NIC Notes

Insights in Seniors Housing & Care


By: Bill Kauffman  |  August 31, 2023

Skilled Nursing Occupancy Hits 2023 High in June

Market Trends  |  NIC MAP Vision  |  Skilled Nursing

NIC MAP Vision released its latest Skilled Nursing Monthly Report on August 31, 2023. The report includes key monthly data points from January 2012 through June 2023.

Here are some key takeaways from the report:

Skilled nursing property occupancy increased in June, after decreasing slightly the previous month. It increased 31 basis points from May to end the month at 81.2%. There was positive momentum in occupancy throughout 2022 and it has increased 77 basis points since December 2022. It is up 6.6 percentage points since the low (74.6%) point reached in January 2021. However, staffing in the sector is still a significant burden on skilled nursing operators and is limiting additional admissions in many markets around the country. Occupancy is down 7.5 percentage points from the pre-pandemic February 2020 level of 88.8%. As staffing continues to be a challenge, skilled nursing property wage growth expense has declined which may provide some relief to operators. However, higher debt costs are a concern.

SNF Blog Slides June_2023_working

Medicare revenue mix declined as the revenue per patient day increased slightly in June. However, both are down from December 2022. Medicare revenue mix is down 615 basis points from the most recent in high in February 2022 which was a time when increased cases of COVID-19 resulted in additional need for utilizing the 3-Day rule waiver and per day reimbursement for COVID-19 positive patients. Medicare revenue mix ended June at 18.0%. Medicare RPPD ended June at $590 and is up 1.38% from one year ago. Meanwhile, Managed Medicare revenue mix was up 61 basis points to 12.0% in June. It is up 280 basis points above the pandemic low of 9.2% set in May 2020.

Managed Medicare revenue per patient day (RPPD) increased in June, but it is down 0.5% from last year in June 2022. Depending on an operator’s business model, the continued decline in managed Medicare revenue per patient day can pose a challenge as the reimbursement differential between Medicare fee-for-service and managed Medicare continues to increase. However, some operators see opportunity to capture patient volume with the growth of managed care. Medicare fee-for-service RPPD ended June 2023 at $590 and managed Medicare ended at $490, representing a $101 differential. In June of 2022, the differential was $90.

Medicaid patient day mix continued the upward trend in June, ending at 66.7%. However, it has increased 353 basis points from the pandemic low of 63.2% set in February 2022.   Meanwhile, Medicaid revenue mix increased 130 basis points from the prior month, ending June at 52.7%. One element of the Medicaid revenue share of a property’s revenue is RPPD and that increased 0.31% from May. It is up 3.2% since last year in June 2022.

To get more trends from the latest data you can download the Skilled Nursing Monthly Report here. 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 here. NIC maintains strict confidentiality of all data it receives.

About Bill Kauffman

Senior Principal Bill Kauffman works with the research team in providing research and analysis in various areas including sales transactions and skilled nursing. He has lead roles in creating new and enhanced products and implementation of new processes. Prior to joining NIC he worked at Shelter Development in investing/acquiring, financing, and asset management for over $1 billion in assets. He also had key roles in the value creation and strategic planning and analysis for over 65 entities. He received his Master of Science in Finance from Loyola University Maryland and holds the Chartered Financial Analyst Designation (CFA).

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