffing shortages continue to limit the ability to admit new residents.

Medicare revenue per patient day (RPPD) decreased from February to end March 2022 at $573. The 1.0% decrease from the prior month suggests that the decline in COVID-19 cases has reduced the amount of reimbursement needed for COVID-19 positive residents. At its height, COVID-19 required additional measures of care to be implemented. The federal government implemented many initiatives to aid properties for cases of COVID-19, including increases in Medicare fee-for-service reimbursements to help care for COVID-19 positive patients who required isolation. The reduction in additional Medicare reimbursement is also evident in the revenue mix data. Medicare revenue mix declined 339 basis points from February, ending March at 21.2%.

Managed Medicare revenue mix decreased 78 basis points from February to end March at 10.6%, reversing the 83-basis point increase that occurred from January to February. Prior to the pandemic, in February 2020, it was 11.2% and then declined to a pandemic low of 8.1% in May 2020. It is now 255 basis points above the low point. The increase from the pandemic low is likely due to growth in elective surgeries from 2020, which typically creates additional referrals to skilled nursing properties.

Medicaid revenue per patient day (RPPD) declined from February to end March 2022 at $246. In addition, Medicaid is down 1.2% from the prior year in March 2021. However, Medicaid RPPD has increased during the pandemic as many states embraced measures to increase reimbursement related to the number of COVID-19 cases to support skilled nursing properties. Medicaid RPPD has increased 2.9% since February 2020, prior to the pandemic.

Get more trends from the latest data by downloading the Skilled Nursing Monthly Report. There is no charge for this report.

The report provides aggregate data at the national level from a sampling of skilled nursing operators with multiple properties in the United States. NIC continues to grow its database of participating operators to provide data at localized levels in the future. Operators who are interested in participating can complete a participation form. NIC and NIC MAP Vision maintain strict confidentiality of all data received.