National fee-for-service skilled nursing facility utilization has been stable year over year from the third quarter of 2023 to the third quarter of this year, but utilization remains 2 percentage points below pre-pandemic, according to Trella Health’s 2024 Post-Acute Care Industry Trend Report.
“It’s possible that the skilled nursing industry still needs some time to recover from the impacts of the COVID-19 pandemic; the stability between the 2022 Q4 and 2023 Q4 reporting periods could also indicate that a slightly lower utilization is the new normal,” according to Trella.
At the state level, utilization rate changes for FFS SNFs vary year over year from negative 1.4 to positive 2 percentage points.
Data show a range of 22.7 percentage points for state-level utilization, but they are misleading, according to Trella. Although it “may appear to indicate significant geographic differences, this range is nearly halved (14.5 percentage points) when the outlier of Alaska is excluded,” Trella said.
The SNF utilization rate in Alaska is 7.4%, with the next closest utilization rates being 15.6%, in Oregon; 17.1%, in South Carolina; 17.5%, in Montana; and 18.1%, in Nevada.
At the upper end, Connecticut leads the states, with 30.1% utilization. Next come Rhode Island, 29.3%; New Jersey, 28.7%; Maryland, 26.5%; and New York, 26.4%.
Labor shortages still challenge the skilled nursing sector. According to Trella, the number of SNF staff members per provider decreased by 9.1% between 2019 and 2022. SNFs fared better than other care segments, however, which saw an overall decrease of 24.5% over the same timeframe.
“The cost report data quantifies a substantial headwind for post-acute care agencies going forward. The market for nurses and therapists has become much more competitive due to increases in demand for healthcare as the population over 65 continues to represent a higher percentage of the overall population,” according to the Trella. “Competitive labor markets, combined with changes in reimbursement rates that fail to keep up with inflation, require agencies to more effectively and efficiently streamline their hiring and retaining of staff.”
