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By: Bill Kauffman  |  July 09, 2021

Skilled Nursing Occupancy Increased in April 2021

Market Trends  |  NIC MAP Vision  |  Skilled Nursing

NIC MAP® Data Service, powered by NIC MAP Vision, an affiliate of NIC, released its latest Skilled Nursing Monthly Report on July 1, 2021, which includes key monthly data points from January 2012 through April 2021.

Here are some key takeaways from the report:

The upward trend in skilled nursing occupancy continued in April. Occupancy increased for the third month in a row, rising 94 basis points from March to end April at 73.2%. Occupancy is now up 185 basis points from the 71.3% low point reached in January. There is optimism that occupancy will continue to increase through 2021 as vaccinations continue around the country and as elective surgeries rise, thereby supporting admissions to skilled nursing properties. However, occupancy still is very low relative to pre-pandemic levels and cash flow is a concern at some properties. Occupancy is down 12.3 percentage points from the pre-pandemic February 2020 level of 85.5%.

Managed Medicare revenue mix decreased 30 basis points to 10.8% from March to April. However, it has increased 159 basis points since the end of 2020 (9.2%) and it is up 245 basis points since the pandemic low of 8.3% set back in May 2020 when many elective surgeries were still suspended and significant restrictions to admissions were in place across the country. This revenue mix trend, along with recent increased occupancy, suggests that managed Medicare admissions have been increasing. Compared to one year ago, managed Medicare revenue mix is up 225 basis points from 8.5%.

Medicare patient day mix decreased 40 basis points to 12.0% in April from March and is down 358 basis points from the 12-month high of 15.6% reached in December 2020. In addition, and a similar trend to patient day mix, Medicare revenue mix decreased 41 basis points from March to end April at 21.1% and is down 4.2 percentage points from the 12-month high of 25.2% reached in January 2021. This decline suggests that as resident cases of COVID-19 have declined, there have been fewer patients converted from Medicaid to Medicare, which was helpful when cases among residents were elevated as CMS waived the 3-Day Rule requiring a new 3-day inpatient hospital stay.

Medicaid revenue mix increased 85 basis points from March, ending April at 50.0%. Medicaid revenue mix was 46.7% in December 2020, representing a time-series low. This was due to factors such as CMS waiving the 3-Day Rule and lower Medicaid days overall due to lower admissions. It has since increased 326 basis points. However, it is still down 449 basis points from one year ago (54.5%). Medicaid days are expected to increase as occupancy continues to increase during 2021.

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 in order to provide data at localized levels in the future. Operators who are interested in participating can complete a participation form at NIC maintains strict confidentiality of all data it receives.


Interested in learning more about NIC MAP data? To learn more about NIC MAP data, powered by NIC MAP Vision, and about accessing the data featured in this article, schedule a meeting with a product expert today.

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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