News & Press Releases

Skilled Nursing Property Occupancy Down in Q2

Medicare patient day mix reached the lowest level in NIC’s five-year time series

FOR IMMEDIATE RELEASE: September 14, 2017

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

Annapolis, Md. – The National Investment Center for Seniors Housing & Care (NIC) today released its second-quarter 2017 NIC Skilled Nursing Data Report. Data in the report show that skilled nursing property occupancy decreased to 81.7% at the end of the quarter, down 100 basis points from the prior quarter and down 147 basis points year-over-year.

“Many factors such as the growing role of managed care, sending patients directly home from the hospital, and more complex surgeries performed in an outpatient setting are contributing to occupancy challenges for skilled nursing operators, specifically in regards to Medicare patient days,” said Bill Kauffman, senior principal at the National Investment Center for Seniors Housing & Care (NIC). “However, recent news from the Centers for Medicare and Medicaid Services (CMS) of the proposal to delay some mandatory bundled payment initiatives could be welcomed news at a time of continued pressure on patient days.”

Contributing to the occupancy decline, Medicare patient day mix reached the lowest level in NIC’s five-year time series. Medicare patient day mix hit a new low at the end of the second quarter, falling 119 basis points from 13.9% in March to 12.7% in June. Since February of 2015, with the start of pressure on Medicare mix, it is down a significant 378 basis points from 16.5%. Year-over-year, it declined 88 basis points from 13.6%.

Medicaid mix continues to be near a five-year peak in the second quarter at 65.9%. Medicaid mix was only 10 basis points lower than the highest Medicaid mix which occurred in November 2016. Quarter-over-quarter, it was up 106 basis points and year-over-year, it was up 91 basis points. “The importance of Medicaid patient days to the current skilled nursing business model is evident by its growing percentage of overall patient day mix,” said Beth Burnham Mace, chief economist for NIC. “Given the fact the aging population is projected to grow significantly in the coming decade, and the likely need for long-term care services, this trend warrants attention.”

Meanwhile, the Medicaid revenue per patient day (RPPD) rate continues to increase slowly, reaching its highest point over the past five years in the second quarter at $201. For the last 12 months, the rate has hovered between $199 and $201, with the two highest RPPD rates both recorded in the second quarter of 2017.

The decline in Managed Medicare revenue per patient day continued to decelerate in the second quarter, but the daily rate still reached its lowest rate since July 2012.  Managed Medicare ended the second quarter at $437 per patient day. The quarter-over-quarter decline was less than $1 equating to a negative 0.2% drop. The year-over-year change was a drop of only $3, compared to a year ago, when the year-over-year change was a decline of $20. While the managed Medicare RPPD continues to decline, the annual rate of decline is approaching zero and is the smallest in the time series at negative 0.7%.

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 July 2012 through June 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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