News & Press Releases

Skilled Nursing Property Occupancy Continues to Fall in First Quarter, 2018

Latest National Investment Center for Seniors Housing & Care Skilled Nursing Data Report also represents increased prevalence of managed Medicare



Contact: Paul Skowronek, (202) 868-4808 or


Annapolis, Md. – The occupancy of skilled nursing properties decreased to 81.6 percent at the end of the first quarter, 2018, according to the National Investment Center for Seniors Housing & Care’s (NIC’s) latest Skilled Nursing Data Report. NIC is a national, non-profit organization that enables access and choice in the seniors housing and care sector.

The report cites skilled nursing property occupancy is down 30 basis points from the prior quarter and down 210 basis points year-over-year. Occupancy declined on a year-over-year basis for urban and rural areas, while it increased for urban cluster properties from the prior quarter.

“The increase in business from Medicare and Managed Medicare during the first quarter suggests that seasonality and the winter flu season may be influencing the data, which we expect to see,” said Bill Kauffman, senior principal at NIC. “What’s surprising is that this failed to drive an overall increase in occupancy.”

The share of patient days paid for by traditional and managed Medicare increased nationally to 13 percent and 6.6 percent, respectively, while revenue from managed Medicare reached a time-series high nationally in February 2018. Even among rural properties, where revenue from managed Medicare is less than half the revenue mix reported in urban areas, the trend is consistent.

“Rural areas have been less affected by managed Medicare than others, but the trend warrants attention in the years to come, in all geographic areas,” said Beth Burnham Mace, chief economist for NIC.

Revenue coming from Medicare increased in the first quarter and was close to the highs of one year ago in urban cluster and rural settings. While the Medicare revenue mix for urban area properties was up quarter-over-quarter, at 23.7 percent, it was far below previous first-quarter highs of approximately 28 percent last seen in 2015.

Nationally and consistently across geographic areas, private revenue per patient day (RPPD) continues to increase, with the fastest growth occurring in rural and urban cluster areas. Nationally, private RPPD reached a six-year high of $262 in February 2018 before ending the quarter at $260.  Revenue mix for private revenue reached a six-year low at 7.7 percent, as the share of private revenue continues to drop.

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 March 2018.  This report, in addition to the skilled nursing quality metrics that were recently launched through NIC MAP® Data Service, represents NIC’s growing commitment to transparency in the skilled nursing sector.

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 and LinkedIn.

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