News & Press Releases

Skilled Nursing Occupancy Falls to a Five-Year Low in the Third Quarter

Managed Medicare revenue per patient day sets a new low in NIC’s five-year time series

FOR IMMEDIATE RELEASE: December 14, 2017

Contact: Biba Aidoo, (443) 926-3181 or

Annapolis, Md. – The National Investment Center for Seniors Housing & Care (NIC) today released its third quarter 2017 NIC Skilled Nursing Data Report. Data in the report show that skilled nursing property occupancy decreased to 81.6% at the end of the quarter, down 29 basis points from the prior quarter and down 167 basis points year-over-year.

“Historically, there has been some variability in the occupancy trend in the third quarter in any given year, so it is difficult to gauge the impact of seasonality,” said Bill Kauffman, senior principal at NIC. “Occupancy did set a new low within this time series in the third quarter as pressure continues on the Medicare mix. However, it did decline at a slower pace from the prior quarter.”

Medicare patient day mix declined 58 basis points from the second quarter and 84 basis points from year-earlier levels, coming in at a new low of 12.2% in the third quarter of 2017. The average Medicare patient day mix for the 12-month period ending in September 2017 was 13%, compared to 14% from September 2015 to September 2016, and 15% in the 12-month period from September 2014 to September 2015.

“While Medicare patient day mix fell to its lowest level of the time series in the third quarter of 2017, Medicaid patient day mix continued to make up a larger share of occupancy, reaching its highest point within the last five years at 66.8%,” said Beth Burnham Mace, chief economist for NIC. “Not only is it important to see how the patient mix is changing over time, but we really need to see how the revenue mix is changing in conjunction with patient days which is why NIC will be expanding this data set to include revenue mix next year.”

Managed Medicare revenue per patient day declined from the prior quarter to set a new low within the time series at $431.  This represents a total decline of 13.2% from five years ago, or a negative 2.8% compounded annual growth rate over the same time period. Quarter-over-quarter, the rate fell 1.8%, which was a significant deterioration from the prior quarterly decline of only 0.2%. The rate fell 2.1% from the year-earlier level of $440 revenue per patient day. Meanwhile, managed Medicare patient day mix declined to 6.2% from its recent five-year high of 6.7% in February of this year.  The average managed Medicare patient mix in the latest 12-month period ending September 2017 was 6.3% compared to 5.9% for the previous 12-month period ending September 2016. Managed Medicare patient day mix appears to be steadily growing, up from 5.1% at the beginning of the five-year time series.

At 9.1%, private patient day mix matched its lowest point, which occurred in April 2017. The lowest private patient day mixes in the five-year time series have occurred in 10 of the last 12 months. This mix has not exceeded 10% since January 2016. Simultaneously, the private revenue per patient day increased to its highest amount at $266. Each of the last 10 months have witnessed the highest private revenue per patient day amounts in five years. The year-over-year increase reached its five-year peak in the third quarter at 2.9%.

NIC’s Skilled Nursing Data Report is released quarterly to provide operators and investors with 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 2012 through September 2017. NIC has collected this data since the fourth quarter of 2011.

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 will grow its base 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.


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