“Skilled nursing occupancy held steady in May, as operators still confront a challenging operating landscape amidst high inflation and staffing challenges.”
– Bill Kauffman
NIC MAP Vision released its latest Skilled Nursing Monthly Report on August 4, 2022. The report includes key monthly data points from January 2012 through May 2022.
Here are some key takeaways from the report:
Skilled nursing property occupancy increased in May, albeit slightly. It increased 9 basis points from April, ending the month of May at 77.3%. In the last three months, skilled nursing occupancy has hovered in the range of 77% which is the highest occupancy level since April 2020, at which time occupancy began to fall rapidly due to the onset of the pandemic. Occupancy continues to recover since the pandemic low of 72.1% set in January 2021 but has encountered challenges such as new COVID-19 variants, e.g. Delta and Omicron. In addition, staffing shortages continue to create difficulties within skilled nursing properties limiting the ability to admit new residents. However, the current occupancy trend does suggest that demand for skilled nursing properties is recovering, given the 149-basis point increase from January to May. Occupancy has increased 307 basis points from one year ago and 518 basis points from its pandemic low.
Skilled mix increased 10 basis points from April to end May at 25.8%. This increase seemingly was driven by Medicare as its patient day mix increased from the prior month and managed Medicare patient day mix decreased in the same period. Managed Medicare patient day mix decreased 7 basis points to end the month of May at 7.6% and Medicare increased 13 basis points ending the month at 11.7%. Skilled mix has increased 11 basis points compared to one year ago. In addition, in a similar trend to patient day mix, Medicare revenue mix increased from the prior month. It increased 49 basis points from 20.8% to end the month of May at 21.3%. This suggests that skilled nursing operators increased the use of the 3-Day Rule waiver as COVID-19 cases increased in the month of May.
Managed Medicare revenue mix decreased 18 basis points in the month of May, ending the month at 10.6%. After increasing 13 basis points from March to April this year, it is now down 82 basis points from 11.4% in February. Historically, there has been declines in the managed Medicare revenue mix from the winter to spring months, which suggests lower volumes in the springtime whereas the winter months typically have an increase due to slips and falls, more illnesses, and elective surgeries. In addition, Managed Medicare revenue mix has increased 251 basis points from the 8.1% pandemic low set in May 2020. Meanwhile, managed Medicare revenue per patient day (RPPD) continued its decline, decreasing from $456 in April to $454 in May. It has decreased 1.84% from the prior year in May 2021.
Medicaid patient day mix increased for the third consecutive month, although only increasing slightly from April to May. It increased 3 basis points from the prior month to end May at 65.9%. Its patient day mix has increased 293 basis points from February, while Medicare patient day mix decreased 255 basis points in the same period. Some of the explanation of this increase in Medicaid patient days is due to the decline in COVID-19 cases relative to February as operators moved residents back to Medicaid days from Medicare days, after requiring isolation and higher skilled care.
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. NIC and NIC MAP Vision maintain strict confidentiality of all data received.