NIC Notes

Insights in Seniors Housing & Care


By: Bill Kauffman  |  November 03, 2023

Skilled Nursing Occupancy Increased in August 2023

Market Trends  |  NIC MAP Vision  |  Skilled Nursing

NIC MAP Vision released its latest Skilled Nursing Monthly Report on November 2, 2023.  The report includes key monthly data points from January 2012 through August 2023.   

Here are some key takeaways from the report:


Skilled nursing property occupancy increased 59 basis points from July to end August at 82.3%. Occupancy is up 142 basis points from one year ago in August 2022 as it continues to recover since the pandemic low of 75.0% set in January 2021. Occupancy hovered around 81% from January 2023 through July 2023. August 2023 represents the first-time occupancy was over 82% since April 2020. However, challenges do persist with staffing shortages that continue to create difficulties within skilled nursing properties limiting the ability to admit new residents in some markets. The current occupancy trend over the past year does suggest that demand for skilled nursing properties is recovering. Occupancy remains low compared to February 2020 pre-pandemic levels of 89.1% (6.9 percentage points). 


Managed Care 

Managed Medicare revenue mix increased 19 basis points from July to end August at 11.8%. It has declined 68 basis points since its recent high of 12.5% in February 2022, but it is up by 262 basis points from the pandemic low set in May 2020 of 9.2%. Expectations are that it will continue to increase over time with the continued growth of managed Medicare. Meanwhile, Managed Medicare revenue per patient day (RPPD) declined 0.6% ending August at $487 and it is down 0.1% from last year in August 2022.  It has decreased $122 (20.1%) since 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. 


Medicaid patient day mix decreased 13 basis points to 67.0% in August. It has increased 397 basis points from the pandemic low of 63.1% set in February 2022. In addition, Medicaid revenue mix decreased in August, but still represented over half of property revenue at 53.8%. It has increased 472 basis points from the pandemic low of 49.1% set in February 2022. Meanwhile, Medicaid revenue per patient day (RPPD) decreased to $277 in August. It increased 2.6% from $270 one year ago in August 2022. 


Medicare revenue per patient day (RPPD) increased from July to end August 2023 at $592. It has increased 2.9% 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 increased slightly from July to end August at 17.3%. However, it is down from one year ago, decreasing 419 basis points from August 2022.  


NIC MAP Vision clients with access to NIC MAP data can access the Skilled Nursing Monthly Report. The report provides aggregate data at the national level from a sampling of skilled nursing operators with multiple properties in the United States. Talk to a product expert to learn more about NIC MAP Vision.

NIC is continuously seeking operators to contribute data featured in the NIC MAP Vision report on a monthly basis. 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 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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