News & Press Releases

Skilled Nursing Property Occupancy Falls in Fourth Quarter, 2017 Despite Early and Severe Flu Season

Rural properties experienced a greater decline than urban properties, according to new data
Latest Skilled Nursing Data Report also reveals Medicaid now stands behind nearly half of all revenue at skilled nursing properties



Contact:  Rachel Griffith, 202-553-8303 or

Annapolis, Md.–The occupancy of skilled nursing properties fell significantly in the fourth quarter of 2017 to 81.9 percent, down 66 basis points from the previous quarter, and 159 basis points year-over-year, according to data from the National Investment Center for Seniors Housing & Care’s (NIC) latest quarterly Skilled Nursing Data Report released today. NIC is a national, non-profit organization that enables access and choice in the seniors housing and care market.

“Occupancy at skilled nursing properties was down despite a relatively early and severe flu season, which usually causes an increase in occupancy in a typical fourth quarter,” said Bill Kauffman, senior principal at NIC. “In addition, occupancy declined more significantly in rural areas than urban areas over the past year.”

This quarter’s Skilled Nursing Data Report is the first time NIC is examining differences in occupancy and other statistics between properties in urban and rural areas. Rural occupancy declined 381 basis points from December 2016 to December 2017, while urban occupancy experienced a 148 basis point decline.

“A combination of factors, including demographics, competition from home healthcare and telehealth, and reforms to the healthcare system may translate into different impacts on occupancy trends in rural and urban settings,” said Beth Burnham Mace, chief economist for NIC.

The report also revealed that revenue from Medicaid now represents just under half of all revenue at skilled nursing properties (49.3 percent), which is up 70 basis points from the prior year (fourth quarter, 2016). Meanwhile, revenue from Medicare, which pays the most for skilled nursing, fell to 22.8 percent, down 98 basis points from the prior year.

Managed Medicare revenue per patient day (RPPD) reached a new low of $433; however, lower revenue from managed Medicare is more prevalent in urban areas. Additionally, more of the total patient days, or the amount of skilled nursing business coming from private payors, either private insurance or payment out-of-pocket, was higher in rural areas (15.6 percent) than it was in urban areas (6.5 percent).

“One possible explanation for the differences among geography types is that urban skilled nursing properties may face higher competition for private payor market share, in part because of a greater supply of similar products such as home care and other types of seniors housing,” said Kauffman.

NIC’s Skilled Nursing Data Report is released quarterly to provide operators and investors timely, relevant data that is not readily available from other sources. Select metrics include: occupancy, quality mix, skilled mix, patient day mix, and revenue per patient day by payor source. The current report features time series data from October 2011 through December 2017.

The NIC Skilled Nursing Data Report is available at 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.
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About NIC

The National Investment Center for Seniors Housing & Care (NIC) is a 501(c)3 organization established in 1991 whose mission is to enable access and choice by providing data, analytics, and connections that bring together investors and providers. For more information, visit, and follow NIC on Twitter.