NIC Notes

Insights in Seniors Housing & Care


By: Bill Kauffman  |  May 04, 2023

Skilled Nursing Occupancy Increased but Still at Low Levels

Market Trends  |  Skilled Nursing  |  medicaid  |  medicare  |  occupancy

NIC MAP Vision released its latest Skilled Nursing Monthly Report on May 4, 2023.  The report includes key monthly data points from January 2012 through February 2023.   

Here are some key takeaways from the report: 


Skilled nursing property occupancy increased 23 basis points from January to end February at 81.3%. Occupancy is up 196 basis points from one year ago in February 2022 as it continues to recover since the pandemic low of 74.6% set in January 2021. Occupancy has increased for three months in a row. To be clear, challenges do persist as staffing shortages continue to create difficulties within skilled nursing properties limiting the ability to admit new residents in some markets. However, the current occupancy trend does suggest that demand for skilled nursing properties is recovering, given the increase in occupancy in 2022 and continuing in 2023. Occupancy remains low compared to February 2020 pre-pandemic levels of 88.8% (7.5 percentage points). 

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Managed Care 

Managed Medicare revenue mix declined slightly, dropping 5 basis points from January to end February at 11.6%. It has declined 78 basis points since its recent high of 12.4% in February 2022. However, it is up by 254 basis points from the pandemic low set in May 2020 of 9.1%. Expectations are that it will continue to increase over time with the growth of managed Medicare. Meanwhile, Managed Medicare revenue per patient day (RPPD) was flat, holding at $473 in February, but it is down 1.7% from last year in February 2022. It has decreased $119 (20.1%) from January 2012 and continues to pressure some operators’ revenue as managed Medicare enrollment grows around the country. However, some operators see managed Medicare as an opportunity for growth in patient volume. 
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Medicaid patient day mix increased slightly to 64.7 % in February. However, it has increased 138 basis points from the pandemic low of 63.3% set in January 2021. In addition, Medicaid revenue mix decreased slightly in February, representing just over half of property revenue at 50.5%. However, it has increased 202 basis points from the pandemic low of 48.5% set in February 2022. Meanwhile, Medicaid revenue per patient day (RPPD) increased to $269 in February. It increased 3.2% from $261 one year ago in February 2022.  


Medicare revenue per patient day (RPPD) decreased slightly from January to end February 2023 at $588. It has increased 2.6% since September 2022. Most of this increase in reimbursement is likely a result of the increase in Medicare rates to skilled nursing properties for fiscal year 2023 and potentially higher acuity patients, which also increases RPPD to care for more complex patients. Meanwhile, Medicare revenue mix decreased for the second month in a row. It decreased 30 basis points from January to end February at 22.1%. It is down from one year ago as well, decreasing 269 basis points from February 2022. 

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 on our website. NIC and NIC MAP Vision maintain strict confidentiality of all data received. 

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 Bachelor of Business Administration in Finance from the College of Business and Economics at Radford University and his Master of Science in Finance from Loyola College in Maryland. He also holds the Chartered Financial Analyst Designation (CFA).

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