NIC Notes

Insights in Seniors Housing & Care


By: Bill Kauffman  |  August 03, 2023

Skilled Nursing Occupancy Continues to Hover Around 81%

Market Trends  |  NIC MAP Vision  |  Skilled Nursing

NIC MAP Vision released its latest Skilled Nursing Monthly Report on August 3, 2023. The report includes key monthly data points from January 2012 through May 2023.   

Here are some key takeaways from the report:


Skilled nursing property occupancy decreased 3 basis points from April to end May at 81.0%. Occupancy is up 97 basis points from one year ago in May 2022 as it continues to recover since the pandemic low of 74.7% set in January 2021. However, occupancy is down 8 basis points from January 2023 as 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 88.9% (7.8 percentage points).


Managed Care

Managed Medicare revenue mix increased 11 basis points from April to end May at 11.4%. It has declined 111 basis points since its recent high of 12.5% in February 2022, but it is up by 219 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 0.4% ending May at $483 and it is down 0.8% from last year in May 2022It has decreased $125 (20.5%) since January 2012 and continues to pressure some operators’ revenue as managed Medicare enrollment grows around the countryHowever, some operators see managed Medicare as an opportunity for growth in patient volume.  


Medicaid patient day mix increased 52 basis points to 65.8 % in May. It has increased 268 basis points from the pandemic low of 63.1% set in February 2022. In addition, Medicaid revenue mix increased in February, representing over half of property revenue at 51.1%. It has increased 230 basis points from the pandemic low of 48.8% set in February 2022. Meanwhile, Medicaid revenue per patient day (RPPD) decreased to $269 in May. It increased 3.0% from $261 one year ago in May 2022. 


Medicare revenue per patient day (RPPD) increased slightly from April to end May 2023 at $592. It has increased 2.7% 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 98 basis points from April to end May at 20.6%. It is down from one year ago as well, decreasing 34 basis points from May 2022. 


To get more trends from the latest data you can download 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 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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